Relationship between Physiological Resorption of Primary Molars with Its Permanent Successors, Dental Age and Chronological Age.

The aim of the present study was to analyse root resorption of the primary mandibular molars and their relationship with their permanent successors and the age of the patient. METHODS: The sample consisted of 408 digital panoramic radiographs. The mesial and distal crown-to-root ratios (CRR) of #74 and #75 were calculated by dividing the measures of the length of each root by its coronal height. The Demirjian formation stage of the premolar was established, and dental age was determined. A descriptive and statistical analysis was performed using SPSS to determine the correlation between the variables (Pearson's correlation coefficient) and to identify the differences between them (Student's t-test), with a confidence level of 95%. RESULTS: 723 molars were measured, and tables of CRR depending on dental and chronological age were obtained. The CRR decreased with increasing dental and chronological age, but not uniformly. The CRR of #74 and #75 decreased slightly when the successor premolar was in the initial stages of formation. Gender differences were obtained with respect to chronological age, mainly in girls, because the root resorption of #74 was always more advanced, and the formation of the #34 more advanced. CONCLUSIONS: Root resorption of the molar is slight and progressive when the successor premolar begins formation until stage D, and becomes higher starting at stage E. It is possible to determine the state of the child's maturation and the CRR according to dental and chronological age.

Clinical study of Mineral Trioxide Aggregate in primary molars. Comparison between Grey and White MTA--a long term follow-up (84 months).

OBJECTIVES: The aim of the present study was to conduct a clinical and radiographic long-term evaluation of pulpotomy in temporary molars performed with Grey and White Mineral Trioxide Aggregate (MTA) and compare the results of Grey and White MTA pulpotomies in a sample of 233 primary molars with a maximum follow-up period of 84 months. METHODS: The sample was selected from patients treated at the Department of Pediatric Dentistry, Faculty of Dentistry, Complutense University of Madrid, Spain. This prospective study included first and second primary molars treated with pulpotomy with Grey or White MTA, controlled for a maximum follow-up period of 84 months. Statistical analysis of clinical and radiographic findings was completed using ANOVA (P<0.05). RESULTS: Follow-up evaluations, performed every 6 months, revealed that only 2 molars treated with White MTA presented abscess and pathological mobility. Radiographic examination of the 210 molars revealed unfavourable pulp response in only 6 molars (internal or furcation root resorption), without statistically significant differences between Grey and White MTA. Two radiological findings were noticed: dentine bridge formation and partial or total root canal stenosis. Grey MTA induced a higher percentage of dentine bridges with statistically significant differences (P<0.05), and a higher percentage of pulp canal stenosis, without a statistically significant difference. CONCLUSIONS: Grey and White MTA presented high levels of clinical and radiographic success. Although the present study showed evidence of a very good biologic response with both types of MTA, Grey MTA showed significantly higher number of dentine bridge formation than White MTA.

A clinical study of caries diagnosis with a laser fluorescence system.

BACKGROUND: The authors conducted an in vivo study to compare a laser fluorescence system with a visual system for occlusal caries diagnosis in children's primary and permanent molars. METHODS: The authors selected for evaluation 320 untreated, cavity-free primary and permanent molars in healthy children aged 6 through 14 years. Two of the authors conducted the laser fluorescence evaluation. Another of the authors completed the clinical evaluation. The kappa value was 0.68. The authors compared sensitivity, specificity, predictive values, odds ratio and receiver operating characteristic (ROC) curves for the laser fluorescence system. RESULTS: For the whole sample, the sensitivity and specificity of the laser fluorescence system were 0.79 and 0.87, respectively. The positive and negative odds ratios for the whole sample were 6.33 and 0.23. The positive and negative predictive values for the whole sample were 33.9 percent and 98.1 percent. The value of the area beneath the ROC curve (AUC) was 0.92 for the whole sample. CONCLUSIONS: The laser fluorescence system was more precise than visual evaluation in identifying lesions without cavities and healthy surfaces in primary and permanent molars. CLINICAL IMPLICATIONS: In daily practice, dentists can consider the laser fluorescence system a complementary tool in the visual exploration of occlusal surfaces of primary molars and permanent first molars.

Mineral trioxide aggregate as pulp dressing agent in pulpotomy treatment of primary molars: 42-month clinical study.

PURPOSE: To evaluate the long-term clinical and radiographical results of using gray mineral trioxide aggregate (MTA) in pulpotomy treatments in primary molars. METHODS: A total of 69 primary molars were treated with pulpotomy procedures using MTA and follow-up every 6 months up to 42 months. RESULTS: Clinical success was 100% as none of the molars showed clinical pathologic signs; radiographical success was 98.5% as one case of internal resorption was recorded. Reparative dentin deposition was found as stenosis of the pulp canals in 84% of the cases 42 months after treatment and as dentin bridge formation in 83% of the cases 42 months after treatment. Moreover, 11 permanent successors erupted at their normal exfoliation time without pathology after pulpotomy treatment with gray MTA of the primary molars.

Self-injurious behavior in a patient with mental retardation: review of the literature and a case report.

Self-injurious behavior is deliberate harm to the body that may lead to factitious oral injuries. Management of patients with self-inflicted injury continues to be a challenge for the dental profession. The purpose of this article is to review clinical findings in a patient who presented with severe, painful gingival recession in the primary dentition. A case report of an 8-year-old girl with mental retardation is presented. The periodontal examination showed bilateral gingival recession of the mandibular canines and the mandibular first and second molars so severe that it was possible to clinically observe the exposed roots. The diagnosis of self-inflicted gingival lesions and self-injurious behavior was established. Although the lesions are no longer present, the self-injurious behavior persists. Psychologic support was suggested, and an oral removable appliance was fitted.

Free-end space maintainers: design, utilization and advantages.

Primary molars are a determining factor in the development of occlusion. Given their importance, when restorative treatment is notfeasible and a primary molar must be extracted, the practitioner should keep in mind the risk of losing space, and the consequent malocclusion. Preservation of the space can eliminate or reduce the needforprolonged orthodontic treatment. For that reason, there are various kinds of space maintainers and the pediatric dentist must decide which one to utilize, on the basis of general and local factors related to the child In the selection of a treatment option for space maintenance, the greatest complications occur when the first permanent molar has not yet erupted A large variety of appliances have been devised to deal with this situation. This article proposes the use of a removable space maintainer that is open on one end and can be employed to guide the first permanent molar, maintaining the integrity of the mucous membrane and serving as a prosthetic appliance, preventing the complications and contraindications often caused by sub-gingival maintainers.

An atypical lingual lesion resulting from the unhealthy habit of sucking the lower lip: clinical case study.

Unhealthy oral habits may be involved in the etiology of a malocclusion, since they may affect development of the orofacial region. There is little information on the habit of sucking the lower lip, to which practitioners attribute less clinical consequences. However, lower lip sucking is a harmful habit which appears frequently in children, especially during situations requiring increased attention and mental concentration. In patients presenting lower lip sucking, strong contractions of the lower lip's orbicular's muscle and the mentalis muscle, associated with hypertonicity of the upper lip caused by sucking, has to be balanced by lingual thrusting during the act of deglutition. A case is presented in which failure to identify the habit of lower lip sucking led to an atypical lesion on the tongue, caused by the tongue's impaction against the orthodontic appliance prescribed to correct a malocclusion. The recognition and elimination of an unhealthy habit is of great importance in diagnosis and the establishment of a treatment plan, so that undesirable complications can be avoided.

Severe trauma in the primary dentition--diagnosis and treatment of sequelae in permanent dentition.

A 2-year 6-month male presented after an intrusive injury sustained at 15 months of age. Intra-oral radiographs showed coronal dilaceration of the germ of the permanent central incisor and the presence of a calcified tissue mass in the area of the trauma which was identified after surgical removal as the permanent upper left lateral incisor. Immediate treatment and long-term options are discussed.

Dentin bridge formation after white mineral trioxide aggregate (white MTA) pulpotomies in primary molars.

PURPOSE: To evaluate, clinically and radiographically, the dentin bridge formation potential of white mineral trioxide aggregate (white MTA) when used in pulpotomy treatments in primary molars. METHODS: A total of 23 primary molars received a pulpotomy treatment using white MTA followed by stainless steel crown restoration and controlled 6 months after treatment. RESULTS: Clinical and radiographic success was 100% as none of the molars showed any clinical or radiographic pathological signs. Reparative dentin deposition was found in some of the cases: stenosis was present in 69.2% of the pulp canals from mandibular molars and formation of dentin bridges was seen in 11.5% of the pulp canals from mandibular molars 6 months after treatment with white MTA.

Displacement and pulpal involvement of a maxillary incisor associated with a talon cusp: report of a case.

The talon cusp is a relatively uncommon dental anomaly manifested as an accessory cusp-like structure on the crown of anterior teeth. The presence of a talon cusp can cause clinical problems. This article reports the case of a patient presenting a talon cusp affecting the permanent maxillary right central incisor causing clinical problems related to caries, displacement of the tooth, occlusal position and tendency to dental traumatism. The management of this tooth included caries removal and reduction of the cusp. Pulp-capping with calcium hydroxide was required because of the presence of pulp horn extensions in the talon cusp.

Dentin bridge formation after mineral trioxide aggregate (MTA) pulpotomies in primary teeth.

PURPOSE: To evaluate the results of using mineral trioxide aggregate (MTA) in pulpotomy procedures in primary teeth. METHODS: Seven patients were selected and a total of 20 molars and two canines were treated with pulpotomy procedures using MTA instead of formocresol. RESULTS: After 6 months, 55% of the molars and 100% of the canines treated showed radiographic signs of dentin bridge formation. Also, 6 months after treatment, 60% of the molars showed root canal calcification (obliteration). Color change of the crown of the canines treated was noticeable. No clinical or radiographic signs of pathology was observed.

Treatment of a non-vital immature incisor with mineral trioxide aggregate (MTA).

- A case of severe crown fracture and luxation in the upper permanent incisors of a 9-year-old boy is reported. The treatment of one of the injured teeth included apexification with calcium hydroxide and endodontic treatment with gutta-percha obturation. The other incisor was also treated with calcium hydroxide, but as there was no apical stop after 3 years of treatment, it was decided to use a new root-end filling material: mineral trioxide aggregate (MTA). At follow-up 12 months later, the tooth was asymptomatic and radiographically showed the initial repair of the radiolucent apical lesion.