One-year radiographic and clinical performance of bioactive materials in primary molar pulpotomy: A randomized controlled trial.

OBJECTIVES: Mineral Trioxide Aggregate (MTA) is considered the gold standard material for pulpotomy procedures. However, some drawbacks such as poor handling and long setting time are challenging when it is used as pulpotomy dressing in primary molars in children. Hence, the purpose of this study was to compare the radiographic and clinical performance of a premixed, fast setting bioceramic root repair material (BC RRM-F) with MTA in vital pulpotomy procedures of primary molars, with or without the added seal of a stainless steel crown (SSC). METHODS: In this double blinded, four-arm, parallel group randomized contolled trial (RCT), 64 primary molars were randomly allocated to one of the four treatment groups: MTA (PDTM MTA WHITE)+SSC, MTA+GI (bulk fill glass ionomer with glass hybrid technology GC EQUIA Forte® HT), BC RRM-F+GI and BC RRM-F+SCC. All molars were evaluated clinically and radiographically according to the modified Zurn and Seale criteria at 1, 3, 6, and 12 months follow up. Multivariate cox regression models and Kaplan-Meier curves were used for survival analysis. RESULTS: There was no statistically significant difference between the success of both pulp capping materials used. Overall survival analysis showed that using GI instead of SCC as a final restorative material was significantly associated with increased risk of failure. CONCLUSIONS: TotalFill® BC RRM™ Fast Set Putty can be used as an alternative to MTA in primary molar pulpotomy. Regardless of the pulp capping material, one year survival of pulpotomized primary molars restored with SSC is higher compared to those restored with GC EQUIA Forte® HT. CLINICAL SIGNIFICANCE: Clinicians' preference and cost effectiveness may justify the use of either material in primary molar pulpotomy. Parents insisting on tooth-colored restorations for their children's pulpotomized teeth cannot be told that the expectation for success is the same as those restored with SSC, even if calcium silicate-based pulp capping materials are used.

Investigation of the effect of breast milk, probiotic supplemented and plain milk formulas on some oral bacteria in infants: an observational and in-vitro study / Investigação do efeito do leite materno, fórmulas de leite puro e suplementado com probióticos sobre algumas bactérias orais em lactentes: um estudo observacional e in vitro

Objetivo: existem evidências inconclusivas sobre a potencial carogenicidade das fórmulas lácteas em comparação com o leite materno. O estudo teve como objetivo comparar a detecção e contagem de Streptococcus mutans(S. mutans) e lactobacilos da saliva entre lactentes alimentados com leite materno (B), com fórmulas de leite puro (France Lait-FL) e suplementada com probióticos (Nan 1 optipro-N), e avaliar crescimento in vitro dessas bactérias em amostras de leite materno e fórmulas lácteas. Material e Métodos: amostras salivares foram obtidas com swabs de algodão estéreis de 60 lactentes que foram agrupados de acordo com o tipo de leite. As amostras foram cultivadas para obter a frequência de detecção e contagens bacterianas. Para a investigação in vitro, sete amostras de leite materno doado e sete amostras recém-preparadas de ambas as fórmulas lácteas foram inoculadas por ambas as bactérias e então cultivadas para avaliar o crescimento bacteriano. Resultados:lactobacilos foram detectados em todos os lactentes, enquanto não foram encontradas diferenças significativas na detecção de S. mutans entre os grupos. As contagens de ambos os microrganismos na saliva foram menores em (B), enquanto uma diferença insignificante foi encontrada entre (B) e (N). Diferenças significativas foram evidentes nas contagens bacterianas in vitro sendo mais baixas em (B) seguido por (N) e (FL). Conclusão: o leite materno e as fórmulas lácteas com suplementos probióticos podem ter um papel protetor contra a cárie dentária em lactentes. (AU)

Objective: inconclusive evidence exists regarding potential cariogenicity of milk formulas compared to breast milk. The study aimed to compare Salivary Streptococcus mutans (S. mutans) and lactobacilli detection and counts among breastfed (B), plain formula (France Lait 1) (FL) and probiotic supplemented formula (Nan 1 optipro) (N) infants and to assess in-vitro growth of these bacteria in breast milk and milk formula samples. Material and Methods:salivary samples were obtained using sterile cotton swabs from 60 infants that were grouped according to nursing milk type. Samples were cultured to obtain the detection frequency and bacterial counts. For the in-vitro investigation, seven donated breast milk samples and seven freshly prepared samples of both milk formulas were inoculated by both bacteria and then cultured to assess bacterial growth. Results:lactobacilli were detected in all infants, while no significant differences were found in S. mutans detection among groups. Counts of both microorganisms in saliva were lowest in (B) while, insignificant difference was found between (B) and (N). Significant differences were evident in in-vitro bacterial counts being lowest in (B) followed by (N) and (FL). Conclusion: breast milk and probiotic supplement infants' milk formulas may have a protective role against dental caries in infants.(AU)

Assessment of oral health status of children with epilepsy: A retrospective cohort study.

BACKGROUND: Epileptic children are liable to experience oral health problems either due to the disease itself or medications administered to control the condition. AIM: We aimed to investigate caries experience, gingival health and oro-facial traumatic injuries in a sample of epileptic Egyptian children. DESIGN: A retrospective cohort study was conducted from September 2016 to April 2017 using data from medical records in Children Hospital at Ain Shams University. Dental examination was performed for 100 epileptic children and 80 healthy subjects who matched in age, gender, and socio-economic status. Caries experience was measured using the decayed, missing and filled teeth (DMFT or dmft) index and gingival index (GI) of Loe and Sillness was used to determine gingival health status. Oro-facial injuries were assessed using the WHO classification of trauma. Quantitative data were presented as mean, SD, and 95% CI values. Qualitative data were presented as frequencies and percentages and the significance level was set at P ≤ 0.05. RESULTS: The mean ± SD GI for epileptic children was significantly higher (1.16 ± 0.42) than that of healthy children. (1.01 ± 0.11) Healthy subjects had significantly lower mean dmf index scores 2.2 ± 2.6 compared to epileptic subjects where mean dmf scores were 4.1 ± 2.1. No significant difference, however, was detected between the two groups regarding caries experience in permanent dentition or incidence of oro-facial injuries. CONCLUSIONS: Epileptic children are highly burdened with gingival problems and liable to develop dental caries especially in primary dentition. Oral traumatic injuries, however, are not common complications if seizure attacks are well controlled.

Prioritizing the Risk Factors of Severe Early Childhood Caries.

Severe early childhood caries remains the most common chronic disease affecting children. The multifactorial etiology of caries has established a controversy about which risk factors were more significant to its development. Therefore, our study aimed through meticulous statistical analysis to arrange the "well agreed upon" common risk factors in order of significance, to aid the clinician in tailoring an adequate preventive program. The study prioritized or reshuffled the risk factors contributing to severe early childhood caries and placed them in the order of their significance as follows: snacking of sugary food several times a day, increased number of siblings to three or more, night feeding, child self-employed brushing, mother's caries experience, two siblings, on demand feeding, once/day sugary food, sharing utensils, one sibling, male gender, father's education, late first dental visit, brushing time, mother's education, no dental visit, decreased brushing frequency, and no night brushing.

Effect of the addition of chlorhexidine and miswak extract on the clinical performance and antibacterial properties of conventional glass ionomer: an in vivo study.

BACKGROUND: Antibacterial restorations can increase the success rate of minimum invasive dentistry especially in young permanent molars with deep carious lesions as an attempt to preserve maximum dental structure and avoid pulp exposure. Further research is warranted to evaluate different antibacterial agents. OBJECTIVES: This study aimed to evaluate the efficacy of adding chlorhexidine gluconate (CHX) or aqueous miswak (Salvadora persica) extract on the clinical performance and in vivo antibacterial activity of conventional anhydrous glass ionomer cement (GIC). DESIGN: The study was a randomized clinical trial. Sixty young permanent molars, with deep carious lesions in 6- to 9-year-old children were included. After randomization, atraumatic restorative treatment (ART) or stepwise excavation was performed followed by bacterial sampling from the center of the remaining carious dentine in the floor of the pulp. GIC powder was mixed with 0.5% chlorhexidine gluconate liquid in group I; with 100% aqueous miswak in group II; and with deionized water in group III (control). Clinical performance for all groups was assessed at 3, 6, and 9 months. After 9 months, restorations were removed and a second bacterial sample was collected for Streptococcus mutans (S. mutans) quantification and analysis by real-time polymerase chain reaction (PCR) test. RESULTS: Results showed no statistically significant difference in the success rate of the three groups at the 3-month interval. At 6 and 9 months, however, restoration success was 75% then 60% in group I, 100% then 90% in group II, and 95% then 85% in control group. Group II and the control group showed statistically significant higher survival rates than group I. All groups showed reduction in S. mutans counts in underlying dentine, but the percent reduction was significantly higher in group I. (P < 0.001). CONCLUSIONS: The addition of CHX and miswak to GIC showed superior antibacterial properties than conventional GIC, without seriously affecting the clinical performance of the restoration until the 6-month follow-up, but failure significantly increased in terms of marginal defects at 9 months with CHX (group 1).

Screening for celiac disease in children with dental enamel defects.

Background. Dental enamel defects (DEDs) are seen in celiac disease (CD). Aim was to detect frequency of CD among such patients. Methods. This study included 140 children with DED. They were tested for CD. Gluten-free diet (GFD) was instituted for CD patients. A cohort of 720, age and sex-matched, normal children represented a control group. Both groups were evaluated clinically. Serum calcium, phosphorus, alkaline phosphatase, serum IgA, and tissue transglutaminase (tTG) IgG and IgA types were measured. Results. CD was more diagnosed in patients with DEDs (17.86%) compared to controls (0.97%) (P < 0.0001). Majority of nonceliac patients showed grade 1 DED compared to grades 1, 2, and 3 DED in CD. Five children had DED of deciduous teeth and remaining in permanent ones. After 1 year on GFD, DED improved better in CD compared to nonceliac patients. Gastrointestinal symptoms did not vary between celiac and nonceliac DED patients. Lower serum calcium significantly predicted CD in this cohort. Conclusion. CD is more prevalent among children with DED than in the general population. These DEDs might be the only manifestation of CD; therefore, screening for CD is highly recommended among those patients especially in presence of underweight and hypocalcemia.