Developmental Dental Defects in Permanent Teeth Resulting from Trauma in Primary Dentition: A Systematic Review

Early onset of enamel formation in Baka pygmy's deciduous canines

OBJECTIVE

Our aim was to evaluate by enamel microstructure analysis two hypotheses that would explain the early dental eruption in the Bakaparticularity, a shorter crown formation time and/or earlier onset of crown formation.

DESIGN

Deciduous canines corresponds to the best teeth to perform the analysis of enamel microstructure. Longitudinal ground sections of 21 deciduous canines from 12 individuals were studied with transmitted light microscopy. Cross-striations, striaes of Retzius (SR) and the neonatal line (NNL) enable to establish the prenatal crown formation time (preCFT), the postnatal crown formation time (postCFT), the crown formation time (CFT) as well as the daily secretion rate (DSR) and the enamel extension rate (EER) and their variation along crown formation.

RESULTS

The DSR and the EER in the Baka are similar than in other populations with an average DSR of 3.26 µm and EER of 18.18 µm. The preCFT was 154 days, the postCFT 265 days and CFT 419 days. Comparison with other population does not show difference in CFT. However, the preCFT and the postCFT differ, the first is higher and the second lower in the Baka than in other populations. Furthermore, the number of prenatal areas of enamel was greater in the Baka.

CONCLUSION

Our analysis suggests that the Baka does not distinguish by a different CFT but the onset of crown formation is earlier than in other groups. Therefore, the early dental eruption in the Baka results from an earlier onset of crown formation.

Union between deciduous and permanent as intrusive luxation sequelae: A case report

Traumatic dental injuries (TDI) are common in children due learning to walk and lack of balance that leads to falls. Luxation is the trauma that occurs most frequently in the deciduous, being that the intrusive and the avulsive are the ones that cause more damage to the permanent successors. The potential to cause disturbances to the developing permanent germ is high due to anatomical proximity and depends on age, direction of intrusion, severity and treatment. The consequences to the permanent range from hypocalcifications of enamel to retention of the permanent germ. In this case, the developmental disturbance of the tooth 21 presenting with acute dentoalveolar abscess was a result of a three-degree intrusive luxation of the deciduous predecessor. The tooth 61 was misdiagnosed initially as avulsion, but it was a total intrusion as uncovered after a radiographic examination that showed an image suggestive of the presence of the deciduous tooth. The deciduous was extracted along with his permanent successor through outpatient procedure under antibiotic coverage and local anesthesia. The macro and microscopic analysis of the piece evidenced the presence of elements 21 and 61 closely united, as well as alterations provoked in both. There was remission of the infectious process and after 7 days it was verified the correct healing of the surgical wound. The radical outcome of this case emphasizes the relevance of appropriate clinical support as soon as possible in all TDI.

Developmental Disturbance in Premolars After Intraligamental Anesthesia Using Computer-Controlled Local Anesthesia Delivery System: An-Eight-Years Follow-Up Study in Children

Aim This study aimed to evaluate the prevalence of developmental disturbances in permanent second premolars in which their tooth buds were exposed to mandibular intraligamental anesthesia (ILA) using a computer-controlled local anesthetic delivery system (CCLAD). Materials and methods This was a longitudinal follow-up study conducted in a previous randomized clinical trial (RCT). In the previous RCT, a total of 91 children were included (61 control and 30 cases). A structured form was created that contained details about the date of birth, age, and sex at which the participants received local anesthesia and the type of local anesthesia administered (ILA using CCLADS, traditional inferior alveolar nerve block [IANB], and IANB using CCLADS). A history of post-treatment abscess, retreatment, and post-treatment extraction was documented in both groups. Descriptive statistics, including frequency and percentage, and additionally, the chi-square test and Fisher's exact test were used to compare ILA and IANB. Results Forty of the 91 children attended follow-up visits. Only two children had developmental defects: one child who received traditional IANB had a demarcated white opacity (this patient had a history of dental abscess), and another who received ILA using CCLADS showed hypoplasia on his permanent premolar. No significant association was found between the type of anesthesia and the presence of developmental defects. Conclusion The slow administration of ILA delivered by CCLADS in the primary teeth does not increase the chances of developmental disturbances or damage to the corresponding permanent tooth bud.

A two-year retrospective study on traumatic dental injury in the primary dentition

The aim of this study was to analyze the causes, clinical characteristics, social factors, and current status of treatment of traumatic dental injury (TDI) in the primary dentition. A retrospective analysis was performed on 144 children (213 teeth) with TDI in the primary dentition from our hospital between December 2017 and June 2020. Data were analyzed using the chi-square test and the Mann-Withney-Wilcoxon test. Boys accounted for 68.1% (98/144) and girls for 31.9% (46/144) of all 144 children with TDI in the primary dentition, with a boy-girl ratio of 2.13:1. The primary age of TDI in deciduous teeth was 2 to 4 years old, accounting for 59% of all cases. Collision with others and fall were the 2 main causes of trauma to the deciduous teeth, making up 52.1% and 44.4% of all causes, respectively. Crown fracture injury was the most common type of TDI in the primary dentition, accounting for 37% of all cases (53/144). Of the 144 cases, 17.4% (25/144) was accompanied by soft tissue laceration, while 22.2% (32/144) by swelling or contusion of tissue. Maxillary teeth (92.4%) were more vulnerable to injury than mandibular teeth (7.5%), with maxillary incisor being the most vulnerable 1 (91.5%). The percentage of children arrived at the hospital for treatment 24 hours after the injury was the highest (57.0%, 82/144). After the hospital visit, 74.3% of children received treatment for the dental trauma. In terms of the treatment modalities, extraction of the traumatized teeth (27.1%) and pulpectomy + resin filling (or preformed crown) restoration were predominant. Approximately 28.5% (41/144) of cases were reviewed within 2 years, with the proportion of children with pulpitis or periapical infection being the highest (29.3%, 12/41). Age, gender, collision, and fall are the factors linked to a higher risk of TDI in the primary dentition in children under the age of 7. Resin filling (or preformed crown) restoration and pulpectomy are effective in preserving the affected tooth and controlling infection. However, the preservation of the affected tooth and the prevention of infection may be hampered by late visits and low follow-up rates.

Mechanical and Biological Properties of Titanium and Its Alloys for Oral Implant with Preparation Techniques: A Review

Dental implants have revolutionised restorative dentistry, offering patients a natural-looking and durable solution to replace missing or severely damaged teeth. Titanium and its alloys have emerged as the gold standard among the various materials available due to their exceptional properties. One of the critical advantages of titanium and its alloys is their remarkable biocompatibility which ensures minimal adverse reactions within the human body. Furthermore, they exhibit outstanding corrosion resistance ensuring the longevity of the implant. Their mechanical properties, including hardness, tensile strength, yield strength, and fatigue strength, align perfectly with the demanding requirements of dental implants, guaranteeing the restoration's functionality and durability. This narrative review aims to provide a comprehensive understanding of the manufacturing techniques employed for titanium and its alloy dental implants while shedding light on their intrinsic properties. It also presents crucial proof-of-concept examples, offering tangible evidence of these materials' effectiveness in clinical applications. However, despite their numerous advantages, certain limitations still exist necessitating ongoing research and development efforts. This review will briefly touch upon these restrictions and explore the evolving trends likely to shape the future of titanium and its alloy dental implants.

Critical appraisal of the 2020 IADT Guidelines: A personal commentary

The 2020 International Association of Dental Traumatology (IADT) Guidelines feature several important changes in the treatment recommendations for traumatic dental injuries (TDIs) from the previous 2012 iteration of these Guidelines. This evidence-based narrative review aims to provide a detailed appraisal of five specific changes incorporated in the 2020 IADT Guidelines, based on the available literature evidence that may have prompted these changes. The paper discusses three excellent additions/changes to the new Guidelines: (i) inclusion of a core outcome set for reporting TDIs; (ii) more conservative management of primary dentition TDIs including the changed recommendations for radiation exposure and managing primary dentition luxation injuries; and (iii) the changes in the treatment recommendations for permanent dentition avulsion injuries. The paper further debates whether two other changes made in the current IADT Guidelines for-(i) intrusion injuries in immature teeth; and (ii) complicated crown-root fractures in mature teeth-have sufficient evidence to support the changed recommendations.

Children's Oral Health Status Among Urban and Rural Areas of Qassim Region, Saudi Arabia: A Cross-Sectional Study

BACKGROUND

 Dental caries is a disease that is quite common in children and has a negative impact on their oral health, mental health, and quality of life. This study aimed to collect and correlate information about oral health awareness, oral health status, and oral hygiene practices in the urban and rural areas of Saudi Arabia.  Methods: The cross-sectional study was carried out among three dental clusters of Qassim from November 2022 to April 2023 in 12 schools on seven- to 12-year-old children. Data collection was done using the WHO Oral Health Questionnaire for Children.

RESULTS

 The current investigation included 700 children, 360 males and 340 females. Both urban and rural parents were more educated. Most children in rural areas reported excellent gum health than in urban areas (48.2% and 41.3%, respectively). Pain was the most common cause of visiting the dentist in rural more than in urban areas (55.7% and 54.5%, respectively). A significantly higher frequency of sugar consumption was reported for rural children.

CONCLUSION

 Most rural and urban children take care of their teeth. The vast majority of them use a toothbrush and toothpaste to clean their teeth. However, the dental visit was not regular and only related to the toothache. They need more oral health education and promotion programs to improve the knowledge of oral health behavior in the Qassim region and the rest of Saudi Arabia.

Long-Term Sequalae of Undiagnosed Intrusion of a Primary Tooth

Aims: This case demonstrates the adverse sequelae that can follow a traumatic dental injury at a young age. It also highlights the importance of taking a full history and undertaking a thorough exam, independent of the information in the referral. Case presentation: A 9-year-old boy was referred for treatment of “an extra tooth” and “hypoplastic and non-vital” maxillary left permanent incisors. Examination revealed a sinus tract labial to these incisors (21,22) with increased probing depth. However, the teeth were otherwise normal. The child sustained a fall as a baby and lost one of his primary teeth that was never recovered. Information collected suggested the most likely diagnosis was an undiagnosed complete intrusion of a primary incisor, with subsequent hypoplasia and malalignment in the developing teeth. Management included the removal of the intruded primary tooth and monitoring of the hypoplastic permanent incisors until complete eruption and root maturation. Aesthetic restorations were then provided. The patient was referred for orthodontic correction of the malalignment. Conclusion: Misdiagnosis and inappropriate management of dental trauma can cause additional damage. In this case, endodontic therapy in the permanent incisors was avoided by correct diagnosis. Clinicians have to correctly assess and justify their decisions on each individual case.

Investigation of the Effect of Oral Implant Surgery on Clinical Treatment and Oral Function of Patients with Dentition Loss

In order to investigate the effect of oral implant surgery on clinical treatment and oral function of patients with dentition loss, a total of 118 patients with dentition loss in the Department of Stomatology of our hospital from January 2019 to January 2022 are retrospectively analyzed. They are randomly divided into the conventional group and the implant group. The conventional group is treated with conventional dentition restoration, and the implant group is treated with oral implant restoration. The repair efficiency of the two groups is compared. The swallowing function of the 2 groups is assessed by Standard Swallowing Assessment (SSA) table before and after treatment. Self-rating depression scale (SDS) and self-rating anxiety scale (SAS) are used to compare the negative emotions of the two groups before and after treatment. Experimental results show that the total effective rate of the implant group is significantly higher than that of the conventional group, but no invalid cases occurred in the two groups after treatment.