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Campbell F, Goldsmith R, Rogers H. Are we practising what we preach and are we all singing from the same hymn sheet? An exploration of teaching in paediatric caries management across UK dental schools. Int J Paediatr Dent 2024; 34:799-810. [PMID: 38590044 DOI: 10.1111/ipd.13181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 12/17/2023] [Accepted: 02/07/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND The evidence underpinning caries management for children has progressed dramatically over the past 20 years. Anecdotally, this is not reflected in the teaching provided to undergraduate dental students, with the ongoing teaching of outdated methods within some dental schools. AIM To capture the current undergraduate teaching provision and clinical treatment experience requirement relative to caries management in paediatric dentistry in UK dental schools. DESIGN Cross-sectional analysis of current teaching methods on paediatric caries management was obtained using a piloted online data collection form. Question content included current caries teaching methods, assessment of student exposure and competence. The results were analysed descriptively. RESULTS Of the 16 UK dental schools, 14 participated. Discrepancy in teaching content was apparent. Many schools (n = 9) taught biological caries management through therapeutic fissure sealants, yet this was not reflected in assessment and clinical requirements. Some schools (n = 4) taught amalgam placement in children, and most (n = 12) operatively taught treatments that would no longer be routinely provided in general dental practice in the UK, including primary tooth pulpotomy. CONCLUSION There is substantial variation in the paediatric caries management techniques that are taught across UK dental schools, demonstrating a need for a national consensus to address these disparities.
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Affiliation(s)
- Faith Campbell
- School of Dentistry, University of Dundee, Dundee, UK
- Glasgow Dental Hospital and School, Glasgow, UK
| | | | - Helen Rogers
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
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Narbutaite J, Santamaría RM, Innes N, Splieth CH, Maciulskiene V. Comparison of three management approaches for dental caries in primary molars: A two-year randomized clinical trial. J Dent 2024; 150:105390. [PMID: 39374732 DOI: 10.1016/j.jdent.2024.105390] [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: 08/19/2024] [Revised: 09/30/2024] [Accepted: 10/03/2024] [Indexed: 10/09/2024] Open
Abstract
AIM to compare two-year clinical success rates of caries management in children (Hall Technique HT, Nonrestorative caries treatment NRCT, Conventional restorations CR), and to evaluate pain perception, behaviour, technique acceptability by patients, parents and dentists. METHODS 122, 3-8-year-olds were enrolled in 2-year parallel group randomised controlled trial (CR, n = 52, HT, n = 35, NRCT, n = 35). Caries was recorded using Nyvad criteria to measure clinical success/ failure rates. Child's pain perception (Visual Analogue Scale of Faces), child behaviour (Frankl scale), parents' and dentists' treatment opinions (5-point Likert scale) were assessed. Statistical analysis included Chi-square, non-parametric Kruskal-Wallis, Bonferroni-corrected Mann-Whitney U tests (p < 0.05), absolute risk reduction (ARR) and number needed to treat (NNT). RESULTS After two years, with 116 participants, clinical success rates were: CR=60.8 % (n = 31), HT=93.8 % (n = 30), NRCT=42.5 % (n = 14) (p < 0.001). Major/minor failure rates differed: CR=17.6 % (n = 9) / 21.6 % (n = 11); HT=6.2 % (n = 2)/ 0 %, NRCT=33.3 % (n = 11)/ 24.2 % (n = 8), (p < 0.05). When comparing HT to CR, ARR = 0.33; NNT= 3 (95 % CI 0.02 -0.58); NRCT to CR, - no observed benefit from NRCT. More than 70 % of children demonstrated "positive/definitely positive" behaviour during treatment. Pain intensity was "very low/low" in 92.3 % of cases for CR, 88.6 % for HT, and 77.1 % for NRCT . NRCT was "very easy" to perform for 82.9 % of participants, compared to 42.3 % for CR and 17.1 % for HT (p < 0.05). CR were reported to take longer than NRCT and HT (p < 0.05). CONCLUSION Clinical success rates of HT were superior to CR and NRCT. All treatment techniques were well tolerated by children, CR was more time-consuming and HT - technically more difficult to perform. CLINICAL SIGNIFICANCE caries management in primary molars can be successfully performed using minimal intervention, particularly, sealing in caries lesions with Hall technique. NRCT can prevent caries progression when adequate access to mechanical plaque disruption and fluoride is provided. However, occasional fluoride application, and uncontrolled toothbrushing with fluoride toothpaste cannot replace restorative procedures.
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Affiliation(s)
- Julija Narbutaite
- Clinic of Preventive and Paediatric Dentistry, Faculty of Odontology, Lithuanian University of Health Sciences, Luksos-Daumanto 6, LT, 50106, Kaunas, Lithuania.
| | - Ruth M Santamaría
- Department of Pediatric Dentistry, Faculty of Dentistry, Greifswald University, Greifswald, Germany.
| | - Nicola Innes
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, Wales, UK.
| | - Christian H Splieth
- Department of Pediatric Dentistry, Faculty of Dentistry, Greifswald University, Greifswald, Germany.
| | - Vita Maciulskiene
- Clinic of Dental and Oral Pathology, Faculty of Odontology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
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Mohamed HA, Abdalla EM, HagOmer NA, Philip N. The Hall technique: knowledge, practice, and concerns of dentists in primary care settings in the State of Qatar-a questionnaire-based survey. Eur Arch Paediatr Dent 2024:10.1007/s40368-024-00943-1. [PMID: 39365545 DOI: 10.1007/s40368-024-00943-1] [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: 06/22/2024] [Accepted: 08/28/2024] [Indexed: 10/05/2024]
Abstract
PURPOSE To assess the knowledge, practice, and concerns about the Hall Technique among pediatric dentists (PDs) and general dental practitioners (GDPs) working in primary care settings in the State of Qatar. METHODS A prospective questionnaire-based survey was distributed to all GDPs and PDs working at different Primary Health Care Corporation centers in Qatar between 1 November and 10 December 2023. Descriptive data analysis was carried out. RESULTS The response rate was 49% among GPDs and 100% among PDs. Approximately 85% of PDs and 48% of GDPs were familiar with the HT although only 58% of the PDs and 4% of the GDPs applied HT preformed metal crowns (HTPMCs) in their current primary care practice. Majority of both PDs and GDPs did not consider HTPMCs as the treatment of choice for restoring asymptomatic carious primary molars and preferred applying the HT for cavitated carious lesions over non-cavitated lesions. Regarding HT practices, 57.7% of PDs and 48% of GDPs always planned on taking a pre-operative radiograph before the procedure, while only 15.4% of PDs and 8% of GDPs would always consider using an orthodontic separator prior to placing an HTPMC. The main concerns among the respondents about the HT included sealing in caries (PDs 31%; GDPs 50%), high occlusion (PDs 57.7%; GDPs 53.3%), and gingival damage (27% PDs; 47% GDPs.) Endorsement by professional bodies and further research evidence were seen as ways to promote wider adoption of the HT. CONCLUSION The HT is recognised but not widely used among primary care dentists working in the State of Qatar. HTPMCs are often seen as secondary options for restoring carious primary molars with dentists still having a number of concerns regarding the HT.
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Affiliation(s)
- H A Mohamed
- Primary Health Care Corporation, Doha, Qatar
| | - E M Abdalla
- Primary Health Care Corporation, Doha, Qatar
| | - N A HagOmer
- Primary Health Care Corporation, Doha, Qatar
| | - N Philip
- College of Dental Medicine, QU Health, Qatar University, Office 160C, Building H12, Doha, Qatar.
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Al-Arwali SAM, AL-Haddad K, Zabara AQMQ, Al Ghwainem A, Alqarni AS, AlGomaiah MA, Alshamrani KK, Al Moaleem MM, Al-Deen HS, Al-Nomair JH. Knowledge, Awareness, and Use of Stainless-Steel Crowns Among Dental Professionals in Sana'a City, Yemen. Med Sci Monit 2024; 30:e945948. [PMID: 39308013 PMCID: PMC11429049 DOI: 10.12659/msm.945948] [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: 07/24/2024] [Accepted: 08/12/2024] [Indexed: 09/29/2024] Open
Abstract
BACKGROUND Stainless-steel crowns (SSCs) have been the most effective and efficient methods of tooth restoration in pediatric dentistry, and they have shown consistently high success rates. This study aimed to evaluate the knowledge, awareness, and practice of SSCs among dental professionals in Sana'a City, Yemen. MATERIAL AND METHODS A modified questionnaire was prepared from previous similar studies and distributed to 700 participants. It consisted of 3 parts: the first was related to participant characteristics; the second consisted of questions related to knowledge and awareness of SSCs such as indications, advantages, challenges, and parent's rejection to SSCs; and the third part was correlated to questions related to the use and practice of SSCs, number of children treated, and SSCs cemented per week. Statistical significance was determined using a chi-square test, and the P value was set at <0.05 for statistical significance. RESULTS A total of 604 dental professionals answered the questionnaire, 159 (26.3%) had used SSC restoration, and 12 (80.0%) of them had a degree in pediatric dentistry, with significant differences among participants (P<0.000). Respondents with higher academic qualifications recorded higher percentages in using SSCs during their clinics, with significant differences (P<0.005). A significant difference was detected between general practitioners and pedodontists in practice questions (P=0.000). Most of the respondents (78.8%) indicated a desire for more practice and hands-on training in use of SSCs. CONCLUSIONS General dentists in Sana'a City, Yemen, do not frequently use SSCs. Most of the respondents stated that they lacked practical training and expressed a need for further knowledge and continuing education.
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Affiliation(s)
| | - Khaled AL-Haddad
- Orthodontics, Pedodontics and Prevention Department, Faculty of Dentistry, Sana’a University, Sana’a, Yemen
| | | | - Abdulhamid Al Ghwainem
- Department of Pediatric Dentistry and Orthodontics, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Adel S. Alqarni
- Division of Paediatric Dentistry, Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Muadh A. AlGomaiah
- Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Khalid K. Alshamrani
- Preventive Dental Science Department, Faculty of Dentistry, Najran University, Najran, Saudi Arabia
| | - Mohammed M. Al Moaleem
- Department of Prosthetic Dental Science, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Hussein Shoga Al-Deen
- Orthodontics, Pedodontics and Prevention Department, Faculty of Dentistry, Sana’a University, Sana’a, Yemen
| | - Jamal H. Al-Nomair
- Orthodontics, Pedodontics and Prevention Department, Faculty of Dentistry, Sana’a University, Sana’a, Yemen
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Tedesco TK, Innes NP, Gallegos CL, Silva GS, Gimenez T, Braga MM, Araujo MP, Jayaraman J, Al-Yaseen W, Raggio DP. Success rate of Hall Technique for restoring carious primary molars - systematic review and meta-analysis. Evid Based Dent 2024:10.1038/s41432-024-01044-0. [PMID: 39152338 DOI: 10.1038/s41432-024-01044-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Accepted: 07/22/2024] [Indexed: 08/19/2024]
Abstract
OBJECTIVES The overall pooled success rate of the Hall Technique (HT) in various types of studies has not been investigated. The present study aims to evaluate the success rate of HT to restore carious primary molars. METHODS A systematic search was carried out in the MEDLINE/PubMed, Excerpta Medica Database (EMBASE), Scopus, Web of Science, and LIVIVO electronic databases, as well as the ProQuest database for grey literature review. A search was carried out up to September 2023 for studies meeting the eligibility criteria: Randomised Clinical Trials (RCTs) and Non-Randomised Studies of Interventions (NRSIs); children with primary molars treated using HT; and reporting success for at least 1-month post-treatment. Single-arm meta-analysis assessed the pooled proportion (95% CI) of HT success rates. Risk of bias and certainty of evidence using the GRADE approach were assessed. RESULTS Searching identified 665 studies, with 25 (15 RCTs and 10 NRSIs) meeting the eligibility criteria. In meta-analyses of RCTs, the pooled proportion success rate was 98% (95% CI: 97-99%) at 12-month follow-up. For NRSIs, the pooled proportion success rate was 95% (95% CI: 91-100%) up to 89 months. CONCLUSIONS HT presents a high success rate, even though the primary studies had "low" to "high" risk of bias and demonstrated "moderate" to "low" certainty of evidence. One of the main reasons for downgrading was related to blinding, which was generally unfeasible due to visibly different restorative materials. The systematic review protocol was registered in PROSPERO (ID: CRD42021204415).
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Affiliation(s)
- Tamara Kerber Tedesco
- Department of Orthodontics and Paediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Nicola Patricia Innes
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Heath Park, Cardiff, UK
| | - Claudia Lopez Gallegos
- Department of Orthodontics and Paediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Gabriela Seabra Silva
- Department of Orthodontics and Paediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Thais Gimenez
- Department of Orthodontics and Paediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Mariana Minatel Braga
- Department of Orthodontics and Paediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | | | - Jayakumar Jayaraman
- Department of Pediatric Dentistry, Virginia Commonwealth University School of Dentistry, Richmond, VA, USA
| | - Waraf Al-Yaseen
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Heath Park, Cardiff, UK
| | - Daniela Prócida Raggio
- Department of Orthodontics and Paediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil.
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He J, Sun J, Liu Y, Luo W, Zheng Z, Yan W. Optimizing restorative procedure and material selection for pulpotomized primary molars: Mechanical characterization by 3D finite element analysis. Heliyon 2024; 10:e35402. [PMID: 39170120 PMCID: PMC11336623 DOI: 10.1016/j.heliyon.2024.e35402] [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: 07/19/2023] [Revised: 07/26/2024] [Accepted: 07/29/2024] [Indexed: 08/23/2024] Open
Abstract
Purpose This study aimed to assess the stress distribution in pulpotomized primary molars with different types of restorative materials using 3D-finite element analysis (FEA), and provide valuable insights into the selection and application of restorative materials, with the ultimate goal of reducing the risk of pulpotomy failure and protecting residual dental tissue. Methods Four 3D models of pulpotomized primary molars with different restorative materials according to the material and its elastic modulus were analysed: resin composite, stainless steel crowns (SSCs), prefabricated zirconia crowns and endocrowns. The food layer was also designed before vertical and bucco-lingual forces were applied to simulate physiological masticatory conditions. The results were obtained by colorimetric graphs of the von Mises stresses (VMS) in the restoration and tooth remnant. The maximum shear stress on the bonding interfaces and pressure stress on the Mineral trioxide aggregate (MTA)-pulp interfaces were recorded. Results The results of the 3D-FEA showed that all restorative materials generated stresses and strains on the tooth structure after pulpotomy. In the resin composite group, the marginal enamel exhibited the highest stress peaks. In the zirconia crown and SSC groups, there was a concentration of stress at the dentin-restoration margin. The shear stress concentrations were mainly at the adhesive margins, with lower levels around endocrowns compared to other groups. MTA in the resin composite group experienced more VMS than in the other group. The resin composite group also generated relatively higher pressure stress values at the MTA-pulp interface compared to the other groups. Significance In the model of primary teeth following pulpotomy, the three types of restorations covering the occlusal surface can effectively reduce the stress on pulp capping materials under occlusal loads, thereby potentially decreasing the risk of pulpotomy failure. In addition, the group of endocrowns demonstrated reduced stress at the bonding interface and in the stress concentration zone near the dentist-restoration edge, making them more effective at protecting residual dental tissue.
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Affiliation(s)
- Jiahui He
- Department of Endodontics, Shenzhen Stomatology Hospital, Shenzhen, PR China
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, PR China
| | - Jin Sun
- Department of Endodontics, Shenzhen Stomatology Hospital, Shenzhen, PR China
| | - Yun Liu
- Stomatology Health Care Center, Shenzhen Maternity & Child Healthcare Hospital, Shenzhen, PR China
| | - Wei Luo
- Department of Medical Affairs, Shenzhen Stomatology Hospital, Shenzhen, PR China
| | - Ziting Zheng
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, PR China
| | - Wenjuan Yan
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, PR China
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Bekes K, Steffen R, Krämer N. Hypomineralised second primary molars: the Würzburg concept. Eur Arch Paediatr Dent 2024; 25:597-602. [PMID: 38805129 PMCID: PMC11341634 DOI: 10.1007/s40368-024-00913-7] [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: 03/16/2024] [Accepted: 05/01/2024] [Indexed: 05/29/2024]
Abstract
PURPOSE In addition to molar incisor hypomineralisation, the occurrence of enamel hypomineralisation in the primary dentition has become increasingly important in recent years. Hypomineralised second primary molar (HSPM) is defined as hypomineralisation of systemic origin affecting from one to all four second primary molars. Some years ago, the "Würzburg concept" was introduced, which proposed a grading of MIH findings (MIH treatment need index) in combination with an appropriate treatment plan depending on the severity of the affected tooth. Recently, this concept was updated and new treatment approaches have been added. However, currently, the concept solely addresses the treatment plan for permanent teeth. As there is a need to expand its scope to encompass primary teeth and, consequently, HSPM, this paper seeks to develop the second component of the Würzburg concept, the treatment plan, for the primary dentition in response to the increased focus on the disease in recent years. Although the evidence base for the different treatment options is still weak, there is a need for guidance for clinicians in their day-to-day practice. METHODS The authors conducted a comprehensive review of the literature, encompassing clinical and laboratory studies along with published guidelines. RESULTS The treatment plan of the HSPM Würzburg concept contains prophylactic and regenerative aspects, non-invasive interventions, temporary and permanent restorative techniques, and extraction. CONCLUSIONS The intention is to provide practical guidance to practitioners, acknowledging the necessity for further validation through clinical trials.
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Affiliation(s)
- K Bekes
- Department of Paediatric Dentistry, University Clinic of Dentistry, Medical University of Vienna, 1090, Vienna, Austria.
| | - R Steffen
- Private Practice, Weinfelden, Switzerland
| | - N Krämer
- Department of Pediatric Dentistry, Justus Liebig University, Giessen, Germany
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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.
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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
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Timms L, Rodd H, Deery C, Brocklehurst P, Marshman Z. Silver diamine fluoride for the management of dental caries in children in primary dental care: protocol for a feasibility study. Pilot Feasibility Stud 2024; 10:95. [PMID: 38915111 PMCID: PMC11194932 DOI: 10.1186/s40814-024-01519-y] [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: 10/23/2023] [Accepted: 06/12/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Dental caries remains a significant problem in England, affecting 11% of 3-year-olds and 23% of 5-year-olds. While current approaches have been extensively investigated, their ability to (1) control pain and infection; (2) prevent hospital admissions, and (3) be implemented within the National Health Service (NHS) contractual arrangements, remains unsatisfactory. Silver diamine fluoride (SDF) is an alternative, non-invasive approach that has proven efficacy in arresting caries progression in primary teeth, principally from studies conducted outside of Europe. Its use in primary dental care in the UK is limited, despite the acknowledged need. The clinical and cost-effectiveness of SDF has not been compared to usual care in the UK. Before a pragmatic randomised controlled trial (RCT) can be conducted to compare SDF to usual care for caries management in young children, there are several uncertainties that require investigation. This study aims to establish whether such an RCT is feasible. METHODS This mixed-method parallel design study is a feasibility study with an embedded process evaluation, to compare SDF with usual treatment in primary dental care in the UK. It will be individually randomised, with 13 dentists and therapists, in 8 different dental primary care sites with a sample size of 80 child participants aged 1-8 years old. The aim will be to recruit ten participants per site with equal arm allocation. Follow-up will be for 1 year. The study will inform whether an RCT is feasible by resolving several key uncertainties. The acceptability and implementation of SDF and the research processes will be explored. Patient and Public Involvement and Engagement representatives will be involved throughout recruitment and retention strategies, participant documentation, analysis, engagement and dissemination. DISCUSSION The ability to conduct an RCT will be evaluated. If feasible, this RCT has the potential to evaluate the effectiveness of a non-invasive approach for the management of untreated caries in young children. A feasibility study also offers the opportunity to consider factors associated with the implementation of SDF at an early stage through a process evaluation that will inform the definitive trial and an implementation strategy for SDF by identifying relevant barriers and facilitators. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT06092151. Date: 19/10/2023.
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Affiliation(s)
- Laura Timms
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK.
| | - Helen Rodd
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Chris Deery
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Paul Brocklehurst
- Dental Public Health, Primary Care Division, Public Health Wales, 10 Llys Castan Parc Menai, Bangor, Wales, UK
| | - Zoe Marshman
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
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AlRamzi B, AlHalabi M, Kowash M, Salami A, Khamis AH, Ghoneima A, Hussein I. Do Hall Technique Crowns Affect Intra-arch Dimensions? A Split-mouth Quasi-experimental Non-randomized Feasibility Pilot Study. Int J Clin Pediatr Dent 2024; 17:673-682. [PMID: 39391144 PMCID: PMC11463813 DOI: 10.5005/jp-journals-10005-2858] [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] [Indexed: 10/12/2024] Open
Abstract
Aim and background The Hall technique preformed metal crowns (HT-PMCs) are allegedly oversized, temporarily altering inter-arch relationships. Intra-arch dimensions and leeway space (LWS) HT effects are unknown. Aim To study single HT-PMC intra-arch effects and treated tooth dimensional changes. Materials and methods Split-mouth, quasi-experimental, non-randomized feasibility pilot study. Intraoral scans (iTero II®) were taken preorthodontic separator placement (scan1), immediately post single HT-PMCs (scan2) in 13 children, and 1 month later (scan3) in eight children. Control and study quadrants' lengths ("arcs") and HT-PMCs/control tooth dimensions [mesiodistal (MD), buccopalatal/lingual (BP/L), diagonal (Diag1/Diag2)] were recorded in mm (OrthoCAD® software). Paired t-test, repeated analysis of variance (ANOVA) post hoc analysis statistics (p < 0.05). Results Compared to scan1, the mean study arc increased by 0.7 mm (±0.5) (n = 13, t-test, p < 0.001) at scan2, while at scan3, it increased by 0.8 mm (±0.34) (n = 8, repeated ANOVA, p = 0.008). The HT-PMCs-treated tooth mean dimensions increased at scan2 by 0.9 mm (MD), 0.8 mm (BP/L), 0.5 mm (Diag1), and 0.7 mm (Diag2) (t-test, p < 0.001) with similar observations at scan3. There were no significant changes in the control arc or the control tooth measurements. Conclusion One single HT-PMC increased the intra-arch quadrant length by approximately up to <1 mm. The HT-PMC-treated tooth was marginally oversized. This pilot study paves the way for a more robust study with a larger sample size. How to cite this article AlRamzi B, AlHalabi M, Kowash M, et al. Do Hall Technique Crowns Affect Intra-arch Dimensions? A Split-mouth Quasi-experimental Non-randomized Feasibility Pilot Study. Int J Clin Pediatr Dent 2024;17(6):673-682.
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Affiliation(s)
- Batoul AlRamzi
- Department of Orthodontics and Pediatric Dentistry, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Manal AlHalabi
- Department of Orthodontics and Pediatric Dentistry, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Mawlood Kowash
- Department of Orthodontics and Pediatric Dentistry, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Anas Salami
- Department of Orthodontics and Pediatric Dentistry, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Amar H Khamis
- Department of Biostatistics, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Ahmed Ghoneima
- Department of Orthodontics and Pediatric Dentistry, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Iyad Hussein
- Department of Orthodontics and Pediatric Dentistry, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
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11
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Barry MJ, Baghlaf K, Alamoudi N. Silver Diamine Fluoride as a Medicament for the Indirect Pulp Therapy in Primary Teeth: A Review of the Literature. Cureus 2024; 16:e60780. [PMID: 38903314 PMCID: PMC11188972 DOI: 10.7759/cureus.60780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2024] [Indexed: 06/22/2024] Open
Abstract
Silver diamine fluoride (SDF) has been demonstrated to be effective in arresting caries lesions and, recently, clinical trials have assessed the effectiveness of SDF as a medicament for indirect pulp therapy (IPT) in primary teeth. This review aims to summarize the literature related to the use of SDF and find out if SDF can be used as an effective material for IPT. A literature search was undertaken on electronic databases including PubMed, MEDLINE, ScienceDirect, and Google Scholar, which elicited 50 studies employing different materials in the IPT of primary molars; however, of them, only four clinical trials used SDF as indirect pulp capping (IPC) material. SDF has the potential to be a useful material for IPT in primary teeth. It is a handy choice for pediatric dentists due to its minimum invasiveness, ease of application, and ability to stop the progression of caries. However, more studies are needed to determine whether SDF can be used routinely for IPT and whether it can even replace the currently available materials, as well as to fully realize its potential and establish criteria for its ideal application in IPT procedures.
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Affiliation(s)
- Mohammed J Barry
- Pediatric Dentistry, Department of Pediatric Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Khlood Baghlaf
- Pediatric Dentistry, Department of Pediatric Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Najlaa Alamoudi
- Pediatric Dentistry, Department of Pediatric Dentistry, King Abdulaziz University, Jeddah, SAU
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12
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Campbell F, Rogers H, Goldsmith R, Rowles K, Raggio DP, Innes N. A scoping review of guidelines on caries management for children and young people to inform UK undergraduate core curriculum development. BMC Oral Health 2024; 24:494. [PMID: 38671432 PMCID: PMC11055302 DOI: 10.1186/s12903-024-04278-7] [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: 01/26/2024] [Accepted: 04/19/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Current evidence in cariology teaching is not consistently reflected in paediatric dentistry in the United Kingdom (UK). Many dental schools are not consistently teaching biological approaches to caries management, with outdated or complex methods being taught outwith the purview of general dental practitioners. This scoping review aimed to map current guidelines on the management of caries in children and young people. This is part of a work package to inform the consensus and development of a UK-wide caries management curriculum for paediatric dentistry. METHODS A search of electronic databases for peer reviewed literature was performed using Cochrane Library, MEDLINE via PubMed, TRIP Medical Database and Web of Science. Hand searching was undertaken for grey literature (citations of sources of evidence, websites of global organisations and Google Web Search™ (Google LLC, California, USA). Results from databases were screened independently, concurrently by two reviewers. Full texts were obtained, and reviewers met to discuss any disagreement for both database and hand searching. RESULTS This review identified 16 guidelines suitable for inclusion. After quality appraisal, eight were selected for synthesis and interpretation. Key themes included the shift towards selective caries removal and avoidance of complete caries removal unless in specific circumstances in anterior teeth. For "early lesions" in primary and permanent teeth with and without cavitation, several guidelines recommend biological management including site specific prevention and fissure sealants. CONCLUSIONS This review mapping current cariology guidelines for children and young people found gaps in the literature including classification of early carious lesions and management of early cavitated lesions. Areas identified for further exploration include integration of biological caries management into treatment planning, selective caries removal and whether pulpotomy is specialist-level treatment, requiring referral. These results will inform consensus recommendations in the UK, using Delphi methods.
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Affiliation(s)
| | - Helen Rogers
- Clinical Lecturer in Paediatric Dentistry, School of Dental Sciences, Newcastle University, Newcastle, UK
| | - Rachel Goldsmith
- Specialty Registrar in Paediatric Dentistry, Newcastle Dental Hospital, Newcastle, UK
| | - Kathryn Rowles
- Clinical Lecturer in Paediatric Dentistry, Cardiff University, Cardiff, UK
| | - Daniela Prócida Raggio
- Department of Paediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Nicola Innes
- Paediatric Dentistry, Honorary Consultant and Head of Cardiff Dental School, Cardiff University, Cardiff, UK
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13
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Buontempo Z, Ashley P, Almaeen S. A quantitative and qualitative investigation into the management of carious primary molars by foundation dentists in primary care in the South East of England. Br Dent J 2024; 236:625-629. [PMID: 38671121 DOI: 10.1038/s41415-024-7339-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/29/2023] [Accepted: 12/04/2023] [Indexed: 04/28/2024]
Abstract
Introduction Dental caries is the most common reason for hospital admission of children aged 5-9 in the UK. Better management of caries in primary molars would reduce the number of children requiring treatment in hospitals; however, little research has been done into why primary care clinicians do not use an evidence-based approach to caries management for deciduous molars.Aims The aim of this paper is to identify the rationale behind caries management techniques used in primary care, as well as the choice of materials and long-term success of restorations placed.Materials and methods Use of a retrospective audit and a focus group with primary care clinicians to provide an insight into the management of carious primary molars and the barriers to achieving gold standard care.Results Glass ionomer cements (GICs) were the restoration of choice in primary care. Lack of time, equipment availability and clinician inexperience were cited as to why Hall crowns were not commonly placed.Conclusions The barriers to gold standard management of carious primary molars in practice are wide-ranging but tend to focus on the limitations of NHS care under the units of dental activity system. Lack of time and cost of materials encouraged clinicians to adopt a 'quick fix' approach in GIC.
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14
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Bekes K, Steffen R, Krämer N. Update of the molar incisor hypomineralization: Würzburg concept. Eur Arch Paediatr Dent 2023; 24:807-813. [PMID: 37856065 PMCID: PMC10657291 DOI: 10.1007/s40368-023-00848-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 09/15/2023] [Indexed: 10/20/2023]
Abstract
PURPOSE Molar incisor hypomineralization (MIH) is playing an increasingly important role in dental practice. MIH is defined as hypomineralization of systemic origin of one to four permanent first molars, often associated with affected incisors. Affected teeth are more susceptible to caries and post-eruptive enamel loss and should be diagnosed and treated as early as possible. In 2016, the Würzburg concept was developed for German-speaking countries including a classification index-the MIH Treatment Need Index (MIH-TNI)-and a treatment plan based on it for the use in daily practice. In the meantime, the concept has also gained international recognition. The aim of this paper is to update part 2 of the Würzburg concept, the treatment plan, as knowledge about MIH has increased and the disease has been studied more extensively in the last years. Other treatment approaches are now available and therefore need to be included in the concept. Although, the evidence of the different treatment options is still weak, practitioners need guidance in their daily practice. METHODS The authors reviewed the available literature, including clinical and laboratory studies and published guidelines. RESULTS The updated version of the Würzburg concept includes additional non-invasive strategies and temporary therapy options, as well as treatment approaches for incisors. It therefore covers currently available treatment modalities for MIH-affected teeth, ranging from prophylaxis, non-invasive treatment to restorative approaches and possibly even extraction. CONCLUSIONS This is intended to help guide the practitioner and will need to be further validated by clinical trials.
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Affiliation(s)
- K Bekes
- Department of Paediatric Dentistry, University Clinic of Dentistry, Medical University of Vienna, 1090, Vienna, Austria.
| | - R Steffen
- Private Practice, Weinfelden, Switzerland
| | - N Krämer
- Department of Paediatric Dentistry, Justus Liebig University, Giessen, Germany
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15
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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.
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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
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de Boer M, Zimmermann M, Attin T, Tauböck TT, Hamza B. Marginal Integrity of Simplified Adhesive Strategies in Primary Teeth. Int Dent J 2023; 73:881-888. [PMID: 37385864 PMCID: PMC10658436 DOI: 10.1016/j.identj.2023.06.002] [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: 03/20/2023] [Revised: 06/07/2023] [Accepted: 06/09/2023] [Indexed: 07/01/2023] Open
Abstract
OBJECTIVE The aim of this research was to investigate the effect of simplified adhesive strategies (self-etch vs selective enamel etch and 10- vs 20-second adhesive application time) on the marginal integrity in primary molars. METHODS Forty deep class-II cavities were prepared in 40 extracted primary molars. The molars were divided into 4 groups based on the applied universal adhesive strategy as follows: groups 1 and 2: selective enamel etch with 20- or 10-second application time and groups 3 and 4: self-etch with 20- or 10-second application time. All cavities were restored with a sculptable bulk-fill composite restoration. The restorations underwent a thermomechanical loading (TML, 5-50 °C, 2-minute dwelling time, ×1000; 400,000 loading cycles, 1.7 Hz, 49 N). Marginal analysis before and after TML was conducted with scanning electron microscopy and the marginal integrity of each restoration was calculated as a percentage of continuous margins. A beta regression model was adopted to statistically analyse the data with a consequent pairwise comparison. RESULTS The mean marginal integrity (% ± SD) of the restorations for each tested adhesive strategy after TML was as follows: selective enamel etch/20 seconds = 85.4 ± 3.9, self-etch/20 seconds = 85.3 ± 5.2, self-etch/10 seconds = 80.1 ± 8.2, and selective enamel etch/10 seconds = 80.0 ± 8.5. The difference between both adhesive strategies was not statistically significant at the same application time. The difference between both application times within the same adhesive strategy was statistically significant (P ≤ .01). CONCLUSIONS Universal adhesives applied either in selective enamel etch or in self-etch mode result in comparable marginal integrities when restoring class-II cavities in primary molars. Shortened adhesive application time (10 seconds) could lead to a reduction in the marginal integrity in comparison to the recommended application time of 20 seconds.
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Affiliation(s)
- Mia de Boer
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Marcus Zimmermann
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Thomas Attin
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Tobias T Tauböck
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Blend Hamza
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
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17
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Bansal K, Shamoo A, Mani K, K PD, Verma A, Mathur VP, Tewari N. Silver diamine fluoride modified atraumatic restorative treatment compared to conventional restorative technique on carious primary molars-A randomized controlled trial. J Dent 2023; 138:104698. [PMID: 37704105 DOI: 10.1016/j.jdent.2023.104698] [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: 07/07/2023] [Revised: 08/12/2023] [Accepted: 09/11/2023] [Indexed: 09/15/2023] Open
Abstract
OBJECTIVE To compare the success of silver diamine fluoride-modified atraumatic restorative technique (SMART) with that of the conventional drill and fill method in restoring carious lesions in primary molars. METHOD Children (4-8years old) reporting to a tertiary care hospital setting with asymptomatic cavitated dentinal carious lesions in primary molars were randomly allocated to two groups; SMART and Conventional; and subsequently restored with Glass Ionomer Cement (GIC). Follow-up evaluations were carried out by blinded independent evaluator at 6-months intervals to assess the status of restorations. Primary outcome was the success of restorations at 24 months and the secondary outcome was the child's behaviour and acceptance of the treatment at the time of interventions. Two sample Z-test of proportion, logistic regression analysis and Chi-square test were used to compare the outcomes in two groups. RESULTS A total of 226 children (SMART group, 112 and conventional, 114) were included with 280 and 282 GIC restorations placed by the SMART and the conventional method respectively. At 24-months, 459 (81.6 %) primary molars were available for evaluation. Success rates of restorations was 38.4 % and 45.8 % % in SMART and conventional groups respectively (p = 0.105). The rate of acceptability of treatment in the SMART and conventional group was 79 % and 56 % (p<0.001) respectively. CONCLUSION There was no significant difference in the success rates of GIC restorations by SMART and conventional technique in carious primary molars at 24 months. SMART was better accepted by children as compared to the conventional restorative technique. CLINICAL SIGNIFICANCE SMART can be an alternative option to treat the asymptomatic carious lesions in primary molars and is well accepted by children than the conventional drill and fill technique thus implying that it has a useful role in un-cooperative children.
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Affiliation(s)
- Kalpana Bansal
- Department of Pediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India.
| | - Azeema Shamoo
- Department of Pediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Kalaivani Mani
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Pavithra Devi K
- Department of Pediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Ankita Verma
- Department of Pediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Vijay P Mathur
- Department of Pediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Nitesh Tewari
- Department of Pediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
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18
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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.
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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.)
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19
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Boyd DH, Foster Page LA, Moffat SM, Thomson WM. Time to complain about pain: Children's self-reported procedural pain in a randomised control trial of Hall and conventional stainless steel crown techniques. Int J Paediatr Dent 2023; 33:382-393. [PMID: 36841968 DOI: 10.1111/ipd.13059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 12/21/2022] [Accepted: 02/18/2023] [Indexed: 02/27/2023]
Abstract
BACKGROUND Children's pain in dentistry has undesirable short- and long-term consequences; therefore, less invasive treatments merit consideration. AIM To investigate procedural pain scores for two treatments for carious primary molars in New Zealand primary care. DESIGN This study was a split-mouth randomised control trial, with secondary outcome analysis. Children (4-8 years) with proximal carious lesions on matched primary molars had one tooth treated with the Hall technique (HT) and one treated with a conventional stainless steel crown (CT); treatment type and order of treatment were randomly allocated (allocation concealment). The Wong-Baker self-report pain scale measured pretreatment dental pain, procedural pain at each treatment and post-operative pain. RESULTS Data were analysed for 103 children: 49 children had the HT first and 54 children had the CT first. Procedural pain scores did not differ by treatment type, with 71.8% and 76.7% of children reporting low pain for the HT and the CT, respectively. Fewer children reported low procedural pain for the second treatment than the first (p = .047). Most children reported low procedural pain for both treatments (58.3%), although 41.7% experienced moderate-high procedural pain with at least one treatment. CONCLUSIONS The HT caused pain for as many children as the CT. There is an opportunity for better dental pain management in this setting.
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Affiliation(s)
- Dorothy H Boyd
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Lyndie A Foster Page
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Susan M Moffat
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - W Murray Thomson
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
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20
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Undre MI, Chunawala Y, Choubey S, Shaikh MN, Ershad A, Qureshi S. Evaluation of the Success of Conventional and Biological Restorative Treatment Approaches for Caries in Primary Molars: An In Vivo Study. Int J Clin Pediatr Dent 2023; 16:591-597. [PMID: 37731796 PMCID: PMC10507310 DOI: 10.5005/jp-journals-10005-2644] [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] [Indexed: 09/22/2023] Open
Abstract
Background In order to compare the clinical and radiographic success of three treatment modalities-conventional restoration (CR), nonrestorative caries treatment (NRCT), and Hall technique (HT), with a 3-month to 1 year follow-up in deciduous molars with occlusal or proximal carious lesions. Design Children between the ages of 5 and 8 were chosen for the study, having a total of 120 teeth. They were split into three groups, each with 40 participants-CR, HT, and NRCT. Clinical and radiographic evaluation was done at 3, 6, 9, and 12 months. Data were statistically analyzed. Results The Chi-squared value and p-value were found to be insignificant when comparing clinical and radiographic ratings of all three groups at 3, 6, 9, and 12-month intervals. Conclusion Hall technique (HT) performed better than CR. NRCT was more acceptable to patients than CR. How to cite this article Undre MI, Chunawala Y, Choubey S, et al. Evaluation of the Success of Conventional and Biological Restorative Treatment Approaches for Caries in Primary Molars: An In Vivo Study. Int J Clin Pediatr Dent 2023;16(4):591-597.
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Affiliation(s)
- Maryam I Undre
- Department of Dentistry, Masina Hospital, Byculla, Mumbai, Maharashtra, India
| | - Yusuf Chunawala
- Department of Pediatric & Preventive Dentistry, MA Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India
| | - Shikha Choubey
- Department of Pediatric and Preventive Dentistry, ITS Dental College, Muradnagar, Ghaziabad, Uttar Pradesh, India
| | - Maheen N Shaikh
- Department of Pediatric & Preventive Dentistry, MA Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India
| | - Aliya Ershad
- Department of Pediatric & Preventive Dentistry, MA Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India
| | - Sana Qureshi
- Department of Pediatric & Preventive Dentistry, MA Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India
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Dhar V, Pilcher L, Fontana M, González-Cabezas C, Keels MA, Mascarenhas AK, Nascimento M, Platt JA, Sabino GJ, Slayton R, Tinanoff N, Young DA, Zero DT, Pahlke S, Urquhart O, O'Brien KK, Carrasco-Labra A. Evidence-based clinical practice guideline on restorative treatments for caries lesions: A report from the American Dental Association. J Am Dent Assoc 2023; 154:551-566.e51. [PMID: 37380250 DOI: 10.1016/j.adaj.2023.04.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 02/07/2023] [Accepted: 04/01/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND An expert panel convened by the American Dental Association (ADA) Council on Scientific Affairs together with the ADA Science and Research Institute's program for Clinical and Translational Research conducted a systematic review and developed recommendations for the treatment of moderate and advanced cavitated caries lesions in patients with vital, nonendodontically treated primary and permanent teeth. TYPES OF STUDIES REVIEWED The authors searched for systematic reviews comparing carious tissue removal (CTR) approaches in Ovid MEDLINE, Embase, Cochrane Database of Systematic Reviews, and Trip Medical Database. The authors also conducted a systematic search for randomized controlled trials comparing direct restorative materials in Ovid MEDLINE, Embase, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform. The authors used the Grading of Recommendations Assessment, Development, and Evaluation approach to assess the certainty of the evidence and formulate recommendations. RESULTS The panel formulated 16 recommendations and good practice statements: 4 on CTR approaches specific to lesion depth and 12 on direct restorative materials specific to tooth location and surfaces involved. The panel conditionally recommended for the use of conservative CTR approaches, especially for advanced lesions. Although the panel conditionally recommended for the use of all direct restorative materials, they prioritized some materials over the use of others for certain clinical scenarios. PRACTICAL IMPLICATIONS The evidence suggests that more conservative CTR approaches may decrease the risk of adverse effects. All included direct restorative materials may be effective in treating moderate and advanced caries lesions on vital, nonendodontically treated primary and permanent teeth.
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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.
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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
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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.
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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
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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.
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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
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25
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When (and when not) to use the Dahl Concept. Br Dent J 2023; 234:155-164. [PMID: 36765221 DOI: 10.1038/s41415-023-5502-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 10/10/2022] [Indexed: 02/12/2023]
Abstract
The Dahl Concept describes the re-establishment of occlusal contacts after the provision of a planned localised appliance or restoration in supraocclusion. Initially developed to create space for prosthetic rehabilitation of anterior teeth suffering from localised wear, the principle has later been successfully applied to a variety of situations, including the Hall technique and resin-bonded bridges cemented in supraocclusion. Despite high levels of success seen in the relevant literature and widespread adoption in specialist care, the wider profession appears to be far more cautious in its use. This article aims to provide a brief summary of the Dahl Concept and discuss the local and general factors that influence its successful implementation in the hope of promoting its increased adoption by the broader dental profession.
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Shih YC, Yang R, Zou J. Assessment of occlusion and temporomandibular joint after placing preformed metal crowns on all primary molars in children. Int J Paediatr Dent 2022; 32:915-924. [PMID: 35484864 DOI: 10.1111/ipd.12970] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 03/16/2022] [Accepted: 04/23/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND Placing preformed metal crowns (PMCs) on all eight primary molars at one single clinical visit may disrupt a child's occlusion; the literature regarding the effects on occlusion and temporomandibular joint (TMJ) is scarce. AIM This study aimed to quantify the changes in occlusion using T-Scan III and to investigate whether there was TMJ dysfunction after placing eight PMCs at the same time. DESIGN In this study, we enrolled children with severe early childhood caries (S-ECC) and dental phobia, who needed eight PMCs to be placed under general anesthesia. The participants underwent occlusal examinations with a computed occlusal analysis system. The vertical dimension of occlusion (VDO) was measured using a dental vertical dimension gauge, TMJ dysfunction signs were recorded by the clinical dysfunction index (Di), and TMJ dysfunction symptoms were recorded using a questionnaire. The data were collected before treatment (T0 ), 1 week after treatment (T1 ), and 1 month (T2 ) and 3 months (T3 ) after treatment during follow-up visits. Repeated-measures analysis of variance and Friedman's test were used for occlusal data analysis. In addition, the Di and symptoms were compared over time using McNemar's test. RESULTS Forty patients (mean age = 4.25 ± 0.63 years, age range = 3-5 years, 21 boys and 19 girls) were followed up for 3 months. The occlusal contact area 3 months after treatment did not return to the pretreatment status (p = .03). The total of force at the 3-month follow-up visit increased significantly (p = .009) compared with that at the pretreatment. The asymmetric ratio of occlusal force at the 1-month follow-up visit was restored to pretreatment. Concerning the occlusion time, no significant changes were observed for any time intervals (p = .069). The VDO was recovered at the 1-month follow-up visit. The statistical analysis of TMJ dysfunction showed no significant differences in the Di and TMJ dysfunction symptoms before and after treatment (p > .05). CONCLUSION After undergoing eight PMC restorations under general anesthesia, occlusal re-equilibration was attained approximately after 1 month. There were no significant signs and symptoms of TMJ dysfunction after treatment.
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Affiliation(s)
- Yi-Chun Shih
- Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University & State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Chengdu, China
| | - Ran Yang
- Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University & State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Chengdu, China
| | - Jing Zou
- Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University & State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Chengdu, China
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27
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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 2022; 23:667-693. [PMID: 34784027 PMCID: PMC9637620 DOI: 10.1007/s40368-021-00675-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [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.
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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.
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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: 22] [Impact Index Per Article: 11.0] [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.
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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.
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Alamoudi RA, Basudan S, Mahboub M, Baghlaf K. Impact of COVID-19 Pandemic on Dental Treatment in Children: A Retrospective Cross-Sectional Analysis in Jeddah City. Clin Cosmet Investig Dent 2022; 14:95-102. [PMID: 35444468 PMCID: PMC9013707 DOI: 10.2147/ccide.s353514] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 04/05/2022] [Indexed: 12/13/2022] Open
Abstract
Background/Purpose The novel coronavirus disease (COVID-19) outbreak has affected individuals worldwide. Considering the nature of dental treatments and direct exposure to saliva, blood, aerosols, or droplets from infected individuals, dentists are at significant risk of COVID-19 infection. Therefore, to decrease aerosol-generating procedures, minimally invasive dentistry (MID) is recommended during this pandemic. The goal of this research was to compare the flow of patients during a pandemic at a single university hospital in Jeddah City, Saudi Arabia, and to retrospectively assess the impact of the COVID-19 pandemic on pediatric dental treatments including MID. Materials and Methods This study was a retrospective cross-sectional analysis of pediatric patient records, dental procedures performed, and minimally invasive techniques using the database of the King Abdul-Aziz University Dental Hospital (R4) system during the period of COVID 19 pandemic compared to the same period in the previous year. Results During the COVID-19 pandemic, pediatric dental patient flow included only 699 patients compared to 1151 patients during the same period in the previous year. The most common pediatric dental procedures performed during the pandemic period were simple restorative treatments, including fissure sealants, followed by dental extractions, and fluoride varnish applications. During the pandemic period, more minimally invasive treatments were performed, including the Hall technique, silver diamine fluoride, resin infiltration, and atraumatic restorative techniques. Conclusion Based on this data, the COVID-19 pandemic had an impact on dental patient flow and the type of dental procedures performed on children. Minimally invasive treatments that minimize air generation are recommended; however, to establish the long-term effectiveness of minimally invasive treatments in pediatric dentistry, more follow-up studies with bigger sample sizes are required. More recommendations regarding conservative pediatric dental management after the COVID-19 era are suggested.
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Affiliation(s)
- Rana A Alamoudi
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Mona Mahboub
- General Dentist, Private Sector, Jeddah, Saudi Arabia
| | - Khlood Baghlaf
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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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.
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de Farias AL, Rojas-Gualdrón DF, Mejía JD, Bussaneli DG, Santos-Pinto L, Restrepo M. Survival of stainless-steel crowns and composite resin restorations in molars affected by molar-incisor hypomineralization (MIH). Int J Paediatr Dent 2022; 32:240-250. [PMID: 34115431 DOI: 10.1111/ipd.12849] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 06/02/2021] [Accepted: 06/03/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Currently, there is no consensus on the superiority of any material for the restorative treatment of molars affected by molar-incisor hypomineralization (MIH). AIM To evaluate the survival of restorations with stainless-steel crown (SSC) or composite resin (CR) in first permanent molars affected by MIH for 24 months. DESIGN In this retrospective cohort study, 61 CR and 54 SSC restorations placed on molars affected by MIH of patients, aged between 7 and 10, that were treated and overseen at a university dental clinic in the period of 2017-2020 were evaluated. The primary outcome was the failure-free survival time. Parametric survival models were used for data censored by interval, and the comparison between SSC and CR was performed using the hazard ratio function with a 95% confidence interval. RESULTS The survival of SSC and CR restorations after 24 months was 94.4% and 49.2%, respectively. This difference was influenced by the presence of previous restoration (aHR = 3.4; 95% CI: 1.2-9.4) and cusp involvement (aHR = 4.0; 95% CI: 1.5-11.2). CONCLUSION In molars with MIH and the need for restorative treatment, SSC had a significantly higher survival rate than CR over 24 months.
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Affiliation(s)
- Aline Leite de Farias
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Araraquara School of Dentistry, São Paulo State University (Unesp), Araraquara, São Paulo, Brazil
| | | | - Juan Diego Mejía
- Basic and Clinical Research Group in Dentistry, School of Dentistry, CES University, Medellín, Colombia
| | - Diego Girotto Bussaneli
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Araraquara School of Dentistry, São Paulo State University (Unesp), Araraquara, São Paulo, Brazil
| | - Lourdes Santos-Pinto
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Araraquara School of Dentistry, São Paulo State University (Unesp), Araraquara, São Paulo, Brazil
| | - Manuel Restrepo
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Araraquara School of Dentistry, São Paulo State University (Unesp), Araraquara, São Paulo, Brazil
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Somani C, Taylor GD, Garot E, Rouas P, Lygidakis NA, Wong FSL. An update of treatment modalities in children and adolescents with teeth affected by molar incisor hypomineralisation (MIH): a systematic review. Eur Arch Paediatr Dent 2022; 23:39-64. [PMID: 34110615 PMCID: PMC8927013 DOI: 10.1007/s40368-021-00635-0] [Citation(s) in RCA: 50] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 05/19/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE To systematically review the treatment modalities for molar-incisor hypomineralisation for children under the age of 18 years. The research question was, 'What are the treatment options for teeth in children affected by molar incisor hypomineralisation?' METHODS An electronic search of the following electronic databases was completed MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, LILACS, Google Scholar and Open Grey identifying studies from 1980 to 2020. The PRISMA guidelines were followed. The studies were screened, data extracted and calibration was completed by two independent reviewers. RESULTS Of 6220 potential articles, 34 studies were included. Twenty studies investigated management of molars with fissure sealants, glass ionomer cement, polyacid modified resin composite, composite resin, amalgam, preformed metal crowns, laboratory-manufactured crowns and extractions. In four articles management of incisors with microabrasion, resin-infiltration and a combination of approaches was reported. Eight studies looked at strategies to mineralise MIH-affected teeth and/or reduce hypersensitivity. Two studies investigated patient-centred outcomes following treatment. Due to the heterogeneity between the studies, meta-analysis was not performed. CONCLUSION The use of resin-based fissure sealants, preformed metal crowns, direct composite resin restorations and laboratory-made restorations can be recommended for MIH-affected molars. There is insufficient evidence to support specific approaches for the management of affected incisors. Products containing CPP-ACP may be beneficial for MIH-affected teeth.
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Affiliation(s)
- C Somani
- Department of Paediatric Dentistry, Institute of Dentistry, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK.
| | - G D Taylor
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - E Garot
- Univ. de Bordeaux, UFR Des Sciences Odontologiques, Bordeaux, France
| | - P Rouas
- Univ. de Bordeaux, UFR Des Sciences Odontologiques, Bordeaux, France
| | - N A Lygidakis
- Private Paediatric Dental Clinic, 2 Papadiamantopoulou Street, 11528, Athens, Greece
| | - F S L Wong
- Department of Paediatric Dentistry, Institute of Dentistry, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
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Lyons-Coleman M, O'Sullivan E, Thompson W. The impact of COVID-19 on paediatric dental services and tips for patient management. Prim Dent J 2022; 10:88-94. [PMID: 35088634 DOI: 10.1177/20501684211066526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Managing paediatric patients in primary dental care while awaiting treatment by the specialist paediatric dental services can be tricky. COVID-19 has had a significant impact on dental services meaning wait times to be seen by a paediatric dental service may have been delayed. This article will discuss the management of paediatric patients in primary dental care and provide an update on some of the latest techniques in paediatric dentistry. It also covers tips that can be employed in the primary dental care setting such as the use of tooth mousse and silver diamine fluoride.
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Affiliation(s)
| | | | - Wendy Thompson
- NIHR Clinical Lecturer in Primary Dental Care, Division of Dentistry, University of Manchester, Manchester, UK
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Lin GSS, Koh SH, Ter KZ, Lim CW, Sultana S, Tan WW. Awareness, Knowledge, Attitude, and Practice of Teledentistry among Dental Practitioners during COVID-19: A Systematic Review and Meta-Analysis. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58010130. [PMID: 35056438 PMCID: PMC8781277 DOI: 10.3390/medicina58010130] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/13/2022] [Accepted: 01/14/2022] [Indexed: 04/14/2023]
Abstract
Background and Objectives: This systemic review aims to appraise and analyse the awareness, knowledge, attitude, and practice of teledentistry among dental practitioners during COVID-19. Materials and Methods: This review was registered in the PROSPERO database (CRD42021283404). Cross-sectional articles on dental practitioners' perceptions towards teledentistry published between March 2020 and September 2021 were searched in ten online databases (PubMed, Google Scholar, Web of Science, ScienceDirect, Cochrane, EMBASE, SIGLE, EBSCO, LILACS, and Open Grey). The Joanna Briggs Institute critical appraisal tool was employed to analyse the risk of bias (RoB) of each article, whereas the Oxford Centre for Evidence-Based Medicine recommendation tool was used to evaluate the level of evidence. Data were analysed using the DerSimonian-Laird random effect model based on a single-arm approach. Results: Six studies were included and demonstrated Level 3 evidence. A single-arm meta-analysis revealed that dental practitioners had a high level of awareness (70.4%) and attitude (72.5%) towards teledentistry during the COVID-19 pandemic, but their knowledge level (57.9%) was moderate with a poor practice level (35.8%). A substantial heterogeneity was observed with the overall I2 ranging from 90.78% to 98.21%. Furthermore, meta-regression indicated that the sample size of each study had a significant (p < 0.05) impact on the degree of data heterogeneity. Conclusions: Despite their high degree of awareness and attitude, dental practitioners demonstrated moderate knowledge and relatively poor practice of teledentistry during the COVID-19 pandemic. More well-designed studies are warranted to investigate the alternatives for enhancing dental practitioners' knowledge and practice of teledentistry interventions.
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Affiliation(s)
- Galvin Sim Siang Lin
- Department of Dental Materials, Faculty of Dentistry, Asian Institute of Medicine, Science and Technology (AIMST) University, Bedong 08100, Kedah, Malaysia
- Correspondence: ; Tel.: +60-4429-8564
| | - Sze Hui Koh
- Puchong Dental Clinic, Ministry of Health Malaysia, Puchong 47100, Selangor, Malaysia;
| | - Karyn Zuhuan Ter
- KK2 Batu Pahat Clinic, Ministry of Health Malaysia, Batu Pahat 83000, Johor, Malaysia;
| | - Chia Wei Lim
- Taman Intan Clinic, Ministry of Health Malaysia, Sungai Petani 08000, Kedah, Malaysia;
| | - Sharmin Sultana
- Department of Orthodontics, Faculty of Dentistry, Manipal University College Malaysia (MUCM), Bukit Baru 75150, Melaka, Malaysia;
| | - Wen Wu Tan
- Department of Dental Public Health, Faculty of Dentistry, Asian Institute of Medicine, Science and Technology (AIMST) University, Bedong 08100, Kedah, Malaysia;
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Lygidakis NA, Garot E, Somani C, Taylor GD, Rouas P, Wong FSL. Best clinical practice guidance for clinicians dealing with children presenting with molar-incisor-hypomineralisation (MIH): an updated European Academy of Paediatric Dentistry policy document. Eur Arch Paediatr Dent 2022; 23:3-21. [PMID: 34669177 PMCID: PMC8926988 DOI: 10.1007/s40368-021-00668-5] [Citation(s) in RCA: 102] [Impact Index Per Article: 51.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 09/22/2021] [Indexed: 12/16/2022]
Abstract
AIM To update the existing European Academy of Paediatric Dentistry (EAPD) 2010 policy document on the 'Best Clinical Practice guidance for clinicians dealing with children presenting with Molar-Incisor-Hypomineralisation (MIH).' METHODS Experts, assigned the EAPD, worked on two different topics: (A) Aetiological factors involved in MIH, and (B) Treatment options for the clinical management of MIH. The group prepared two detailed systematic reviews of the existing literature relevant to the topics and following a consensus process produced the updated EAPD policy document on the 'Best Clinical Practice guidance for clinicians dealing with children presenting with molar-incisor-hypomineralisation (MIH).' The GRADE system was used to assess the quality of evidence regarding aetiology and treatment which was judged as HIGH, MODERATE, LOW or VERY LOW, while the GRADE criteria were used to indicate the strength of recommendation regarding treatment options as STRONG or WEAK/CONDITIONAL. RESULTS (A) Regarding aetiology, it is confirmed that MIH has a multifactorial aetiology with the duration, strength and timing of occurrence of the aetiological factors being responsible for the variable clinical characteristics of the defect. Perinatal hypoxia, prematurity and other hypoxia related perinatal problems, including caesarean section, appear to increase the risk of having MIH, while certain infant and childhood illnesses are also linked with MIH. In addition, genetic predisposition and the role of epigenetic influences are becoming clearer following twin studies and genome and single-nucleotide polymorphisms analyses in patients and families. Missing genetic information might be the final key to truly understand MIH aetiology. (B) Regarding treatment options, composite restorations, preformed metal crowns and laboratory indirect restorations provide high success rates for the posterior teeth in appropriate cases, while scheduled extractions provide an established alternative option in severe cases. There is great need for further clinical and laboratory studies evaluating new materials and non-invasive/micro-invasive techniques for anterior teeth, especially when aesthetic and oral health related quality of life (OHRQoL) issues are concerned. CONCLUSIONS MIH has been studied more extensively in the last decade. Its aetiology follows the multifactorial model, involving systemic medical and genetic factors. Further focused laboratory research and prospective clinical studies are needed to elucidate any additional factors and refine the model. Successful preventive and treatment options have been studied and established. The appropriate choice depends on the severity of the defects and the age of the patient. EAPD encourages the use of all available treatment options, whilst in severe cases, scheduled extractions should be considered.
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Affiliation(s)
- N A Lygidakis
- Private Paediatric Dental Clinic, 2 Papadiamantopoulou Street, 11528, Athens, Greece.
| | - E Garot
- Univ. de Bordeaux, UFR des Sciences Odontologiques, Bordeaux, France
- CHU de Bordeaux, Pôle médecine et chirurgie bucco-dentaire, Pellegrin, Bordeaux, France
- Univ. de Bordeaux, PACEA, UMR 5199, Pessac, France
| | - C Somani
- Paediatric Dentistry, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - G D Taylor
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - P Rouas
- Univ. de Bordeaux, UFR des Sciences Odontologiques, Bordeaux, France
- CHU de Bordeaux, Pôle médecine et chirurgie bucco-dentaire, Pellegrin, Bordeaux, France
- Univ. de Bordeaux, PACEA, UMR 5199, Pessac, France
| | - F S L Wong
- Paediatric Dentistry, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Almaghrabi MA, Albadawi EA, Dahlan MA, Aljohani HR, Ahmed NM, Showlag RA. Exploring Parent's Satisfaction and the Effectiveness of Preformed Metal Crowns Fitting by Hall Technique for Carious Primary Molars in Jeddah Region, Saudi Arabia: Findings of a Prospective Cohort Study. Patient Prefer Adherence 2022; 16:2497-2507. [PMID: 36105659 PMCID: PMC9467849 DOI: 10.2147/ppa.s370159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 08/25/2022] [Indexed: 12/03/2022] Open
Abstract
PURPOSE The Hall technique (HT) is a non-invasive approach to treating carious primary teeth. Its acceptability by parents and effectiveness is not widely known in the Middle East. Therefore, we aimed to conduct this study to explore the effectiveness of preformed metal crowns (PMCs) fitting by HT and to what extent the parent's satisfaction for their children in Jeddah region. MATERIALS AND METHODS A prospective cohort study was conducted in the outpatient pediatric dental clinic at Jeddah Specialty Dental Center, in 2018. The cohort of children was exposed to the HT and was recalled 3 months to two years later to examine present or absence of: crown loss, open margin, signs or symptoms of reversible or irreversible pulpitis, and if the tooth exfoliated naturally. Parents who agreed to undergo the HT for their children completed a 5-point Likert questionnaire after treatment and after three months. RESULTS A total of 48 children (72 teeth) were initially enrolled, but only 25 children (49 teeth) completed two years of follow-up. At 2 years follow-up, one PMC was lost (2.04%) while no teeth fitted with the HT required any further intervention. Around 96% of parents were satisfied with this procedure and 92% wanted other carious teeth to be treated similarly. All parents were satisfied with this technique because it did not include local anesthesia and no drilling. It was found that parents of girls were satisfied more than parents of boys and on average their satisfaction score at the time of treatment was 3.04 units higher than parents of boys with a significant p-value of 0.02 and 95% CI for the beta coefficient to be 0.46 to 5.62. CONCLUSION The HT is effective as a treatment of dental caries and it was generally accepted by parents initially and during their follow-up visits.
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Affiliation(s)
- Manal A Almaghrabi
- Pediatric Dental Department, Specialty Dental Center, Ministry of Health, Jeddah, Saudi Arabia
- Correspondence: Manal A Almaghrabi, Pediatric Dental Department, Specialty Dental Center, Ministry of Health, J56+49R, King Fahd Br Rd, An Nuzhah, Jeddah 23532, Saudi Arabia, Tel +699503002376, Fax +966 126205570, Email
| | - Emad A Albadawi
- Pediatric Dental Department, Specialty Dental Center, Ministry of Health, Jeddah, Saudi Arabia
| | - Mohammad A Dahlan
- Pediatric Dental Department, Specialty Dental Center, Ministry of Health, Jeddah, Saudi Arabia
| | - Hanan R Aljohani
- Pediatric Dental Department, Specialty Dental Center, Ministry of Health, Jeddah, Saudi Arabia
| | - Neveen M Ahmed
- Pediatric Dental Department, Specialty Dental Center, Ministry of Health, Jeddah, Saudi Arabia
| | - Riham A Showlag
- Pediatric Dental Department, Specialty Dental Center, Ministry of Health, Jeddah, Saudi Arabia
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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.
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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
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Vafaei A, Nikookhesal M, Erfanparast L, Løvschall H, Ranjkesh B. Vital pulp therapy following pulpotomy in immature first permanent molars with deep caries using novel fast-setting calcium silicate cement: A retrospective clinical study. J Dent 2021; 116:103890. [PMID: 34780875 DOI: 10.1016/j.jdent.2021.103890] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 11/02/2021] [Accepted: 11/10/2021] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES To compare the success rate of vital pulp therapy following complete pulpotomy in immature first permanent molars, during caries treatment, using novel fast-setting calcium silicate cement (Novel CSC) versus MTA. METHODS Six- to eight- years old children, who received pulpotomy of first immature permanent molar using one layer novel CSC (Protooth) or two layers slow-setting MTA (MTA Angelus) covered with glass ionomer were recalled for radiographic and clinical evaluation after two years. The effects of cement type, age, gender, jaw, anesthesia type, and restoration type were assessed on the clinical success of pulpotomy and continued root formation (apexogenesis) as the treatment outcome. RESULTS Out of 366 included teeth in the study, 316 teeth were available for statistical analysis. The mean observation time was 28.2 ± 2.7 months. Novel CSC showed significantly higher clinical success rate (93.1%) compared to MTA (84.5%). Restored teeth with stainless steel crowns after pulpotomy and treatments performed under general anesthesia had a statistically significant effect on treatment outcome in contrast to age, gender, and jaw type. CONCLUSION The observations of this retrospective study suggested that the success rate of vital pulp therapy following complete pulpotomy using one layer fast-setting novel CSC was significantly higher than slow-setting MTA covered with glass ionomer. Treatment under general anesthesia and restoration using stainless steel crowns influenced the treatment outcome. CLINICAL SIGNIFICANCE Novel fast-setting calcium silicate cement is a promising new biomaterial for vital pulp therapy in immature permanent molars that allows complete root formation overtime with apexogenesis. Clinicians must also be aware of the importance of immediate definitive restoration and proper sealing and isolation in vital pulp therapy.
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Affiliation(s)
- Ali Vafaei
- Department of Pediatric Dentistry, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Mahsa Nikookhesal
- Department of Pediatric Dentistry, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leila Erfanparast
- Department of Pediatric Dentistry, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Henrik Løvschall
- Department of Dentistry and Oral Health, Section for Oral Ecology and Caries Control, Aarhus University, Aarhus, Denmark
| | - Bahram Ranjkesh
- Department of Dentistry and Oral Health, Section for Prosthetic Dentistry, Aarhus University, Aarhus, Denmark
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Al-Nashi Elia R, Ikram J, Clayton T, Chow V, Aldred E, Pilotille K, Stones N, Mustufvi Z. Primary care research: views of a dental team on their experiences of a primary care study. Prim Dent J 2021; 10:75-80. [PMID: 34727767 DOI: 10.1177/20501684211030087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | - Javed Ikram
- Advisor to Strategic Group College of General Dentistry and General Dental Practitioner, Lytham St Annes, UK
| | | | | | | | | | | | - Zhain Mustufvi
- NIHR Academic Clinical Fellow, University of Leeds, Leeds, UK
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Schwendicke F, Walsh T, Lamont T, Al-Yaseen W, Bjørndal L, Clarkson JE, Fontana M, Gomez Rossi J, Göstemeyer G, Levey C, Müller A, Ricketts D, Robertson M, Santamaria RM, Innes NP. Interventions for treating cavitated or dentine carious lesions. Cochrane Database Syst Rev 2021; 7:CD013039. [PMID: 34280957 PMCID: PMC8406990 DOI: 10.1002/14651858.cd013039.pub2] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Traditionally, cavitated carious lesions and those extending into dentine have been treated by 'complete' removal of carious tissue, i.e. non-selective removal and conventional restoration (CR). Alternative strategies for managing cavitated or dentine carious lesions remove less or none of the carious tissue and include selective carious tissue removal (or selective excavation (SE)), stepwise carious tissue removal (SW), sealing carious lesions using sealant materials, sealing using preformed metal crowns (Hall Technique, HT), and non-restorative cavity control (NRCC). OBJECTIVES To determine the comparative effectiveness of interventions (CR, SE, SW, sealing of carious lesions using sealant materials or preformed metal crowns (HT), or NRCC) to treat carious lesions conventionally considered to require restorations (cavitated or micro-cavitated lesions, or occlusal lesions that are clinically non-cavitated but clinically/radiographically extend into dentine) in primary or permanent teeth with vital (sensitive) pulps. SEARCH METHODS An information specialist searched four bibliographic databases to 21 July 2020 and used additional search methods to identify published, unpublished and ongoing studies. SELECTION CRITERIA: We included randomised clinical trials comparing different levels of carious tissue removal, as listed above, against each other, placebo, or no treatment. Participants had permanent or primary teeth (or both), and vital pulps (i.e. no irreversible pulpitis/pulp necrosis), and carious lesions conventionally considered to need a restoration (i.e. cavitated lesions, or non- or micro-cavitated lesions radiographically extending into dentine). The primary outcome was failure, a composite measure of pulp exposure, endodontic therapy, tooth extraction, and restorative complications (including resealing of sealed lesions). DATA COLLECTION AND ANALYSIS Pairs of review authors independently screened search results, extracted data, and assessed the risk of bias in the studies and the overall certainty of the evidence using GRADE criteria. We measured treatment effects through analysing dichotomous outcomes (presence/absence of complications) and expressing them as odds ratios (OR) with 95% confidence intervals (CI). For failure in the subgroup of deep lesions, we used network meta-analysis to assess and rank the relative effectiveness of different interventions. MAIN RESULTS We included 27 studies with 3350 participants and 4195 teeth/lesions, which were conducted in 11 countries and published between 1977 and 2020. Twenty-four studies used a parallel-group design and three were split-mouth. Two studies included adults only, 20 included children/adolescents only and five included both. Ten studies evaluated permanent teeth, 16 evaluated primary teeth and one evaluated both. Three studies treated non-cavitated lesions; 12 treated cavitated, deep lesions, and 12 treated cavitated but not deep lesions or lesions of varying depth. Seventeen studies compared conventional treatment (CR) with a less invasive treatment: SE (8), SW (4), two HT (2), sealing with sealant materials (4) and NRCC (1). Other comparisons were: SE versus HT (2); SE versus SW (4); SE versus sealing with sealant materials (2); sealant materials versus no sealing (2). Follow-up times varied from no follow-up (pulp exposure during treatment) to 120 months, the most common being 12 to 24 months. All studies were at overall high risk of bias. Effect of interventions Sealing using sealants versus other interventions for non-cavitated or cavitated but not deep lesions There was insufficient evidence of a difference between sealing with sealants and CR (OR 5.00, 95% CI 0.51 to 49.27; 1 study, 41 teeth, permanent teeth, cavitated), sealing versus SE (OR 3.11, 95% CI 0.11 to 85.52; 2 studies, 82 primary teeth, cavitated) or sealing versus no treatment (OR 0.05, 95% CI 0.00 to 2.71; 2 studies, 103 permanent teeth, non-cavitated), but we assessed all as very low-certainty evidence. HT, CR, SE, NRCC for cavitated, but not deep lesions in primary teeth The odds of failure may be higher for CR than HT (OR 8.35, 95% CI 3.73 to 18.68; 2 studies, 249 teeth; low-certainty evidence) and lower for HT than NRCC (OR 0.19, 95% CI 0.05 to 0.74; 1 study, 84 teeth, very low-certainty evidence). There was insufficient evidence of a difference between SE versus HT (OR 8.94, 95% CI 0.57 to 139.67; 2 studies, 586 teeth) or CR versus NRCC (OR 1.16, 95% CI 0.50 to 2.71; 1 study, 102 teeth), both very low-certainty evidence. CR, SE, SW for deep lesions The odds of failure were higher for CR than SW in permanent teeth (OR 2.06, 95% CI 1.34 to 3.17; 3 studies, 398 teeth; moderate-certainty evidence), but not primary teeth (OR 2.43, 95% CI 0.65 to 9.12; 1 study, 63 teeth; very low-certainty evidence). The odds of failure may be higher for CR than SE in permanent teeth (OR 11.32, 95% CI 1.97 to 65.02; 2 studies, 179 teeth) and primary teeth (OR 4.43, 95% CI 1.04 to 18.77; 4 studies, 265 teeth), both very low-certainty evidence. Notably, two studies compared CR versus SE in cavitated, but not deep lesions, with insufficient evidence of a difference in outcome (OR 0.62, 95% CI 0.21 to 1.88; 204 teeth; very low-certainty evidence). The odds of failure were higher for SW than SE in permanent teeth (OR 2.25, 95% CI 1.33 to 3.82; 3 studies, 371 teeth; moderate-certainty evidence), but not primary teeth (OR 2.05, 95% CI 0.49 to 8.62; 2 studies, 126 teeth; very low-certainty evidence). For deep lesions, a network meta-analysis showed the probability of failure to be greatest for CR compared with SE, SW and HT. AUTHORS' CONCLUSIONS Compared with CR, there were lower numbers of failures with HT and SE in the primary dentition, and with SE and SW in the permanent dentition. Most studies showed high risk of bias and limited precision of estimates due to small sample size and typically limited numbers of failures, resulting in assessments of low or very low certainty of evidence for most comparisons.
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Affiliation(s)
- Falk Schwendicke
- Department of Oral Diagnostics, Digital Health and Health Research Services, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Tanya Walsh
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Thomas Lamont
- School of Dentistry, University of Dundee, Dundee, UK
| | - Waraf Al-Yaseen
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Lars Bjørndal
- Cariology and Endodontics, Section of Clinical Oral Microbiology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Janet E Clarkson
- Division of Oral Health Sciences, School of Dentistry, University of Dundee, Dundee, UK
| | - Margherita Fontana
- Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Michigan, USA
| | - Jesus Gomez Rossi
- Department of Oral Diagnostics, Digital Health and Health Research Services, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Gerd Göstemeyer
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Colin Levey
- Division of Restorative Dentistry, School of Dentistry, University of Dundee, Dundee, UK
| | - Anne Müller
- Department of Oral Diagnostics, Digital Health and Health Research Services, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | | | | | - Ruth M Santamaria
- Department of Preventive and Pediatric Dentistry, University of Greifswald, Greifswald, Germany
| | - Nicola Pt Innes
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
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Tonmukayakul U, Forrest H, Arrow P. Cost-effectiveness analysis of atraumatic restorative treatment to manage early childhood caries: microsimulation modelling. Aust Dent J 2021; 66 Suppl 1:S63-S70. [PMID: 34028828 DOI: 10.1111/adj.12857] [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] [Accepted: 05/13/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND This study assessed the cost-effectiveness of atraumatic restorative treatment and the Hall Technique approach (ART/HT) in managing dental caries in young children under the health provider perspective in order to explore a best-buy alternative to dental general anaesthesia (DGA). METHODS Sixty-five observations from a randomized controlled trial were used to construct 20 000 microsimulations representing individual-level clinical outcome and costs of the DGA and ART/HT. Outcome was percentage of successfully managed cases. Costs were reported in 2020 price. Three different scenarios with different assumptions of clinical success of the DGA and the ART/HT were analysed. Probabilistic sensitivity analysis was carried out. RESULTS The ART/HT successfully managed more cases at lower cost ($557) than the DGA when the system failure of the DGA was considered. Under per protocol analysis, participants in both arms were successfully managed, but the ART/HT costed $580 less than the DGA. Probabilistic sensitivity analysis confirmed the ART/HT was a dominant intervention. CONCLUSIONS The ART/HT approach was non-inferior in managing dental caries in young children but at lower costs than the DGA. The ART/HT could be a viable option in the provision of comprehensive dental care in locations with limited access to DGA and reduce hospital admission.
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Affiliation(s)
- U Tonmukayakul
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - H Forrest
- Dental Health Services, Bentley Delivery Centre, Perth, Western Australia, Australia
| | - P Arrow
- Dental Health Services, Bentley Delivery Centre, Perth, Western Australia, Australia
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Loch C, Jansen van Vuuren L, Duncan WJ, Boyd DH, Foster Page LA. Ultrastructure and properties of primary carious molars treated using the Hall Technique. Int J Paediatr Dent 2021; 31:290-298. [PMID: 32516864 DOI: 10.1111/ipd.12681] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 04/10/2020] [Accepted: 05/22/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND The Hall Technique (HT) is a method of restoring decayed primary teeth using stainless steel crowns (SSCs) without tooth preparation, caries removal, or local anaesthetic. AIM To investigate the ultrastructural, biomechanical, and chemical characteristics of teeth managed with the Hall Technique in comparison with conventional SSC (controls). DESIGN Twelve HT-treated primary molars and four controls were analysed. Teeth were dehydrated in ethanol, embedded in methylmethacrylate, mesio-distally sectioned, X-rayed, mounted, and polished. Biomechanical, ultrastructural, and chemical characterisation was performed for carious lesion and sound areas of each specimen. RESULTS Pre-treatment and post-treatment X-rays showed evidence of little to no caries progression over time. In carious lesions, mean hardness and elastic modulus values were lower in HT-treated teeth than in controls. In both controls and HT-treated teeth, carious lesions had the lowest %wt of Ca and P of all tissues sampled. CONCLUSIONS Although the retained carious tissue was biomechanically more compromised in HT-treated teeth, the Ca and P values were higher than reported elsewhere for carious lesions in primary molars, suggesting remineralisation may have occurred in caries in HT-treated teeth. Future investigations will help elucidate the processes involved with carious lesion arrest under SSC.
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Affiliation(s)
- Carolina Loch
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Ludwig Jansen van Vuuren
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Warwick J Duncan
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Dorothy H Boyd
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Lyndie A Foster Page
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
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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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Sapountzis F, Mahony T, Villarosa AR, George A, Yaacoub A. A retrospective study of the Hall technique for the treatment of carious primary teeth in Sydney, Australia. Clin Exp Dent Res 2021; 7:803-810. [PMID: 33830674 PMCID: PMC8543483 DOI: 10.1002/cre2.421] [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: 11/02/2020] [Revised: 02/24/2021] [Accepted: 03/02/2021] [Indexed: 01/07/2023] Open
Abstract
Objectives The aim of this retrospective study was to evaluate the outcome of preformed metallic crowns (PMC) utilizing the HT in carious primary molars for children treated within public dental clinics across the Sydney region. Materials and Methods A retrospective cohort study was designed, whereby two investigators evaluated 113 primary molars treated with HT PMCs involving 71 participants (aged between 5 and 11 years) after a minimum of 6 months post treatment. The mean time elapsed between crown placement (treatment) and the review was 1.42 years (17 months). The outcome of the HT was assessed by clinical and radiographic criteria. Results One hundred thirteen HT PMCs were reviewed from 71 participants. The overall success rate of PMCs placed utilizing the HT was 99%, with only one case presenting with confirmed failure. Conclusions HT PMCs have an overall high success rate as a treatment option in carious primary molars.
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Affiliation(s)
- Fani Sapountzis
- Nepean Blue Mountains Local Health District Oral Health Services, Nepean Hospital, Kingswood, New South Wales, Australia
| | - Tanya Mahony
- Nepean Blue Mountains Local Health District Oral Health Services, Nepean Hospital, Kingswood, New South Wales, Australia
| | - Amy R Villarosa
- Centre for Oral Health Outcomes and Research Translation (COHORT), Western Sydney University, Penrith, New South Wales, Australia
| | - Ajesh George
- Centre for Oral Health Outcomes and Research Translation (COHORT), Western Sydney University, Penrith, New South Wales, Australia.,Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia.,The University of Sydney, Sydney, New South Wales, Australia
| | - Albert Yaacoub
- Nepean Blue Mountains Local Health District Oral Health Services, Nepean Hospital, Kingswood, New South Wales, Australia
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Boyd DH, Zhang Y, Smith L, Adam L, Foster Page L, Thomson WM. Caregivers' Understanding of Informed Consent in a Randomized Control Trial. JOURNAL OF BIOETHICAL INQUIRY 2021; 18:141-150. [PMID: 33449316 DOI: 10.1007/s11673-020-10085-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 12/29/2020] [Indexed: 06/12/2023]
Abstract
There are differences in caregivers' literacy and health literacy levels that may affect their ability to consent to children participating in clinical research trials. This study aimed to explore the effectiveness, and caregivers' understandings, of the process of informed consent that accompanied their child's participation in a dental randomized control trial (RCT). Telephone interviews were conducted with a convenience sample of ten caregivers who each had a child participating in the RCT. Pre-tested closed and open-ended questions were used, and the findings were produced from an inductive analysis of the latter and a descriptive analysis of the former. Participants had limited understanding of the purpose of the RCT and rated the readability of the consent form more highly than they rated their understanding of the research. All felt that informed consent was vital, but some caregivers had not read the consent documents. Some caregivers enrolled their child in the RCT because they trusted the researchers, and the majority wanted to improve dental care for children. The informed consent process was not always effective despite high readability of the informed consent documents. Researchers must consider the health literacy of the study group, and actively engaging with caregivers to achieve meaningful informed consent may be challenging. Future research could explore participants' perspectives of informed consent in populations with low health literacy and assess whether an underlying expectation not to comprehend health-related information may be a barrier to informed consent.
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Affiliation(s)
- Dorothy Helen Boyd
- Faculty of Dentistry, University of Otago, 310 Great King Street, Dunedin, 9016, New Zealand.
| | - Yinan Zhang
- Stratford Dental, 82 Miranda Street, Taranaki, Stratford District, 4332, New Zealand
| | - Lee Smith
- Wellington Institute of Technology, Private Bag 39803, Wellington Mail Centre, Lower Hutt, 5045, New Zealand
| | - Lee Adam
- Faculty of Dentistry, University of Otago, 310 Great King Street, Dunedin, 9016, New Zealand
| | - L Foster Page
- Faculty of Dentistry, University of Otago, 310 Great King Street, Dunedin, 9016, New Zealand
| | - W M Thomson
- Faculty of Dentistry, University of Otago, 310 Great King Street, Dunedin, 9016, New Zealand
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Binladen H, Al Halabi M, Kowash M, Al Salami A, Khamis AH, Hussein I. A 24-month retrospective study of preformed metal crowns: the Hall technique versus the conventional preparation method. Eur Arch Paediatr Dent 2021; 22:67-75. [PMID: 32342287 DOI: 10.1007/s40368-020-00528-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 04/15/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE Conventional and Hall Technique (HT) Preformed Metal Crowns (PMCs) are used for treatment of carious primary molars. The aim was to evaluate the clinical and radiographic success of conventional and HT PMCs in a postgraduate dental setting. METHODS A retrospective study using patients' electronic case-notes and radiographic images of carious primary molars treated with either conventional or HT PMCs was conducted to assess clinical and radiographic success/failure. A Kaplan-Meier curve was used to assess PMC survival. RESULTS 187 PMCs (110 HT and 77 conventional) in 65 children (34 females and 31 males) at 6, 12, 18 and 24 months were assessed. At 24 months, the success rates of conventional and HT PMCs were 97.6% and 93.5%, respectively. Two HT (perforated/abscessed) and four conventional (abscessed) PMCs failures occurred. There was no significant difference in success/failure (p = 0.362) at 12 months, but the HT was more successful at 24 months (p = 0.002) with similar survival times for both methods. CONCLUSION HT and conventionally placed PMCs, when placed in a postgraduate paediatric dentistry setting, were clinically and radiographically very successful at 6, 12, 18 and 24 months post operatively with a slightly higher success of the HT at 24 months.
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Affiliation(s)
- H Binladen
- Department of Pediatric Dentistry, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - M Al Halabi
- Department of Pediatric Dentistry, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - M Kowash
- Department of Pediatric Dentistry, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - A Al Salami
- Department of Pediatric Dentistry, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - A H Khamis
- Department of Biostatistics Mohammed, Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - I Hussein
- Department of Pediatric Dentistry, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.
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Crisp J, Mihas P, Sanders AE, Divaris K, Wright JT. Influences on dentists' adoption of nonsurgical caries management techniques: A qualitative study. J Am Dent Assoc 2021; 152:463-470. [PMID: 33461729 DOI: 10.1016/j.adaj.2020.10.001] [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] [Received: 07/09/2020] [Revised: 09/27/2020] [Accepted: 10/04/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Nonsurgical caries management techniques (NSCMT) offer a simple, conservative approach to treating caries. Despite evidence supporting and potential advantages of NSCMT, dentists can be reluctant to adopt these techniques. To better understand this phenomenon, the authors interviewed dentists who primarily treat children regarding their thoughts, attitudes, and adoption of 3 NSCMT. METHODS The 3 NSCMT were fluoride varnish, silver diamine fluoride, and Hall stainless steel crowns. The authors interviewed dentists in North Carolina whose practices were restricted mostly to children. A nonprobabilistic maximum-variation design was used in the sampling. Using a semistructured interview guide, the authors recorded the interviews digitally and analyzed them thematically. The authors stratified the analysis according to years of practice, geographic location, and type of practice. Reporting was based on emerging and recurring themes and insightful quotes. RESULTS Factors most likely to promote the adoption of NSCMT were related to clinical practice, family preference, patient safety, and provider philosophy. Barriers to adoption included previous practitioner negative experiences using the techniques, high-risk caries population, and perceived likelihood of negative outcomes. Characteristics of the practice environment, patient population, communication with families, and financial considerations were influential in the clinician's determination as to whether to use these techniques. CONCLUSIONS These findings provide valuable insight into practitioners' influences, motivations, and clinical decision making in the adoption and use of management and treatment approaches for carious lesions in the pediatric population. PRACTICE IMPLICATIONS The primary factors and barriers identified in this study are possible targets for education and quality improvement programs aimed at increasing NSCMT use.
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Araujo MP, Innes NP, Bonifácio CC, Hesse D, Olegário IC, Mendes FM, Raggio DP. Atraumatic restorative treatment compared to the Hall Technique for occluso-proximal carious lesions in primary molars; 36-month follow-up of a randomised control trial in a school setting. BMC Oral Health 2020; 20:318. [PMID: 33176756 PMCID: PMC7656501 DOI: 10.1186/s12903-020-01298-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 10/26/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Atraumatic Restorative Treatment (ART) and the Hall Technique (HT) are both minimally invasive, non-aerosol generating procedures (non-AGPs). They seem to have never been directly compared, nor has the HT been studied in a non-clinical setting. This study compared the HT and ART restorations placed in a school setting after 36 months. METHODS Children (5-10 yo) who had a primary molar with a dentinal occluso-proximal, cavitated carious lesion were allocated to the ART (selective removal) or HT arms. PRIMARY OUTCOME restoration survival over 36-months (using Kaplan-Meier survival analysis, log rank test, and Cox regression). SECONDARY OUTCOMES (1) occlusal vertical dimension (OVD) (1, 2, 3, 4 weeks) and (2) child self-reported discomfort; (3) treatment acceptability (immediately following interventions); (4) Child Oral Health Related Quality of Life (OHRQoL), before treatment and after 6 months and (5) a post hoc analysis of time to tooth exfoliation (1, 6, 12, 18, 24, 30, 36 months). RESULTS One-hundred and thirty-one children (ART = 65; HT = 66) were included (mean age = 8.1 ± 1.2). At 36 months, 112 (85.5%) children were followed-up. PRIMARY OUTCOME restoration survival rates ART = 32.7% (SE = 0.08; 95% CI 0.17-0.47); HT = 93.4% (0.05; 0.72-0.99), p < 0.001; Secondary outcomes: (1) OVD returned to pre-treatment state within 4 weeks; (2) treatment discomfort was higher for the HT (p = 0.018); (3) over 70% of children and parents showed a high acceptability for treatments, with crown aesthetics being a concern for around 23% of parents; (4) Child OHRQoL improved after 6 months; and (5) teeth treated with the HT exfoliated earlier than those in the ART group (p = 0.007). CONCLUSIONS Both ART and the HT were acceptable to child participants and their parents and all parents thought both restorations protected their child's tooth. However, the crown appearance concerned almost a quarter of parents in the HT arm. Children experienced less discomfort in the ART group. Although both treatments can be performed in a non-clinical setting and have the advantage of being non-aerosol generating procedures (non-AGPs), the HT had almost three times higher survival rates (93.4%) for restoring primary molar occluso-proximal cavities compared to ART (32.7%). TRIAL REGISTRATION This trial was registered in ClinicalTrials.gov (NCT02569047), 5th October 2015. https://clinicaltrials.gov/ct2/show/study/NCT02569047?cond=Hall+Technique+Atraumatic+Rest orative+Treatment&draw=2&rank=2.
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Affiliation(s)
- Mariana Pinheiro Araujo
- Department of Paediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil.,School of Dentistry, University of Dundee, Dundee, Scotland, UK
| | - Nicola Patricia Innes
- School of Dentistry, University of Dundee, Dundee, Scotland, UK. .,School of Dentistry, Cardiff University, Heath Park, Cardiff, CF14 4XY, UK.
| | - Clarissa Calil Bonifácio
- Department of Paediatric Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Daniela Hesse
- Department of Paediatric Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Isabel Cristina Olegário
- Department of Public and Child Dental Health, Dublin Dental University Hospital, Trinity College, Dublin, Ireland, UK
| | - Fausto Medeiros Mendes
- Department of Paediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Daniela Prócida Raggio
- Department of Paediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
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Nair K, Chikkanarasaiah N, Poovani S, Thumati P. Digital occlusal analysis of vertical dimension and maximum intercuspal position after placement of stainless steel crown using hall technique in children. Int J Paediatr Dent 2020; 30:805-815. [PMID: 32248585 DOI: 10.1111/ipd.12647] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/12/2020] [Accepted: 03/25/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND The stainless steel crowns (SSCs) placed using the Hall technique disrupt the occlusion, but stabilization appears to occur within a short period post-placement. Negligible understanding and comprehension is presently handy about the changes in overbite and bite force after placement of stainless steel crown using the Hall technique in children. AIM/HYPOTHESIS To evaluate the digital occlusal analysis of vertical dimension and maximum intercuspal position to understand the changes in overbite and bite force after placement of stainless steel crown using the Hall technique. DESIGN Twenty children who needed treatment for the carious tooth with decay extending to enamel and dentin and multisurface caries were managed using the Hall technique. Following that, overbite measurement for vertical dimension was carried out clinically using digital vernier calipers. Later, the T-Scan III was used for measuring occlusal load at the maximum intercuspal position. The bite force and occlusal premature contacts were digitally analysed and recorded pre-operatively, immediately after placement of SSC and after 1 month follow-up period. RESULTS A significant result in the vertical dimension, bite force on crowned tooth, and significant reduction in the prematurities were seen from baseline to one-month follow-up. CONCLUSION There was an occlusal re-equilibration attained after 1 month.
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Affiliation(s)
- Karthik Nair
- Department of Pedodontics and Preventive Dentistry, Rajarajeswari Detal College and Hospital, Bangalore, Karnataka
| | - Nagarathna Chikkanarasaiah
- Department of Pedodontics and Preventive Dentistry, Rajarajeswari Detal College and Hospital, Bangalore, Karnataka
| | - Swetha Poovani
- Department of Pedodontics and Preventive Dentistry, Rajarajeswari Detal College and Hospital, Bangalore, Karnataka
| | - Prafulla Thumati
- Department of Pedodontics and Preventive Dentistry, Rajarajeswari Detal College and Hospital, Bangalore, Karnataka
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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: 19] [Impact Index Per Article: 4.8] [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.
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