Lack of Correlation Between the Penetration of Two Types of Sealers and Interfacial Adaptation to Root Dentine.

OBJECTIVE: This study aimed to determine the correlation between sealer penetration into dentinal tubules and interfacial adaptation to root canal walls using a hydraulic calcium silicate-based sealer, Endosequence Bioceramic Sealer (Brasseler USA, Savannah, GA, USA), and an epoxy resin-based sealer, AH Plus (Dentsply DeTrey, Konstanz, Germany). METHODS: Sixty-four maxillary central incisors were endodontically prepared with nickel-titanium rotary instruments and randomly assigned into two groups (n=32). Roots were filled with gutta-percha using a single-cone technique in conjunction with one of the two sealers, AHP or BCS. Sealers were mixed with Rhodamine B and analysed under a confocal laser scanning microscope. Transverse sections at 5 mm from root apex were obtained. The circumference of the root canal wall was first outlined and measured to determine the circumferential percentage of sealer penetration. The regions along the canal walls where the sealer had penetrated the dentinal tubules were delineated and measured. Then, the outlined distances were divided by the canal circumference. The width of each gap was measured and pooled for each specimen for comparison to determine the interfacial adaptation. The measurements were repeated twice to ensure reproducibility. Mann-Whitney tests were performed to compare continuous variables between AHP and BCS groups. The correlation between gap width and percentage of sealer penetration was investigated using the Spearman correlation coefficient. RESULTS: No significant difference was observed between groups regarding the percentage of sealer penetration (P>0.05) and the gap width (P>0.05). Also, there was no significant correlation between the two variables analysed for AHP (r=0.165; P>0.05) and BCS (r=-0.147; P>0.05) and in the overall sample (r=0.061; P>0.05). CONCLUSION: The present results show no correlation between interfacial adaptation and sealer penetration in dentinal tubules in the total sample and among sealer subgroups. The ability of root canal sealers to penetrate dentinal tubules cannot be considered a sign of better interfacial adaptation.

Prevalence of Hypodontia and Supernumerary Teeth in Patients Attending Private Pediatric Dental Clinic in Lebanon.

Purpose: Because of the high rate of agenesis and supernumerary teeth in orthodontic patients and the lack of studies in Lebanon that document the prevalence of those anomalies, the aim of this study was to determine the prevalence of hypodontia and supernumerary teeth in patients attending a pediatric dental office and examine the associated factors. Study design: This was a cross-sectional design study. The patients were clinically examined followed by panoramic radiograph. Two calibrated investigators have examined the radiographic films and diagnosed the dental anomalies. Tooth agenesis and supernumerary teeth were the outcome variables of the study. Tooth agenesis was diagnosed when there were no sign of crown calcification and no evidence or history of loss attributable to orthodontic treatment, caries, periodontal problems and dental trauma. Tooth agenesis and supernumerary teeth were the outcome variables of the study. Chi-Square tests and Fisher Exact tests were performed to assess the association between outcome variables, gender and presence of medical problem. Results: 334 participants (mean age 7.31±2.17 years) were included in the study. The presence of dental anomalies was not reported as a reason for dental visits. The rate of tooth agenesis was 8.7% in the whole sample, 9.9% among boys and 7.6% among girls with no difference (p=0.442). The rate of tooth agenesis was elevated in participant with medical problems (14.5%) compared to those with no medical problem (7.0%) (p=0.041). The rate of supernumerary teeth was 0.6% among boys and 0% among girls (p=0.485). Conclusion: Oral anomalies could be detected relatively at early age. It can help in a long-term and effective treatment planning. Early diagnosis and appropriate follow-up with panoramic radiograph is extremely important to avoid maxillofacial deformity and other complications.

Lesión quística en un premolar superior relacionada con un molar primario pulpotomizado / Lesão cística num pré-molar superior relacionada com um molar decíduo pulpotomizado / Cystic lesion on an upper premolar related to pulpotomized primary molar

La pulpotomía es un tratamiento endodóncico frecuentemente realizado en niños. A pesar de que se trata de un procedimiento seguro, se han reportado efectos secundarios. Caso clínico: Un niño de 10 años de edad llegó para revisión dental. Los resultados de los rayos X mostraron una lesión radiolúcida por encima del segundo molar primario superior izquierdo, relacionada con el diente permanente. La extracción de los primeros y segundos molares primarios se realizó bajo anestesia local. La lesión quística se eliminó quirúrgicamente, y el análisis histopatológico mostró un quiste dentígero inflamatorio. Una cavidad casomarsupialización fue creada para permitir la erupción de los premolares. Después de un año de seguimiento, el hueso se había regenerado totalmente y los premolares habían erupcionado completamente. Conclusión: Este caso resalta la necesidad de una supervisión regular de los dientes pulpotomizados, incluso si están asintomáticos, además de la fase de erupción de los dientes permanentes y primarios. La marsupialización del quiste dentígero permitió el tratamiento eficaz y la preservación del premolar involucrado.

A pulpotomia é um tratamento endodôntico frequentemente realizado em crianças. Ainda que seja um procedimento seguro, efeitos colaterais foram reportados. Relato de caso: Um menino de 10 anos veio para um check-up dentário. Os resultados da radiografia mostraram uma lesão radiolúcida acima do segundo molar superior esquerdo, relacionada com o dente permanente. A extração dos primeiros e segundos molares decíduos foi realizada sob anestesia local. A lesão cística foi removida cirurgicamente e a análise histopatológica revelou um cisto dentígero inflamado. Uma cavidade marsupialização foi criada para permitir a erupção dos pré-molares. Depois de um ano de acompanhamento, o osso encontrava-se completamente regenerado e os pré-molares tinham erupcionado completamente. Conclusão: Este relato de caso destaca a necessidade de uma supervisão regular dos dentes pulpotomizados, mesmo se estes são assintomáticos, tal como acontece na fase de erupção dos dentes permanentes e decíduos. A marsupialização do cisto dentígero proporcionou um tratamento eficaz e permitiu a preservação do pré-molar envolvido.

Pulpotomy is a frequent endodontic treatment performed in children. Even though it is a safe procedure, side effects have been reported. Case Report: A 10-year-old boy came for a dental checkup. X-ray findings showed a radiolucent lesion above the maxillary second deciduous left molar, related to the permanent tooth. Extraction of the first and second deciduous molars was realized under local anesthesia. The cystic lesion was removed surgically, and histo-pathological analysis showed an inflammatory dentigerous cyst. A marsupialization cavity was created to allow eruption of the premolars. After a one-year follow-up, the bone had completely regenerated, and premolars had completely erupted. Conclusion: This case report highlights the need for regular supervision of pulp treated teeth, even if they are asymptomatic, as well as eruption phase of permanent and deciduous teeth. Marsupialization of the dentigerous cyst provided effective treatment and allowed preservation of the involved premolar.

AGE AND REASONS OF THE FIRST DENTAL VISIT OF CHILDREN IN LEBANON.

BACKGROUND: The American Academy of Pediatrics and the American Academy of Pediatric Dentistry have recommended that the child's first dental visit should be during the child's first year of life for dental disease prevention and to decrease the invasive restorative interventions. In Lebanon, no study has been conducted to determine the age and the reasons of the first dental visit of children and who requested the first dental screening. OBJECTIVES: To assess at what age occurred the first dental visit in a group of Lebanese children visiting a private pediatric dental clinic and to explore the reasons for their first dental consultation. MATERIALS AND METHODS: An observational cross-sectional study was conducted. During a five-year period, all children visiting the pediatric clinic were invited to participate in the study. Parents were asked about the general health status of their child, the use of antibiotics before the age of 2 years. Parents were also requested to give the dental reasons for their initial visit to a pedodontist. RESULTS: Two hundred and twenty children (mean age 4.24 ± 1.35 years) visited the pedodontic care office for the first time and were included in the study. All participants had visited a pediatrician before the age of 1 year. Fifty-seven (25.9%) children were referred by a dentist and 163 (74.1%) came with their parents without referral. All participants had at least one reason for the first consultation; the most common were the presence of decayed teeth (50.9%) and a dental pain perception (29.5%). CONCLUSION: All participants had visited a pediatrician at an earlier age but none was referred to a pedodontist by a pediatrician for check-up or prevention. Children came upon the decision of their parents. A dental problem was the major reason which triggered the first visit. Therefore, pediatricians in Lebanon need to keep themselves updated on recommendations regarding children oral health and be encouraged to play an important role in prompting oral health and first dental visits.

Impact of breast vs. formula feeding mode on primary teeth lead level. Retrospective clinical study and literature review.

UNLABELLED: Lead exposure is a global environmental problem inducing lifelong adverse health effects. Children's exposure to lead, from birth to 6 months, is typically dominated by dietary sources. The first primary mandibular molar could provide an integrated record of lead exposure. The aim of this study is to detect the level of lead in the first primary molar of a group of Lebanese children born between 1990 and 2000, living in Beirut and suburbs, and to compare the amount of lead according to gender and feeding mode. MATERIALS AND METHODS: A group of 53 first primary molars belonging to 53 Lebanese children (31 girls and 22 boys), and aged 9 to 12 years old, were included in the study. The primary outcome variable of the study was the amount of lead level (mg/kg) in the first primary mandibular molars taken at the time of the natural exfoliation and measured by ICP/MS (Inductively Coupled Plasma Mass Spectrometry). Children included in the study were fed exclusively with formula feeding or maternal feeding for six months. RESULTS: The mean lead level of the first primary molar was 0.678 mg/kg +/- 0.717. The mean lead was significantly higher among children fed with instant formula milk (0.876 +/- 0.802) than breastfed children (0.455 +/- 0.540), (p = 0.044). No significant difference was found between girls (0.595 < or = 0.548) and boys (0.794 +/- 0.905), (p = 0.440). CONCLUSION: Within the limitations of this study, we found a statistically significant difference in the teeth lead level between breastfeeding and formula feeding, in favor of breastfeeding. This difference proves once more the importance of breastfeeding ; on the other hand, the Lebanese children accumulated lead in their teeth to levels below the international levels.

Two-year clinical evaluation of three restorative materials in primary molars.

UNLABELLED: A variety of alternatives to amalgam are now available for use in Class I and Class II restorations in primary teeth, including glass ionomer cements, compomers and resin modified glass ionomer cements (RMGIC). OBJECTIVES: This study evaluated the two-year clinical performance of three restorative dental materials: A resin modified glass ionomer cement (Fuji IILC), a compomer (Dyract AP) and a high viscosity glass ionomer cement (Fuji IX), in primary molars of pediatric patients with high caries risk activity and compared these results to those reported for amalgam restorations. STUDY DESIGN: One hundred and forty nine Class I and Class II cavities in 45 patients aged 6 to 8 years were restored with compomer, glass ionomer cements and amalgam. Restorations were evaluated according to modified Ryge criteria by two examiners at baseline, and after 6, 12, 18 and 24 months of oral function. The data was submitted to statistical analysis (binomial and hyper geometric tests, p<0.05). RESULTS: Two-year recall rate was 62.42%. Class I performed better than class II restorations. The difference in marginal discoloration between compomer and amalgam restorations was statistically significant (p=0.014). No other significant differences were found between GIC, compomer and amalgam restorations. The clinical performance of the three restorative materials compared to amalgam in Class I and Class II cavities at two-year recall was acceptable. CONCLUSIONS: The results, even in a population with high caries risk activity, suggest that these materials are suitable alternatives to amalgam in Class I and Class II restorations in primary teeth.

Clinical success of compomer and amalgam restorations in primary molars. Follow up in 36 months.

The purpose of this study was to evaluate the three-year clinical performance of a compomer and an amalgam in primary molars and to determine fluoride content in the enamel of these teeth after exfoliation. Twenty patients aged six to eight years randomly received one compomer and one amalgam restoration. Restorations were evaluated at baseline, 12, 24 and 36 months according to modified USPHS criteria. In six pairs of exfoliated teeth fluoride content at 1 and 5 mm distance from the restorations was determined. Replicas were made to determine marginal adaptation (MA) by scanning electron microscopy (SEM). At occlusal margins compomer restorations had better MA than amalgam restorations (p < 0.01). Compomer and amalgam restorations did not lead to different fluoride uptake in adjacent enamel and had an overall clinically satisfactory performance. The study confirmed that the assessed compomer is a suitable restorative material for class I and class II restorations in primary molar teeth.

Clinical evaluation of four different dental restorative materials: one-year results.

The purpose of the present study conducted in a school in Lebanon was to evaluate the one-year clinical performance of a polyacid-modified resin composite (PMC), a resin-modified glass ionomer cement (RMGIC), a high viscosity GIC (HVGIC) and an amalgam (Amlg). Hundred and forty-nine class I and class II cavities in 45 patients aged 6 to 8 years, with a high caries risk activity, were restored with these materials. Restorations were evaluated by two examiners at baseline, 6 and 12 months, according to USPHS criteria. Evaluation at 12 months showed that the retention of materials in class I and class II restorations in primary teeth was good. The recall rate was 97.4%. None of the restorations were clinically unacceptable, except for those with secondary caries (9/138). RMGIC gave the best results. At one year, RMGIC had the highest percentage of intact marginal integrity. Marginal discoloration in PMC restorations compared to Amlg restorations was statistically more important (p = 0.013). Secondary caries in HVGIC restorations, compared to Amlg restorations, were higher (p = 0.013). Clinical performance of the 3 restorative materials compared to Amlg in class I and class II cavities at one-year recall is not uniform. The results suggest that RMGIC is a suitable alternative to Amlg for restorations in primary teeth. Restrictions should be considered for the materials with more secondary caries (HVGIC) and higher marginal discoloration (PMC).