Systematic review and meta-analysis on prevalence and anamnestic risk factors for erosive tooth wear in the primary dentition.

BACKGROUND: Erosive tooth wear is a multifactorial and common condition in children. AIM: This systematic review and meta-analysis aimed to determine the prevalence and key risk factors for erosive tooth wear in the primary dentition of children up to 7 years of age. DESIGN: Electronic databases (PubMed, Embase, Scopus, and Web of Science) were searched in February 2023 for observational studies reporting prevalence and anamnestic risk factors. Additionally, a manual hand search was performed. Meta-analyses were conducted for the prevalence and odds ratios of identified risk factors. Risk of bias was assessed using the Newcastle-Ottawa scale modified for cross-sectional studies. RESULTS: A total of 26 sources, reporting on 23 studies, were included in the systematic review. The overall estimated prevalence of children with erosive tooth wear in the primary dentition amounted to 35.6% (95% CI: 24.8-48.1). Anamnestic factors were structured into domains. Meta-analyses revealed gastroesophageal reflux disease (GERD; padj. = .008; OR = 1.98, 95% CI: 1.37-2.87), consumption of acidic food (padj. < .001; OR = 5.14, 95% CI: 3.56-7.42) and acidic drinks (padj. < .001; OR = 6.90, 95% CI: 4.64-10.25), holding beverages in the mouth while drinking (padj. = .035; OR = 1.82, 95% CI: 1.26-2.63), and snacking regularly (padj. = .041; OR = 1.58, 95% CI: 1.18-2.10) to be significantly associated with erosive tooth wear. CONCLUSION: Future research should use standardized questionnaires to assess erosive tooth wear and its underlying risk factors (PROSPERO: CRD4202339776).

Morphometric variations and nonmetric anatomical traits or anomalies of the primary molar teeth, plus the molars' size thresholds for sex identification.

INTRODUCTION: Morphological and morphometric features of the teeth are of interest to various clinical and academic dental and medical fields including prosthodontics, orthodontics, anatomy and anthropology, pathology, archeology, and forensic dentistry. These have been more or less researched in the case of the permanent dentition. However when it comes to the primary dentition, the literature is scarce and controversial. No study worldwide exists on the cutoff points (thresholds) for sex identification; no study exists on metric or nonmetric traits of deciduous teeth in Iranians. Hence, the aim of the study was to assess both the metric and nonmetric traits of primary molars, as well as their cut-off points for sex identification. METHODS: In this epidemiological cross-sectional study, pretreatment casts of 110 children (51 boys and 59 girls) aged 6 to 12 years were collected. Maxillary and mandibular first and second primary molars were evaluated regarding their metric traits (mesiodistal and buccolingual widths) and 9 nonmetric traits (Accessory cusp on the upper D, Accessory cusp on the lower D, Fifth cusp on the upper E, Carabelli's cusp on the upper E, Protostylid on the lower E, Fifth cusp on the lower E, Sixth cusp on the lower E, Tuberculum intermedium [metaconulid] on the lower E, and Deflecting wrinkle on the lower E). ROC curves were used to identify cut-off points for sex determination as well as the usefulness of metric measurements for this purpose. Data were analyzed using independent-samples and paired-samples t-tests, McNemar, Fisher, and chi-square tests, plus Pearson and Spearman correlation coefficients (α = 0.05). RESULTS: All the primary molars' coronal dimensions (both mesiodistal and buccolingual) were extremely useful for sex identification (ROC curves, all P values ≤ 0.0000099). Especially, the mandibular primary molars (areas under ROC curves [AUCs] between 85.6 and 90.4%, P values ≤ 0.0000006) were more useful than the maxillary ones (AUCs between 80.4 and 83.1%, P values ≤ 0. 0000099). In the mandible, the first primary molar (maximum AUC = 90.4%) was better than the second molar (maximum AUC = 86.0%). The optimum thresholds for sex determination were reported. Sex dimorphism was significant in buccolingual and mesiodistal crown widths of all the primary molars (all P values ≤ 0.000132), but it was seen only in the case of 2 nonmetric traits: Deflecting wrinkle (P = 0.001) and Tuberculum intermedium (metaconulid, P = 0.029) on the lower Es, taking into account the unilateral and bilateral cases. The occurrence of nonmetric traits was symmetrical between the right and left sides (all P values ≥ 0.250). All mesiodistal and two buccolingual molar measurements were as well symmetrical (P > 0.1); however, two buccolingual measurements were asymmetrical: in the case of the maxillary E (P = 0.0002) and mandibular D (P = 0.019). There were three weak-to-moderate correlations between the nonmetric traits of the mandibular second molars (Spearman correlations between 22.7 and 37.5%, P values ≤ 0.045). Up to 6 concurrent nonmetric traits were observed in the sample, with 53.6% of the sample showing at least 2 concurrent nonmetric traits at the same time, without any sex dimorphism (P = 0.658). CONCLUSION: Sex dimorphism exists considerably in primary molars' sizes, but it is not as prevalent in their nonmetric traits or abnormalities. Primary molars' crown sizes are useful for sex identification; we calculated optimum cut-off points for this purpose, for the first time.

PARENTAL EDUCATION, CARIES EXPERIENCE, PLAQUE ACCUMULATION, AND Mutans Streptococci COUNT MAY PREDICT THE INCREMENT OF EARLY CHILDHOOD CARIES IN PRESCHOOL CHILDREN OVER 24 MONTHS.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: RISK PREDICTORS OF EARLY CHILDHOOD CARIES INCREMENT-A SYSTEMATIC REVIEW AND META-ANALYSIS. Lam PPY, Chua H, Ekambaram M, Lo ECM, Yiu CKY. J Evid Based Dent Pract. 2022 Sep;22(3):101732. SOURCE OF FUNDING: Government TYPE OF STUDY/DESIGN: Systematic review with meta-analysis of data.

Caesarean-section delivery and caries risk of 3-year-old Chinese children: a retrospective cohort study.

BACKGROUND: Caesarean-section (C-section) may influence children's long-term health by affecting bacterial colonization. However, few studies have focused on the association between C-section delivery (CSD) and dental caries, and previous conclusions have been conflicting. This study aimed to explore whether CSD would increase the risk of early childhood caries (ECC) in preschool children in China. METHODS: This study was a retrospective cohort study. Three-year-old children with full primary dentition were included through the medical records system. Children in the nonexposure group were vaginally delivered (VD), while children in the exposure group were delivered through C-section. The outcome was the occurrence of ECC. After agreeing to participate in this study, guardians of included children completed a structured questionnaire on maternal sociodemographic factors, children's oral hygiene and feeding habits. The chi-square test was used to determine differences in the prevalence and severity of ECC between the CSD and VD groups and to analyse the prevalence of ECC according to sample characteristics. Subsequently, potential risk factors for ECC were preliminarily identified through univariate analysis, and the adjusted odds ratios (ORs) were further calculated through multiple logistic regression analysis after controlling for confounding factors. RESULTS: The VD group included 2115 participants while CSD group included 2996 participants. The prevalence of ECC was higher in CSD children than in VD children (27.6% vs. 20.9%, P < 0.05), and the severity of ECC in CSD children was higher (mean number of decayed, missing, and filled teeth, dmft: 2.1 vs. 1.7, P < 0.05). CSD was a risk factor for ECC in 3-year-old children (OR = 1.43, 95% CI = 1.10-2.83). In addition, irregular tooth brushing and always prechewing children's food were risk factors for ECC (P < 0.05). Low maternal educational attainment (high school or below) or socioeconomic status (SES-5) may also increase the prevalence of ECC in preschool children and CSD children (P < 0.05). CONCLUSIONS: CSD would increase the risk of ECC in 3-year-old Chinese children. Paediatric dentists should devote more attention to the development of caries in CSD children. Obstetricians should also prevent excessive and unnecessary CSD.

Caries in children with and without orofacial clefting: A systematic review and meta-analysis.

This systematic review compared children's primary dentition caries experience for those with cleft lip and/or palate (CL/P) and without. Four databases were searched without date restriction for; cross-sectional studies comparing caries experience for children with CL/P to those without. Screening, data extraction and risk assessment were carried out independently (in duplicate). Meta-analyses used a random-effects model. Twenty studies (21 reports) fitting the inclusion criteria comprised 4647 children in primary dentition from 12 countries. For dmft (n = 3016 children; 15 groups), CL/P mean = 3.2; standard deviation = 2.22 and no CL/P mean dmft = 2.5; sd 1.53. For dmfs (n = 1095 children; 6 groups), CL/P mean = 4; sd = 3.5 and no CL/P mean = 3; sd = 2.8. For % caries experience (n = 1094 children; 7 groups), CL/P mean = 65%; sd = 20.8 and no CL/P mean = 52%; sd = 28.1. Meta-analysis showed higher caries experience in children with CL/P, standardised mean difference = 0.46; 95% CI = 0.15, 0.77. Studies' risk of bias was high (n = 7), medium (n-10) and low (n = 3). Children with CL/P had higher caries experience compared to those without CLP.

Clinical and radiographic effectiveness of mineral trioxide aggregate (MTA) partial pulpotomy with low power or high power diode laser irradiation in deciduous molars: a randomized clinical trial.

This study investigated the clinical and radiographic effectiveness of MTA partial pulpotomy with low power or high power diode laser irradiation in primary molars. In this randomized single-blind clinical trial, 63 mandibular second molars were assigned into three groups (n = 21). After pulp amputation and achieving hemostasis, MTA was placed over pulp stumps in group 1 (MTA). The patients in groups 2 (LLLT-MTA) and 3 (DL-MTA) underwent low level (660 nm, 200 mW) and high power (810 nm, 1 W) diode laser radiation prior to MTA placement, respectively. The occurrence of clinical failure (spontaneous pain, tenderness upon percussion, swelling, fistula, mobility) and radiographic failure (periodontal ligament widening, external or internal root resorption, periapical or furcal radiolucency) was recorded up to 18 months after therapy. MTA and LLLT-MTA groups showed clinical success rate of 100% throughout the experiment. The clinical success rate of DL-MTA group was 95.2%, 95.2%, and 87.5% after 6, 9, and 18 months. The radiographic success rates were 90.5%, 90.5%, and 87.5% in the MTA group; 100%, 95.2%, and 88.2% in the LLLT-MTA group, and 85.7%, 76.2%, and 68.7% in the DL-MTA group, at 6-, 9-, and 18-month follow-ups, respectively. No significant differences were found in the frequency of clinical or radiographic failure among the groups at any interval (p > 0.05). MTA partial pulpotomy was a suitable technique for vital pulp therapy in deciduous teeth. The addition of low power or high power diode laser radiation to the procedure did not cause a significant difference in success rate values.

Prevalence and patterns of traumatic dental injuries in primary teeth: a 3-year retrospective overview study in Vienna.

OBJECTIVES: The aim of this study was to retrospectively identify the prevalence, patterns, and accident types of traumatic dental injuries (TDIs) in children with primary teeth in Vienna, Austria. MATERIAL AND METHODS: The investigation was conducted as a retrospective overview study including all children with TDIs in primary teeth at the University Dental Clinic of Vienna (Austria) between 2014 and 2016. Dental records including age, gender, location of trauma, type of trauma, cause of TDI, and location of traumatic incident were obtained. Furthermore, the time of presentation and the time span between TDI and initial treatment were evaluated. RESULTS: The sample comprised TDIs in 243 patients with 403 primary teeth. In a ratio of 1:1.45, boys were significantly more involved than girls. Upper central and lateral incisors were most frequently affected (n = 371, 92.1%). Dislocations were the most common type of injury (n = 298, 74%) with subluxations being the most prevalent form (n = 85, 28.5%). In 23% (n = 92), fractures were observed. The majority of traumatic incidents occurred at home (88.5%). CONCLUSION: The injury characteristics are comparable to what has previously been reported in other studies in pediatric populations. CLINICAL RELEVANCE: TDIs are a prevalent event in children worldwide and incisors are the most affected teeth in the primary dentition. Thus, dental practitioners should be able to handle these injuries.

Occlusal features of 5-year-old Greek children: a cross-sectional national study.

BACKGROUND: Occlusal characteristics of the primary dentition are crucial in predicting and determining permanent tooth alignment and occlusion. The aim of our study was to determine the occlusal characteristics of the primary dentition of 5-year-old children in Greece through a national pathfinder survey. METHODS: A stratified cluster sample of 1222 5-year-old children was selected according to the WHO guidelines for national pathfinder surveys. Five occlusal traits were registered clinically in centric occlusion, separately for the left and right sides: sagittal relationships of the second primary molars and primary canines, overjet, overbite, crossbite, and maxillary and mandibular spacing. RESULTS: Most children showed a flush terminal plane of primary second molars (44.8%), a class I primary canine relationship (52.2%) and normal overjet (46.4%), but a high prevalence of Class II canine relationship (25.6%) and overjet (37.8%) were also observed. A normal overbite was found in 40% of the children and 40% had a deep overbite. Spacing was apparent in both maxilla (71.1% of children) and mandible (56.4%). The prevalence of open bite and distal step molar relationship significantly rose in children with non-nutritive sucking habits. CONCLUSIONS: Νon-nutritive habits were associated to altered occlusal features. No sex significant differences were found in either the sagittal relationships of second primary molars and primary canines, or overjet, overbite, crossbite and spacing.

Risk prediction models for erosive wear in preschool-aged children: a prospective study.

BACKGROUND: Despite increasing prevalence, age-specific risk predictive models for erosive tooth wear in preschool-age children have not been developed. Identification of at-risk groups and the timely introduction of behavioural change or treatment will stop the progression of erosive wear in the permanent dentition. This study aimed to identify age-specific risk factors for erosive wear. Distinct risk prediction models for 3-year-old and 5-year-old children were developed. METHODS: A prospective cohort study included school-based clinical examinations and parent administered questionnaires for consented 3 and 5-year-old healthy children. Calibrated examiners measured the following health parameters under standardised conditions: erosion, using the Basic Erosive Wear Examination Index (BEWE), caries using the International Caries Detection and Assessment System (ICDAS), plaque and calculus according to the British Association for the Study of Community Dentistry (BASCD) scores, dental traumatic injuries and soft tissue lesions, salivary testing and BMI. Other health conditions were collected via a parent-administered questionnaire that explored oral- and general-health. Non parametric tests were utilised to explore the temporal relation of erosion with, demographic factors, oral hygiene habits, general health and dietary habits. Variables showing significance with a difference in BEWE cumulative score over time were utilised to develop two risk prediction models. The models were evaluated by Receiver Operating Characteristics analysis. RESULTS: Risk factors for the 3-year-old cohort (N = 336) included erosive wear (χ2(1, 92) = 12.829, p < 0.001), district (χ2(5, 92) = 17.032, p = 0.004) and family size (χ2(1, 92) = 4.547, p = 0.033). Risk factors for the 5-year-old cohort (N = 441) also included erosive wear (χ2(1, 144) = 4.768, p = 0.029), gender (χ2(1, 144) = 19.399, p < 0.001), consumption of iced tea (χ2(1, 144) = 8.872, p = 0.003) and dry mouth (χ2(1, 144) = 9.598, p = 0.002). CONCLUSIONS: Predictive risk factors for 3-year-old children are based on demographic factors and are distinct from those for 5-year-old children based on biological and behavioural factors. Erosive wear is a risk factor for further wear in both age cohorts.

Association Between Breastfeeding Type and Duration and the Molar and Facial Characteristics of Preschoolers Aged 2 To 6 Years: A Cross-Sectional Study.

OBJECTIVE: To calculate the association between the type and duration of breastfeeding and the deciduous molar relationship and facial characteristics of preschoolers aged 2 to 6 years. STUDY DESIGN: This crosssectional study included 160 pre-schoolers aged 2 to 6 years old, enrolled in the 2019 academic year from 3 public schools in Data collection involved two phases. The first phase consisted in determining the facial type, anteroposterior and vertical profile, facial dimensions, and the molar relationship between primary second molars. The second phase included interviews with the parents or legal guardians. Children with exclusive breastfeeding and with mixed/artificial feeding (breastfeeding and bottle-feeding, or exclusive artificial bottle-feeding) were included. Chi-square test, t-test, multiple linear regression, and binary logistic regression tests were applied (p<0.05). RESULTS: The facial length, width, and the lower third were greater in the exclusive breastfeeding group than in the mixed/artificial feeding group (3.74mm, p=0.002; 2.06mm, p=0.047; and 2.94mm, p=0.015; respectively). In addition, children with breastfeeding for more than six months showed greater facial length, facial width and lower third (3.20mm, p=0.038; 3.68mm, p=0.006; and 3.57mm, p=0.026; respectively). The duration of exclusive breastfeeding influenced facial width, noting an increase of 3.32mm (p=0.011) if a pre-schooler had exclusive breastfeeding for more than six months. CONCLUSION: There were no significant associations between type and duration of breastfeeding and the molar terminal plane, facial type, or profile. However, facial dimensions were greater in the exclusive breastfeeding group, and when breastfeeding was longer than six months.

Prevalence of Oral Habits and its Association with Malocclusion in Primary Dentition among School Going Children of Nepal.

OBJECTIVES: The objectives of this study were to: (1) study the prevalence of oral habits among school going children with primary dentition; (2) determine the association of oral habits with malocclusion in primary dentition; and (3) compare the prevalence of oral habits based on gender, race, age and grade. STUDY DESIGN: A community based cross-sectional study was conducted among 625 school going children with a complete set of primary dentitions. A closed-ended questionnaire was developed to gather information about oral habits followed by clinical examination. RESULTS: The prevalence of oral habits was 42.7%. Finger nail biting (19.5%) was the most prevalent oral habit, whereas self-destructive oral habits (0.7%) were the least prevalent. Multivariate logistic regression analysis revealed significant association of (P<0.05): digit sucking habit with distal step molar relationship, class II canine relationship and increased overjet; pacifier sucking habit with presence of distal step molar relationship, class II canine relationship, crossbite and increased overjet; and finger nail biting habit with absence of primate spaces. CONCLUSIONS: Nearly half of the participating children indulged in one or more oral habits. There was significant association between some oral habits and malocclusion traits, indicating the requirement of timely screening and interception.

Distal guide as a substitute for distal shoe space maintainer: a case series study.

Early loss of the primary second molar (DSM) before the eruption of the permanent first molar (PFM) may result in its mesial drift during the eruption. Traditionally, a distal shoe space maintainer is used in this situation to control the path of eruption and preserve the space. However, considering its disadvantages, an alternative appliance needs to be developed for guiding the unerupted PFM. The purpose of this article is to represent an innovative design for preserving space after the early loss of the DSM, describe the fabrication process, and present some data on the successful results of using the appliance in five cases.

The association between black stain and lower risk of dental caries in children: a systematic review and meta-analysis.

BACKGROUND: Previous literature shows that children with dental black stain might be less susceptible to dental caries. The aim of this study was to systematically review the available literature to determine whether black stain presence could influence the prevalence or severity of dental caries in primary dentition. METHODS: A systematic search of PubMed, Web of Science, Scopus, Google Scholar, OpenGrey, and Egyptian Universities Libraries Consortium was conducted up to December 2020. Quality assessment was done using a modified version of Down's and Black checklist. Meta-analyses were performed to assess the association between dental black stain and: (i) Likelihood of developing dental caries/being caries-free (ii) Number of teeth affected by dental caries (iii) Number of tooth surfaces affected. RESULTS: The database search yielded 2164 results, 14 of which matched the eligibility criteria. The meta-analysis showed that the likelihood of developing caries (Fixed effect model: OR [95% CI]: 0.67 [0.54; 0.82]; I2=37%; τ2=0.05), number of teeth affected (Random effects model: MD [95% CI]: -0.98 [-1.54; -0.42]; I2=79%; τ2 =0.44), and number of surfaces affected (Random-effects model: MD [95% CI]: -2.34 [-4.23; -0.44]; I2=85%; τ2 =2.93), were all lower in children with black stain. CONCLUSIONS: It is suggested that dental black stain is associated with lower dental caries experience in children with primary dentition. However, it is questionable whether black stain has a protective effect against dental caries, or whether children at low risk of dental caries are more likely to develop BS because their oral microbiome favors BS-forming organisms.

Dental erosive wear in primary teeth among five-year-olds - Bergen, Norway.

OBJECTIVE: To estimate the prevalence of dental erosive wear among five-year-olds in Bergen, Norway, and to investigate associations between background factors and the condition. METHODS: A total of 387 children received a dental examination in five Public Dental Service clinics in Bergen, Norway. The parents responded to items about the children's dental hygiene and drinking habits, type of beverage container, diet, and other habits, and about their own age, educational level and country of origin. We explored background variables for possible associations with the outcome status as worst affected by erosive wear (19.4%, n = 75). Chi-squared statistics and logistic regression (Odds Ratios (OR): 95% Confidence Intervals (CI), served as statistical tools). RESULTS: Approximately 80% showed erosive wear (by SEPRS and by adopted diagnostic instrument (78.5% vs 79.8%)). The condition affected maxillary anterior teeth in 13.9% (n = 54), and cuppings in molars in 79.3% (n = 307) of cases. Grinding teeth during the day and/or night (OR: 1.87, CI: 1.07-3.25) and male sex (OR: 1.76, CI: 1.05-2.96) significantly related to outcome status as worst affected by erosive wear, respectively. CONCLUSION: Dental erosive wear was widespread. Grinding teeth and male sex associated with outcome status as worst affected by erosive wear.

A 3-Year retrospective study of traumatic dental Injuries to the primary dentition.

BACKGROUND/AIMS: Traumatic dental injuries (TDIs) in the primary dentition are a significant public health problem, which has been neglected worldwide. Despite its high prevalence, limited studies address this injury. The aim of this study was to determine the characteristics and treatment modalities of TDIs affecting primary teeth, along with accompanying medical co-morbidities and attendance at follow-up appointments. MATERIAL AND METHODS: This retrospective analysis included all TDIs affecting primary teeth from January 2014 to January 2017. Data abstraction included demographics, time lapse prior to arrival at hospital, trauma etiology, classification of TDIs, soft tissue and supporting bone injuries, medical co-morbidities, emergency treatment, follow-up appointments and prognosis. RESULTS: Records of 283 children with 536 traumatized primary teeth were reviewed. The median age was 2 years and the maxillary right central incisor (35.1%) was the most frequently injured tooth. Almost half the patients, 46.3%, sought treatment after 24 h. Periodontal tissue injuries (97.2%) predominated TDIs for which fall accidents (82.0%) were the most encountered cause. Most patients (177/283) had accompanying soft tissue/supporting bone injuries and 67.2% had multiple traumatized teeth. Seventy percent of the patients were examined only or were prescribed medication. Survival time following TDIs was unknown in 67.7% of traumatized teeth due to non-attendance at follow-up appointments. Most patients (55.1%) did not attend the follow-up appointments. CONCLUSIONS: TDIs occurred in the primary dentition with the predominance of periodontal tissue injuries. When TDI was the presenting problem to hospital, accompanying systemic injury was rare. Treatment modalities were mostly limited to examination or extraction. The follow-up appointments were poorly attended.

Dental Subphenotypes in Infants With Orofacial Clefts-A Longitudinal Population-Based Retrospective Radiographic Study of the Primary and Secondary Dentitions.

OBJECTIVES: To determine the developmental patterns of primary and secondary dentitions in infants with orofacial clefts. DESIGN: Retrospective, longitudinal, population-based cohort study. MATERIALS: Longitudinal records and radiographs of 192 nonsyndromic Northern European infants with isolated unilateral cleft lip (UCL, n = 111) and isolated cleft palate (CP, n = 81). METHODS: Radiographic assessments of primary and secondary dentition anomalies and dental maturation, by gender and cleft severity for comparisons between the groups and with historical controls. RESULTS: In infants with UCL, the frequencies of dental anomalies were high in both primary (38.7%) and secondary (18.0%) dentitions. Primary and secondary dentition anomalies were not observed in infants with CP and different in the UCL group (P = .003). Risk differences involved primary supernumerary teeth (P = .0001) and talon cusp formation (P = .0001), and secondary tooth agenesis (P = .001) of the maxillary lateral incisor on the side of the cleft lip. Delayed primary and secondary dental maturation occurred in the UCL and CP groups, greater in infants with UCL (P < .0001). Primary and secondary dental maturation featured sexual dimorphism with greater delay in males (UCL, P < .0001; CP, .0001 > P = .001). The effect of cleft severity on dental maturation was significant in infants with UCL (P = .0361) and CP (P = .0175) in the primary but not in the secondary dentition. CONCLUSIONS: There were different dental anomalies in the primary and secondary dentitions in operated infants with UCL and no dental anomalies in unoperated infants with CP. Dental maturation was delayed in infants with UCL and CP with greater delay in males compared to females.

Bilateral occurrence of bimaxillary bi-rooted primary canines: a rare case report with review of the literature.

Multiple roots in anterior teeth are very rarely reported in the literature. The occurrence of multi-rooted canine in primary dentition is an infrequent entity. This unusual abnormality is an accidental finding on routine examination. Radiographic examination plays a significant role in the identification of this anomaly. This rare anomaly has been reported very infrequently reported and has not been published in a Saudi Arabia population. Therefore, the purpose of the present case report is to describe a case of an 8-year old Saudi boy presented with the bimaxillary occurrence of bi-rooted primary canine. This report discusses this unique occurrence in the context of the published literature.

Validation of digital analysis of occlusion in primary and mixed dentition using GEDAS.

AIM: The present prospective clinical study aimed to validate the Greifswald Digital Analyzing System (GEDAS) as a method for digital assessment of the occlusion in primary and mixed dentition. MATERIALS AND METHODS: The reproducibility of GEDAS in primary and mixed dentition was assessed using the intraclass correlation coefficient (ICC). In addition, the acceptability of the method to the dentist, the child, and the parent/caregiver was assessed using a modified visual analog scale of faces, the Frankl behavior scale, and the 10-point Likert scale. In total, 20 participants aged between 3 and 9 years (mean age: 6; standard deviation: ± 1.74) with primary (n = 10) and mixed (n = 10) dentition were recruited. RESULTS: The ICC for the number of contact points in all teeth was 0.94 and for the area of contact points was 0.97, indicating good to excellent reproducibility. The average total number of contacts per bite registration per arch in the primary and mixed dentition was 36.5 (17 to 66) and 37.9 (9 to 74), respectively. The average of the total area of interocclusal contact area in the primary and mixed dentition was 25.55 mm2 (5.39 to 70.20) and 29.59 mm2 (2.80 to 78.53), respectively. During the procedure, the majority of dentists reported the child's behavior to be positive (85%) and found the procedure easy to perform (80%), short (6.0 min), and tolerable (80%). CONCLUSION: GEDAS is an occlusal analysis tool with good acceptability and reproducibility in children and could be considered for the planning and assessment of restorative and orthodontic treatment in the intermediate stages.

Clinical management of fusion in primary mandibular incisors: a systematic literature review.

Objective: Dental anomalies occurring in deciduous teeth can affect the eruption of the permanent dentition and the occlusion stability. The occurrence of dental anomalies such as double teeth during the primary dentition in the daily practice might be frequent. The study aimed to qualitatively summarize the therapeutic management of double teeth in primary incisors.Material and Methods: A systematic review regarding the therapy of primary fused incisors in the mandible was performed and the obtained data were assessed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The following electronic databases were screened from 1st January, 1996 until 30th July, 2019: PubMed, Scopus, EBSCO and the archives of paediatric dental journals. The search terms were grouped in anatomic entity: (tooth OR teeth OR incisor), pathological condition: (fused OR fusion OR geminated OR double), intervention: (treatment OR intervention OR therapy OR prevention OR control OR management OR restoration), observed parameters: (primary dentition OR primary tooth OR primary teeth).Results: Ten articles met all inclusion criteria. The data disclosed the occurrence of double teeth in mandibular incisors. The main management of this clinical condition is either preventive or surgical involving the extraction of fused teeth, based on the deciduous nature of the teeth, the degree of caries and malocclusion development risk.Conclusion: An early diagnosis of dental anomalies is fundamental for the application of proper preventive strategies to avoid a potential malocclusion in permanent dentition and to maintain these teeth sound and caries-free until the eruption of the permanent dentition.

ACTN2 (rs6656267) and MPPED2 (rs11031093 and rs536007) polymorphisms in primary dentition caries: A case-control study.

BACKGROUND: Dental caries represents one of the most common human diseases which can lead to pulpitis, pain, and tooth loss and can negatively affect growth and well-being. Although dietary and environmental factors have been extensively studied towards their contribution of the disease, genetic factors that contribute one's susceptibility over caries development remain rather clouded. AIM: To investigate the possible contribution of ACTN2 (rs6656267) and MPPED2 (rs11031093 and rs536007) polymorphisms in primary dentition caries. DESIGN: Samples from children (5-12 years old) were collected and genotyped for ACTN2 (rs6656267) and MPPED2 (rs11031093 and rs536007) polymorphisms. With regard to dmfs index and socio-economic status, an association between these polymorphisms and primary dentition caries was investigated. RESULTS: ACTN2 (rs6655267) and MPPED2 (rs536007) are not associated with primary dentition caries. MPPED2 (rs11031093, G Allele) is marginally associated. CONCLUSIONS: MPPED2 (rs11031093, G Allele) is marginally associated with caries susceptibility on primary dentition.