Vital root submergence of immature permanent incisors after complicated crown-root fracture followed by orthodontic space maintenance: A presentation of two cases.

Complicated crown-root fractures are considered rare occurrences in young permanent dentition; however, they pose a particularly difficult clinical challenge, especially when the traumatized tooth is immature. Two cases of complicated crown-root fractures of immature incisors are presented. In both cases, vital root submergence with no treatment to the exposed pulp was introduced as a stage in a complex treatment plan with the primary goal of preserving the shape of the alveolar ridge in the traumatized area until the root was completely formed or facial growth was finished. No inflammatory symptoms were detected either radiographically or clinically during the 15- and 16-month follow-up periods. In the chosen clinical cases, vital root submergence followed by orthodontic space maintenance can be beneficial to young patients if other treatment options are limited by the depth of the crown-root fracture or if the patient suffers from high dental fear and presents a particularly low level of compliance.

Prenatal and familial factors of caries in first permanent molars in schoolchildren living in urban area of Lódz, Poland.

The objective of the present work is to identify the set of prenatal and familial factors that contribute to dental caries of first permanent molars in preschool and young schoolchildren, which will make it possible to determine a high-risk group that should be considered for special preventive measures. This study contributes to the evidence for the multifactorial nature of dental caries. Material was collected during a 2009-2010 study conducted in randomly selected schools and kindergartens in the city of Lódz (Poland). Only children with first permanent molars present were considered for the analysis, which limited the database to 1131 children. Dental examinations were accompanied by a questionnaire completed by the parents, covering items pertaining to prenatal and familial determinants. The present study shows that there are significant differences in the prevalence of caries in first molars between children of different ages (5-13 lat) and that no such differences exist between boys and girls. The prenatal and familial factors conducive to caries include maternal education level (OR=0.55), mode of delivery (OR=0.63) and birth order (OR=0.63). Mothers' smoking habit is also associated with increased caries prevalence in children. Caries prevention should already begin during the prenatal period primarily in respect of mothers with lower educational attainment who are pregnant with a second or subsequent child.

Caries Experience and Distribution by Tooth Surfaces in Primary Molars in the Pre-school Child Population of Lodz, Poland.

PURPOSE: To evaluate caries experience in primary molars as well as the differences in caries prevalence and caries lesion location on individual tooth surfaces between first and second primary molars in pre-school children. MATERIALS AND METHODS: A cross-sectional study was conducted on 307 children, aged 3 to 5 years, from randomly chosen kindergartens in Lodz, Poland. Caries experience was scored according to WHO recommendations. The caries intensity (dmft, dmfts) for first and second primary molars was calculated. In addition, the percentage of particular surfaces with caries was counted for each molar separately. RESULTS: The mean dmft for primary molars was 1.84 (dmfts=2.47) and dmft>0 was seen in 53.09% of the study subjects. While in the entire examined population dmft and dmfts for first and second molars did not differ significantly, in 5-year-old children, the left mandibular first molar was associated with a higher caries intensity than the left mandibular second molar (dmfts=0.465 vs 0.344, Z=-1.98, p=0.04). However, in 5-year-olds, higher caries occurrence was seen for occlusal surfaces of the tooth 85 than 84 (33.62% vs 20.68%, χ2=4.09, p=0.03). The distal surface was more frequently affected in first molars than in second molars in children aged 4 (85 vs 84, χ2=17.1, p<0.001; 75 vs 74, χ2=11.5, p=0.007, 55 vs 54; χ2=4.6, p=0.03) and 5 years (54 vs 55, χ2=20.09; 64 vs 65, χ2=16.75; 74 vs 75, χ2=21.6; 84 vs 85, χ2=31.07; all comparisons p<0.001). In contrast, the mesial surfaces of mandibular second molars demonstrated more caries than the homologous surfaces of first molars, both in 4-year-olds (85 vs 84, χ2=6.15, p=0.01) and 5-year-olds (75 vs 74, χ2=3.9, p=0.04). CONCLUSION: In 5-year-old children, caries of occlusal and mesial surfaces was more common in primary second molars. However, distal surfaces were affected more in first than second molars.