Incisor liability and its effects among East Asian children.

BACKGROUND/PURPOSE: Incisor liability is the discrepancy in the sum of the mesiodistal crown width between the primary and permanent incisors. Incisor liability affects the integrity and eruption of the permanent incisors during the transition from the primary to permanent dentition. This study investigated the incisor liability in the primary dentition of Taiwanese children. METHODS: The digital periapical films of 203 upper arches of 105 boys and 98 girls and 195 lower arches of 119 boys and 76 girls aged between 3 and 6 years were selected in this retrospective study. The mesiodistal crown widths of the primary and permanent incisors were measured using the medical imaging software for both arches. Differences in incisor liability values were statistically analyzed. RESULTS: The mean ± standard deviation of the incisor liability values were 8.32 ± 1.88 and 6.91 ± 1.13 mm for the upper and lower arches, respectively, in all children. The incisor liability was closely related with the total crown widths of the permanent incisors for upper and lower arches. The incisor liability values were higher among boys than girls for the upper but not lower arch. CONCLUSION: Incisor liability differs depending on ethnicity. In Taiwanese children, incisor liability was closely related with the crown widths of the permanent incisors. The incisor liability values of boys were higher than those of girls in the upper arch but not the lower arch.

Comparison of Different Clinical Decision Support Tools in Aiding Dental and Medical Professionals in Managing Primary Dentition Traumatic Injuries.

BACKGROUND: Many patients are taken to the emergency room for dental trauma treatment, but studies reveal that medical professionals do not feel confident in diagnosing and treating children with traumatic dental injuries. The purpose of this study was to determine if a clinical decision support tool (CDST) would improve dental trauma knowledge of primary teeth in medical students and pediatric dentists. Another purpose was assessing effectiveness of print and mobile app CDSTs. METHODS: Medical students (n = 100) and pediatric dentists (n = 49) were given a pretest to assess baseline dental trauma knowledge. All subjects were randomly assigned to 1 of 3 groups for the posttest: no CDST, print CDST, and mobile app CDST. Test scores and total time spent on each test were recorded and analyzed. RESULTS: Compared with medical students, pediatric dentists scored significantly higher in both pretest (8.57 ± 0.96 vs 4.20 ± 1.58; P < 0.001) and posttest (8.37 ± 1.09 vs 4.96 ± 1.99; P < 0.001). There was no significant difference in time spent to complete the 2 tests between both groups. Medical students and pediatric dentists who utilized the mobile app CDST had scored highest (P = 0.028) but took the longest time (P < 0.001) on the posttest. CONCLUSIONS: Both print and mobile app CDSTs improved diagnosing and managing traumatic dental injuries in primary dentition significantly compared with those without aid. Medical students with CDSTs showed significant improvement in managing primary dental trauma; therefore, it is recommended for better, more accurate diagnosis and treatment in patients.

Comparison of Microbial Activity Among Infants With or Without Using Presurgical Nasoalveolar Molding Appliance.

PURPOSE: The aim of the current study is as follows: (1) to study whether wearing the presurgical nasoalveolar molding appliance (PNAM) had facilitated the establishment of Streptococcus mutans and Lactobacillus (LB) and to determine other factors including pH and caries susceptibility associated with wearing the PNAM. METHODS: Saliva samples of 61 infants (4.5 ± 2.06 months old) were collected from the following 3 groups: PNAM (n = 23), healthy (n = 30), and cleft lip and palate (CLP) without any treatment (n = 8). Saliva samples were assessed using selective agar to enumerate total LB and S mutans and subjected to adenosine triphosphate (ATP)-driven bioluminescence determinations using a luciferin-based assay system, and pH level was evaluated. One-way analysis of variance with least significant difference post hoc test (P < .05) and Pearson correlation were used to evaluate S mutans, LB, pH, and ATP levels. RESULTS: A total of 63 patients (30 healthy patients, 23 patients with cleft lip/palate who had PNAM appliance and 8 patients with cleft lip/palate who did not use the appliance) were seen in this study. There is a significant difference in pH (P = .012), LB Caries Risk Test (P < .001), LB colony count (P < .001), S mutans Caries Risk Test (P < .001), and S mutans colony count (P < .001) among the 3 groups (PNAM > CLP > healthy). The ATP level was not significantly different among the 3 groups. CONCLUSION: Higher bacterial count and lower pH were found in the PNAM group. Cleft lip and/or palate patients wearing the PNAM appliance are at higher risk for dental caries.

Use of a clinical decision support tool for the management of traumatic dental injuries in the primary dentition by novice and expert clinicians.

BACKGROUND/AIM: Studies reveal many dental students and general dentists have inadequate knowledge about treating children who sustain traumatic dental injuries. The aims of this study were to assess dental trauma knowledge among novice clinicians and expert pediatric dentists and determine the effectiveness of a clinical decision support tool (CDST) for the management of trauma scenarios. A secondary purpose was to compare the effects of a print and mobile app format of the CDST. METHODS: A print and mobile app CDST was developed based upon current AAPD and IADT clinical guidelines. Baseline knowledge for dental students (n = 84) and pediatric dentists (n = 60) was assessed using a multiple-choice Pre-test. A Post-test was used to evaluate changes in the knowledge level following the random assignment of participants into 3 groups: Group A (control) had no CDST provided; Group B (print CDST) had access to the print paper pamphlet; and Group C (mobile app CDST) had access to the mobile app on a handheld device for use during the Post-test. Test scores and time required to complete each test were recorded. RESULTS: Pediatric dentists scored significantly higher and required less time on both the Pre-test (P < .001) and Post-test (P < .05) compared to dental students. Dental students and pediatric dentists who had access to the mobile app CDST scored significantly higher (P < .05) in the Post-test compared to the control and the print CDST groups. Post-test time for the dental students in the mobile app group was significantly longer (P < .001) compared to the control and print format. CONCLUSION: Expert pediatric dentists demonstrated greater knowledge of dental trauma compared to novice clinicians. The mobile app clinical decision support tool was a more effective means of improving the diagnosis and management of traumatic dental injuries by both dental students and pediatric dentists than the print CDST.

Pharmacologic management for pediatric dental patients in the 21st century.

Most children are able to cooperate during conventional, in-office dental treatment using traditional, communicative behavior guidance techniques that are carefully selected and applied to the developmental needs of a particular child. Children who are unable to cooperate during conventional treatment due to a lack of psychological or emotional maturity and/or the existence of a mental, physical, or medical disability may require pharmacologic techniques such as procedural sedation or general anesthesia to complete rehabilitative dental treatment. Patient safety dictates that careful preparation and robust case selection processes guide clinical decision-making related to pharmacologic behavior guidance. Before using these techniques, the sedation provider must demonstrate an adequate understanding of these techniques, from definitions and best practices to case selection and patient safety. This article presents essential information-with an emphasis on best practices and patient safety-for dentists who are considering pharmacologic behavior guidance for the children they treat.

Pre-Eruptive Intracoronal Resorption (PEIR): Literature Review and Case Report.

Pre-eruptive intracoronal resorption (PEIR) are lesions that are often located in the occlusal portion of the crown in unerupted teeth. The etiology and pathology of these lesions remain unclear and most go undetected until later stages of development. Prognosis is dependent on early detection, and conservative treatment is recommended. This report reviews the etiology, prevalence, diagnosis and treatment of PEIR and describes a case of a permanent second molar with PEIR diagnosed in an 11-year-old patient.

Comparing Shear Bond Strength Between Pink Opaquer and Other Tooth-Colored Restorative Materials on Demineralized Dentin Treated with Silver Diammine Fluoride.

Purpose: The purposes of this study were to evaluate the effect of silver diammine fluoride (SDF) on the shear bond strength (SBS) of pink opaquer (PO) compared to resin-modified glass ionomer (RMGI) and conventional composite (COMP) on demineralized dentin, and also to investigate the mode of failure (MOF). Methods: Sixty extracted third molars were prepared, demineralized for 14 days, and divided into four groups: (1) COMP; (2) SDF+PO; (3) SDF+RMGI; and (4) SDF+COMP (restoration size: two by two mm). SBS, MOF, modified adhesive remnant index (MARI), and remnant adhesive volume (RAV) were evaluated using an Instron® machine, light microscopy, 3D digital scanner ( 3Shape©), and GeoMagic Wrap© software. Results: There was no significant difference in SBS (MPa) among the COMP mean??standard deviation (2.5±1.59), SDF+COMP (2.28±1.05), SDF+PO (3.31±2.63), and SDF+RMGI groups (3.74±2.34). There was no significant difference in MOF and MARI among the four groups (P>0.05). There was no significant difference in RAV (mm3) among the COMP (0.5±0.33), SDF+COMP (0.39±0.44), SDF+PO (0.42±0.38), and SDF+RMGI groups (0.42±0.38; P>0.05). A significant correlation existed between MOF and RAV (R equals 0.721; P<0.001). MOF, MARI, and RAV did not show any correlations with SBS (P>0.05). Conclusions: Silver diammine fluoride does not affect shear bond strength between carious dentinal surface and tooth color restorative materials. The amount of material left on the interface is not related to the amount of shear force needed to break the restoration.

Evaluating Streptococcus mutans Colonization on 3D-Printed, Milled, and Conventional Acrylic Resin Materials: An In Vitro Study.

Purpose: To compare surface roughness and bacterial colonization of Streptococcus mutans to 3D printed (3DP), milled (M), and conventional (CV) acrylic resin. Methods: Thirty-six discs (n equals 12 per group) were fabricated from 3DP, M, and CV materials. One surface of sample was polished (Po); the opposite surface was left unpolished (UPo). Surface roughness (µm) was assessed using a contact profilometer. The specimens were placed in S. mutans suspension and incubated at 37 degrees Celsius overnight. The attached colonies were separated using a sonicator, and the resulting solution was diluted to 10-3 to assess colony-forming units per milliliter (CFU/ml) after 48 hours. The colonies were categorized into a quantitative S. mutans (QS) index. Data were analyzed using one-way ANOVA, chi-squares, and multivariate analysis of variance analysis with the least significant difference (LSD) post-hoc test (P<0.05). Results: Roughness average (Ra) values of CV were higher than 3DP and M for UPo surfaces (P<0.001; 3DP=0.10; M=0.13; CV=0.26 µm, respectively). For Po and UPo surfaces, the CV harbored more S. mutans colonies than M and 3DP (P<0.001; 3DP=5.2x10 6 ; M=4.7x10 6 ; CV=1.49x10 7 CFU/ml, respectively). M group had the lowest range of QS scores, while CV had the highest range (P<0.001). Conclusions: Digitally manufactured material provides smoother surfaces than the conventional group, resulting in fewer Streptococcus mutans colonies. However, all the material groups must still be adequately polished to prevent the colonization of S. mutans, regardless of the manufacturing methods, as higher S. mutans counts were observed with an increase in surface roughness values.

Methemoglobin levels in generally anesthetized pediatric dental patients receiving prilocaine versus lidocaine.

The purpose of this study was to measure and compare peak methemoglobin levels and times to peak methemoglobin levels following the use of prilocaine and lidocaine in precooperative children undergoing comprehensive dental rehabilitation under general anesthesia. Ninety children, 3-6 years of age, undergoing dental rehabilitation under general anesthesia were enrolled and randomly assigned into 3 equal groups: group 1, 4% prilocaine plain, 5 mg/kg; group 2, 2% lidocaine with 1:100,000 epinephrine, 2.5 mg/kg; and group 3, no local anesthetic. Subjects in groups 1 and 2 were administered local anesthetic prior to restorative dental treatment. Methemoglobin levels (SpMET) were measured and recorded throughout the procedure using a Masimo Radical-7 Pulse Co-Oximeter (Masimo Corporation, Irvine, Calif, RDS-1 with SET software with methemoglobin interface). Data were analyzed using chi-square, one-way analysis of variance (ANOVA), and Pearson correlation (significance of P < .05). Group 1 had a significantly higher mean peak SpMET level at 3.55% than groups 2 and 3 at 1.63 and 1.60%, respectively. The mean time to peak SpMET was significantly shorter for group 3 at 29.50 minutes than that of group 1 at 62.73 and group 2 at 57.50 minutes. Prilocaine, at 5 mg/kg in pediatric dental patients, resulted in significantly higher peak SpMET levels than lidocaine and no local anesthetic. In comparison to no local anesthetic, the administration of prilocaine and lidocaine caused peak SpMET levels to occur significantly later in the procedure.

Wear Resistance Comparison of Prefabricated Primary Crowns Using a Novel 3D Computed Tomography Method.

PURPOSE: The purpose of this study was to compare the wear resistance of stainless steel crowns, (SSCs), zirconia crowns (ZRCs), and nanohybrid crowns (NHCs) using a 3D tomography method. METHODS: Prefabricated SSCs, ZRCs, and NHCs (n equals 80) were worn for 400,000 cycles, equivalent to three years of simulated clinical wear, at 50 N and 1.2 Hz using the Leinfelder-Suzuki wear tester. Wear volume, maximum wear depth, and wear surface area were computed using a 3D superimposition method and 2D imaging software. Data were statistically analyzed using one-way analysis of variance with the least significant difference post hoc test (P<0.05). RESULTS: After a wear simulation of three years, NHCs had a 45 percent failure rate; NHCs also had the greatest wear volume loss (0.71 mm³), maximum wear depth (0.22 mm), and wear surface area (4.45 mm²). SSCs (0.23 mm³ , 0.12 mm, 2.63 mm²) and ZRCs (0.03 mm³ , 0.08 mm, 0.20 mm ²) had less wear volume, area, and depth (P<0.001). ZRCs were the most abrasive to their antagonists (P<0.001). The NHC (against SSC wearing group) had the greatest total wear facet surface area (4.43 mm²). CONCLUSIONS: Stainless steel crowns and zirconia crowns were the most wear-resistant materials. Based on these laboratory findings, in the primary dentition, nanohybrid crowns are not recommended as long-term restorations beyond 12 months (P=0.001).

Accuracy of cone beam computerized tomography and a three-dimensional stereolithographic model in identifying the anterior loop of the mental nerve: a study on cadavers.

The objective of this ex vivo cadaver study was to determine the accuracy of cone beam computerized tomography (CBCT) and a 3-dimensional stereolithographic (STL) model in identifying and measuring the anterior loop length (ANLL) of the mental nerve. A total of 12 cadavers (24 mental nerve plexus) were used for this study. Standardized CBCT scans of each mandible were obtained both with and without radiographic contrast tracer injected into the mental nerve plexus, and STL models of the two acquired CBCT images were made. The ANLL were measured using CBCT, STL model, and anatomy. The measurements obtained from the CBCT images and STL models were then analyzed and compared with the direct anatomic measurements. A paired sample t test was used, and P values less than .05 were considered statistically significant. The mean difference between CBCT and anatomic measurement was 0.04 mm and was not statistically significant (P = .332), whereas the mean difference between STL models and anatomic measurement was 0.4 mm and was statistically significant (P = .042). There was also a statistical significant difference between CBCT and the STL model (P = .048) with the mean difference of 0.35 mm. Therefore, CBCT is an accurate and reliable method in determining and measuring the ANLL but the STL model over- or underestimated the ANLL by as much as 1.51 mm and 1.83 mm, respectively.

The incidence of maxillary sinus membrane perforation during endoscopically assessed crestal sinus floor elevation: a pilot study.

Transcrestal sinus membrane elevation is a surgical procedure performed to increase the bone volume in the maxillary sinus cavity. Because of visual limitations, the potential for maxillary sinus membrane perforations may be greater than with the lateral approach technique. The aim of this study was to macroscopically investigate ex vivo the occurrence of sinus membrane perforation during surgery using 3 transcrestal sinus floor elevation methods. Twenty fresh human cadaver heads, with 40 intact sinuses, were used for simultaneous sinus membrane elevation, placement of graft material, and dental implants. Real-time sinus endoscopy, periapical digital radiographs, and cone-beam computerized tomography (CBCT) images were subsequently used to evaluate the outcome of each surgical procedure. Perforation rates for each of the 3 techniques were then compared using a significance level of P < .05. No statistically significant differences in the perforation rate (P = .79) were found among the 3 surgical techniques. Although the sinus endoscope noted a higher frequency of perforations at the time of implant placement as compared with instrumentation or graft insertion, the difference was not statistically significant (P = .04). The CBCT readings were judged to be more accurate for identifying evidence of sinus perforations than the periapical radiographs when compared with the direct visualization with the endoscope. This pilot study demonstrated that a sinus membrane perforation can occur at any time during the sinus lift procedure, independent of the surgical method used.

A MicroCT Study on Mineral Change over Time Associated with Demineralisation in Primary Teeth.

OBJECTIVE: To evaluate the change in demineralisation depth (DD)and mineral density (MD) over time in primary teeth exposed to a demineralisation protocol with microcomputed tomography (microCT). METHODS: Caries lesions were artificially induced on the labial surfaces of 9 primary incisors by way of a demineralisation protocol using 0.1 M lactic acid with 10% methylcellulose gel for 7 and 14 days. The specimens were scanned with microCT and CTAn software (Bruker, Billerica, MA, USA) was used to analyse the changes in DD and MD. Statistical analyses were performed using SPSS software (IBM, Armonk, NY, USA). Repeated analysis of variance (ANOVA) test and Pearson bivariate correlation were used and the level of significance was set at P < 0.05. RESULTS: The DD ranged from 0.00 to 0.99 µm (mean ± standard deviation [SD] 0.70 ± 0.43 µm) at baseline, 11.18 to 29.5 µm (18.15 ± 5.23 µm) at 7 days and 18.00 to 55.30 µm (34.20 ± 8.70 µm) at 14 days. The MD for all specimens (n = 9) ranged from 1.48 to 1.76 g/cm3 (1.65 ± 0.08 g/cm3) at baseline, from 1.47 to 1.74 g/cm3 (1.62 ± 0.08 g/cm3) at 7 days demineralisation and 1.33 to 1.72 g/cm3 (1.54 ± 0.13 g/cm3) at 14 days. There were statistically significant differences in DD (P < 0.001) and MD (P = 0.016) between different durations of demineralisation. CONCLUSION: DD and MD change with time after being exposed to demineralising solution. MicroCT is a nondestructive method that allows repeated MD evaluations of the same sample.

Comparison of the Masking Ability and Translucency of Different Tooth-Colored Restorative Materials.

PURPOSE: The purpose of this study was to evaluate the masking of simulated silver diamine fluoride (SDF) carious tooth discoloration using tooth-colored restorative materials. METHODS: Eighty disc specimens (N equals 10 disc specimens per group) were prepared using pink opaquer (PO), pink opaquer with composite resin (DUAL), opaque-shade composite resin (OSC), and resin-modified glass ionomer (RMGI) of one-mm and two-mm thicknesses. Three backgrounds were prepared: white, dark dentin shade (C4D), and black tile. Vita Easyshade® spectrophotometer was used to determine the color values of each disc specimen against each background. Color difference (E) and translucency parameter (TP) were analyzed. RESULTS: There was a significant difference in material masking black background (one-way analysis of variance; P<0.001) in the following order: PO (TP 5.47) and DUAL (TP 3.89) are similar in masking ability but much higher than RMGI (TP 11.03) and OSC (TP 17.81). For masking the dark background, the result was similar. The material thickness makes a significant difference in color masking, with two mm superior to one mm for all four tooth-colored materials (multivariate analysis of variance; P<0.001). Both PO and DUAL two mm were clinically acceptable in masking dark and black backgrounds (E less than 2.7). CONCLUSION: Pink opaquer and pink opaquer with composite resin restorative materials were found to be the best masking materials for simulated silver diamine fluoride-arrested carious lesions.

An Investigation of the Long and Short Term Behavioral Effects of General Anesthesia on Pediatric Dental Patients With Autism.

Purpose: The purpose of this study was to compare the incidence of short and long term adverse behavioral effects of general anesthesia (GA) in healthy vs. moderate to severe autistic (ASD) children. Methods: Forty healthy and 37 ASD children, aged 3-17 years, undergoing GA for dental surgery participated in this study. Their anesthesia records were reviewed, and their parents answered telephone surveys to assess activity level, sleep disturbances, gastrointestinal disturbances, central nervous system effects, and respiratory depression. Three follow-up surveys were taken 8 h, 24 h, and 3 months post-surgery. Results: Four hundred fifty-five incidences of adverse behavioral effects occurred within 8 h post-surgery. Significantly more ASD patients had difficulty walking (P = 0.016) and nausea (P = 0.030), while more healthy children snored in the car ride home (P = 0.036) and talked about the dental surgery (P = 0.027). Three months post-discharge, sixASD patients acted in a way that concerned caregivers compared to 0 healthy patients, (P = 0.008). Incidence of adverse behavioral effects significantly decreased from 8 to 24 h overall. Conclusions: Most behavioral effects occur within 8 h post-surgery. There are potential long term adverse behavioral effects in ASD children from GA, but the chance is low and generally not long lasting.

Using the Timmer Scale to Standardize Pediatric Dentistry Residents' Scientific Appraisal Skills.

Introduction: There is no consensus on the best methodology to apply evidence-based practice principles to develop a systematic approach to improve critical appraisal or research design evaluation skills in advanced education journal clubs. Methods: We implemented a tool-based approach for our pediatric dentistry residents' journal club centered on the use of a study quality assessment tool, the Timmer scale. The tool consisted of 19 standard questions that evaluated the research methodology, data collection, statistical analysis, and reporting of the findings of each article. Learners first underwent a 4-hour training session on study quality assessment. They were then assigned to read articles from monthly issues of core journals and appraised the quality of each article using the Timmer scale and submitted their scores in advance of the group session. Then, during a 1-hour journal club, the group came to a consensus on the Timmer scale score, and group and individual scores were compared to the course director's scores as prompts for feedback and further discussion. Results: Over 3 years, 24 pediatric dentistry residents participated in the course. A noticeable improvement in the pediatric dentistry residents' performance was noticed, with the discrepancy between their scores and group scores improving over time. Discussion: Using a quality assessment tool in journal clubs appeared to improve the residents' ability to critically assess articles in a systematic way. Additionally, the tool was useful for assessing residents' performance over time.

Immediate loading of unsplinted implants in the anterior mandible for overdentures: a case series.

PURPOSE: This case series evaluated the implant success rate and peri-implant tissue response of immediately loaded unsplinted implants retaining a mandibular overdenture. MATERIALS AND METHODS: Eight completely edentulous patients (five men, three women) with a mean age of 69.1 years were included in the study. All participants received new maxillary and mandibular complete dentures prior to implant placement. Two 4.0- 3 13-mm threaded implants with a fluoride-modified microrough titanium surface were placed mesial to the mandibular canine position bilaterally. Individual stud attachments were connected and torqued to 25 Ncm and the overdenture was immediately attached. The patients were evaluated clinically and radiographically at implant placement and at 3, 6, and 12 months after implant placement. The data were analyzed using the paired-samples t test and the Wilcoxon signed-ranks test at a significance level of a = .05. RESULTS: At 12 months, all implants remained osseointegrated and showed an overall mean marginal bone change of -0.36 ± 0.29 mm and a mean Periotest value of -6.94 ± 0.73. The modified Plaque Index scores indicated improvements in oral hygiene over time. Surgical complications involved two episodes of implant rotational instability. Prosthetic complications were attributed to abutment loosening, the patients' inability to insert the prosthesis correctly, and soft tissue shrinkage. CONCLUSIONS: The results of this study suggest that favorable implant success rates and peri-implant tissue responses can be achieved with mandibular overdentures retained with two immediately loaded unsplinted threaded implants with a fluoride-modified microrough titanium surface.

Comparison of fluoride concentrations in commonly consumed ready-to-eat infant foods.

PURPOSE: The purpose of this study was to measure the fluoride concentrations in ready-to-eat infant food, and to determine if significant differences exist among flavors and brands. METHODS: One hundred fifty samples of 5 infant food flavors from an organic infant food manufacturer and the largest infant food manufacturer were compared using the Taves microdiffusion method. Total fluoride ingestion per serving was calculated based on average amounts consumed and container size of individual products. RESULTS: Fluoride concentrations ranged from 0.01 to 0.60 ppm (mean = 0.170 +/- 0.125 [SD] ppm) for all samples, with both the highest and lowest fluoride concentrations found in processed banana infant food (Gerber, mean = 0320 +/- 0.167 ppm; Earth's Best, mean = 0.030 +/- 0.013 ppm). Significant differences were noted when comparing the 2 infant food manufacturers for all flavors. CONCLUSIONS: The fluoride concentrations in ready-to-eat infant food varied among the 5 flavors tested. All infant foods tested were found to provide less fluoride than the Institute of Medicine tolerable upper daily intake. No trends in fluoride concentrations for different flavors or brands were noted. Fluoride in infant foods should be considered when determining total fluoride intake.

Effectiveness of impacted and supernumerary tooth diagnosis from traditional radiography versus cone beam computed tomography.

PURPOSE: The purpose of this study was to determine if cone beam computed tomography (CBCT) is more effective than traditional radiography (TR) in diagnosing pediatric dental clinical cases involving impacted and supernumerary teeth. METHODS: Surveys were given to 10 pediatric dental faculty and 10 pediatric dental residents after viewing 8 clinical cases in either CBCT or TR in which the patient presented with pathology (impaction or supernumerary) in the anterior maxilla. The surveys asked for pathology diagnosis, location, and identification of root resorption, as well as questions about the usefulness of the radiographic mode in treatment planning. RESULTS: A statistically significant difference in CBCT vs. TR viewed cases was found with CBCT statistically better (P<0.05) for pathology location, determining root resorption, usefulness, adequacy in treatment planning, and was the overall recommended mode. More faculty were able to correctly identify the pathology location (P=0.034), while more residents believed they could determine presence of root resorption P=0.029). For impacted versus supernumerary cases, more pathology was correctly located when viewed in CBCT mode (P<0.05). No statistical significance in diagnosing the presence of pathology for all cases was found. CONCLUSIONS: CBCT and TR were effective in the initial diagnosis of pathology in the cases presented. CBCT, however, provides more information on the location of pathology, the presence of root resorption, and treatment planning. The pediatric dental community can benefit from the amount of additional information provided by CBCT. The benefits of CBCT imaging must be weighed against the radiation risk to the pediatric patient and the complexity of the pathology.