Partial pulpotomy on caries-free teeth using enamel matrix derivative or calcium hydroxide: a randomized controlled trial.

AIM: To compare the effect of enamel matrix derivative (EMD) and calcium hydroxide [Ca(OH)(2)] on exposed human pulp. METHODOLOGY: Fifteen pairs of human contralateral premolars were intentionally and partially pulpotomized. The exposed pulps were randomly capped with either EMDgel (Emdogain) or a mix of Ca(OH)(2) and sterile water. The subjects recorded pain or discomfort during the first 10 days and were also interviewed and examined by a blinded examiner at 1 day, 2 weeks, 3 and 6 months post-operation. Periapical radiographs were taken prior to the operation, and 3 and 6 months post-operation. After 6 months, the teeth were extracted and processed for histological evaluation. The data were described and analysed using McNemar test and Kaplan-Meier survival analysis. RESULTS: The EMDgel-treated teeth had significantly less tooth hypersensitivity than the Ca(OH)(2)-treated teeth during the first 2 weeks (P = 0.031) but were not significantly different after 2 weeks (P = 0.125). No detectable periapical radiographic changes were observed in any teeth and radiographic evidence of dentine bridge formation from both groups were not significantly different during the follow-up periods (P > 0.05). Histological evaluation demonstrated that the Ca(OH)(2)-treated teeth had less inflammation and more dentine bridge formation than those in the EMDgel-treated teeth. CONCLUSIONS: After 6 months, healthy pulps capped with Ca(OH)(2) had more favourable results than counterparts capped with EMDgel. However, similar clinical and radiographic results were seen in both groups.

Risks for early childhood caries analyzed by negative binomial models.

Because of the high incidence of early childhood caries (ECC), a longitudinal study to identify risk factors from the prenatal period to the child's first birthday among 9- to 18-month-old children was conducted with negative binomial modeling. Overall, 495 children had dental examinations at ages 9, 12, and 18 months. Mothers were interviewed during the 2nd trimester of pregnancy and when the children had dental examinations. The highest incidence of caries was found among children who were born to mothers with >or= 10 decayed teeth and who never received calcium supplements during pregnancy, and children who were not fed supplementary foods at age 3 months, had sweet-tasting foods at 5 months, started snacking at 5 months, had sugary snacks, had soft drinks, and did not have their teeth brushed daily at 9 months. Thus, prenatal care and child-rearing-practices during and after birth are important risk factors for the incidence and incremental rate of ECC.

Longitudinal study of the presence of mutans streptococci and lactobacilli in relation to dental caries development in 3-24 month old Thai children.

OBJECTIVE: To study the acquisition of mutans streptococci (MS) and lactobacilli in relation to dental caries development in 3-24 month old Thai children. METHODS: Salivary samples were collected from 169 children using sterile wooden tongue depressors at the ages of 3, 9, 12, 18 and 24 months. The blades were pressed onto selective media for MS or lactobacilli. After incubation, the colony forming units of MS/lactobacilli were counted. Dental status was recorded from 9 months old using modified WHO criteria. RESULTS: The number of children with caries and number and severity of decayed teeth significantly increased with age. The presence of MS/lactobacilli was detectable at an early age and the cumulative prevalence of MS/lactobacilli increased with age. Children who were colonised early by MS or lactobacilli showed a higher number of decayed teeth than of those who were colonised later. The children with no MS/lactobacilli had significantly fewer decayed teeth and there was a significant correlation between MS/lactobacilli level and tooth decay. CONCLUSIONS: This longitudinal study shows early colonisation of the mouths of Thai children by MS/lactobacilli and where there are persistently high levels of the bacterias increased risk of development of dental caries.