Root resorption of primary molars and dental development of premolars in children with Osteogenesis Imperfecta medicated with bisphosphonates, grouped according to age and gender.

BACKGROUND: Osteogenesis imperfecta (OI) is an inherited disorder characterized by bone fragility and skeletal alterations. The administration of bisphosphonates (BPs) to patients with OI reduces pain, thereby improving their quality of life. The main mechanism of action of BPs is the inhibition of osteoclast action. In the oral cavity of children with OI during growth and development, physiological processes that require the function of osteoclasts occur. The aim of this investigation was to study the dental development of premolars and the root resorption of primary molars in children with OI medicated with BPs according to age and sex. METHODS: An observational and analytical study was designed. The study sample consisted of 26 6- to 12-year-old children with a confirmed diagnosis of OI treated with BPs with available panoramic radiographs. The control group consisted of 395 children with available panoramic radiographs. Both groups were divided into subgroups according to sex and age. The third quadrant was studied, focusing on the first left temporary molar (7.4), the second left temporary molar (7.5), the first left permanent premolar (3.4) and the second left permanent premolar (3.5). The Demirjian method was used to study the dental development of 3.4 and 3.5, and the Haavikko method was used to study the root resorption of 7.4 and 7.5. The Mann‒Whitney U test was used for comparisons, and p < 0.05 indicated statistical significance. RESULTS: The mean chronological age of the 421 patients was 9.21 years (95% CI 9.05-9.37). The sample was reasonably balanced by sex, with 52.5% (221 patients) boys versus 47.5% (200 patients) girls. Delayed exfoliation and tooth development were described in children with OI (p = 0.05). According to sex, the root resorption of primary molars and tooth development were significantly lower in boys in both groups and in girls in the OI group, but the differences between the age groups were not significant. CONCLUSIONS: Children with OI treated with BPs exhibit delayed dental development of the premolars and delayed root resorption of the primary molars. Boys exhibited delays in both variables, but the differences by age subgroup were not significant. These clinical findings support the importance of clinically and radiographically monitoring the dental development and root resorption of primary teeth in children with OI treated with BPs to avoid alterations of the eruptive process.

Chemo mechanical caries removal CMCR: Efficacy of Carisolv gel in primary molar teeth.

Objectives: To evaluate the efficacy of CariSolv gel with respect to chemo-mechanical caries removal in primary molar teeth. METHODS: The cross-sectional study was conducted at the Department of Paediatric Dentistry, Bakhtawar Amin Dental College and Hospital, Multan, Pakistan, from July to December 2022, and comprised patients of either gender aged 6-12 years having vital, primary molar teeth with clinical and radiographic evidence of carious lesion. Freshly prepared CariSolv gel 0.2 ml to 1.0ml was applied to carious dentine for a minimum of 30 seconds, using chemo-mechanical caries removal hand instruments. The cavity preparation was rinsed and dried. Image caries detector dye was applied by micro brush for 10 seconds. After the cavity preparation was washed and dried, any red-stained dentine indicated residual infected dentine. A maximum of 3 chemo-mechanical caries removal cycles were allowed. Data was analysed using SPSS 26.0. RESULTS: Of the 134 patients, 74(55.2%) were boys and 60(44.8%) were girls. The overall mean age was 8.55±1.58 years. The procedure was successful in 115(85.8%) cases. Age and gender were not significantly associated with the outcome (p>0.05). CONCLUSIONS: Chemo-mechanical caries removal method using CariSolv gel was found to be a viable alternative to traditional drilling techniques for caries removal in primary molar teeth.

Arm design of band and loop space maintainer affects its longevity: a patient-specific finite element study.

Fixed space maintainers (FSMs) are commonly utilized in pediatric dentistry to prevent space loss following premature tooth extraction. Although previous studies have examined the survival rates and causes of FSM failure, the impact of arm design on failure has not been investigated. This study aimed to investigate the tensile and compressive stresses related to FSMs with different arm designs and evaluate the effect of arm designs on FSM failure. Cone beam computed tomography images of a child who experienced premature loss of a primary mandibular left second molar tooth were retrieved from our database, then processed and simulated using the Rhinoceros software. Finite element analysis was performed to evaluate the stresses on four distinct FSM arm designs under simulated chewing forces. The results showed that the straight-arm FSM design exhibited the highest von Mises principal stress, while FSMs with curved arms and surrounding primary mandibular left first molar in the mesial area demonstrated the lowest von Mises stress accumulation. Intense stress accumulation on the distal surface of tooth 74 was observed in the test models due to the transmitted forces by the FSM. The maximum principal stresses accumulated at the base of the alveolar socket of the mesial root of tooth 36, while the minimum principal stresses were identified at the mesio-marginal area of the alveolar crest. The arm design played a crucial role in enabling the appliance to effectively withstand the stresses accumulating on the Space maintainer (SM) and orthodontic band. Bending the SM arms to match the surrounding profile with curvature increased the stress absorption capacity by increasing the arm length.

The prevalence and characteristics of and the association between MIH and HSPM in South-Western France.

BACKGROUND: Molar-incisor hypomineralisation (MIH) and hypomineralised second primary molars (HSPM) involve qualitative structural developmental anomalies of tooth enamel, affecting the first permanent molars (FPM) and the second primary molars, respectively. This developmental anomaly of systemic origin has important consequences for oral health. AIM: To determine the prevalence of MIH and HSPM in south-western France and explore the distribution of hypomineralised lesions on permanent and primary molars. DESIGN: Amongst 856 children (aged 7-9 years) in schools randomly selected by the Academy of Bordeaux (Ministry of Education), the FPM, permanent incisors and the second primary molars were examined by two examiners trained and calibrated for the diagnostic criteria for MIH and HSPM of the European Academy of Paediatric Dentistry. RESULTS: Molar-incisor hypomineralisation was present in 160 children (18.7%) and HSPM in 81 children (9.5%); 4.9% had both HSPM and MIH (42 of 856). Hypomineralised lesions were present in 1-4 FPM in affected individuals (mean = 2.4) and were distributed in an asymmetrical manner with widely varying severity at the tooth and individual level. A child with HSPM was more likely to have MIH than a child without HSPM (95% CI OR = 6.0 [3.7-9.7]; p < .0001). CONCLUSION: Molar-incisor hypomineralisation and HSPM have three main asymmetrical characteristics: tooth location, severity of hypomineralisation and number of teeth affected.

A retrospective study of iRoot BP Plus pulpotomy compared with Vitapex pulpectomy for irreversible pulpitis of primary molars with the presence of coronal pulp tissue.

BACKGROUND: Pulpotomy has been successfully performed in immature and mature permanent teeth with irreversible pulpitis but rarely in primary teeth. AIM: To evaluate the outcomes of iRoot BP Plus pulpotomy and Vitapex pulpectomy in primary molars with irreversible pulpitis. DESIGN: We selected 130 primary molars of 99 patients, aged 3-7 years, diagnosed with irreversible pulpitis with coronal pulp tissue and treated with iRoot BP Plus pulpotomy or Vitapex pulpectomy (median follow-up period: 18 months). They were divided into the pulpotomy (n = 88) and pulpectomy (n = 42) groups according to treatment procedure. The pulpotomy group was further divided into asymptomatic (n = 46) and symptomatic (n = 42) subgroups according to preoperative symptoms. The chi-squared test and Cox regression were performed to analyze the outcomes. RESULTS: Clinical and radiographic success rates were significantly higher in the pulpotomy group (98.9% and 95.5%) than in the pulpectomy group (88.1% and 54.8%) and did not differ significantly between asymptomatic and symptomatic pulpotomy subgroups. CONCLUSION: Irreversible pulpitis of primary molars with coronal pulp tissue can be successfully treated with iRoot BP Plus pulpotomy. Early intraradicular resorption of materials is the main adverse outcome of Vitapex pulpectomy.

Clinical application of a digital semi-rigid bridge space maintainer fabricated from polyetheretherketone for premature loss of primary molars.

BACKGROUND: Premature loss of primary molars can be treated with a band loop space maintainer (SM). However, fabricating a conventional band loop SM requires multiple clinical and laboratory procedures, which can potentially affect the accuracy of the SM. Moreover, the conventional SM is unable to fully restore masticatory function and maintain the vertical dimension of the edentulous space. In this current study, a fully digital workflow to fabricate a semi-rigid bridge SM made from polyetheretherketone (PEEK) has been described and evaluated for its clinical effectiveness. METHODS: A total of 15 children (eight males and seven females) between the ages of 4-8 years, who experienced the premature loss of a single primary molar, were included in this study. Digital impressions were taken using the CEREC CAD/CAM chair system and imported into CAD software to design the semi-rigid bridge SM, which was fabricated using PEEK block as the maintainer material. The digital SM was tried-in and bonded to the abutment with resin cement. The edentulous space was measured immediately after bonding (T0) and 1 month (T1), 3 months (T2), and 6 months (T3) after treatment. The periodontal condition and mobility of the SM and abutment were also examined. RESULTS: The use of digital impressions resulted in a decreased occurrence of the pharyngeal reflex. The digital semi-rigid bridge SM, fabricated with PEEK, was both convenient and aesthetically pleasing, and successfully restored the anatomy and masticatory function of the missing primary molar. None of the 15 semi-rigid bridge SMs or abutments became loose or fell off during the study, and only one child presented with gingivitis. Furthermore, the difference in the edentulous space at T0, T1, T2, and T3 was not statistically significant (all P > 0.05). CONCLUSIONS: The digital semi-rigid bridge SM fabricated with PEEK was clinically effective in maintaining the missing space and had advantages over the traditional band/crown loop SM.

Emil Zuckerkandl and his Dental Tubercle (Historical Note).

One of the eponyms most frequently cited in dental morphology texts, together with the Carabelli tubercle of the first permanent maxillary molars, is the Zuckerkandl tubercle of deciduous molars. However, references about Emil Zuckerkandl in the field of dental history and this particular entity are scarce. The reason this dental eponym was pushed "into the shadows" probably lies in the many other anatomical parts (including another tubercle, the pyramidal one of the thyroids), which took their names from this great anatomist.

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.

Wear and marginal quality of aesthetic crowns for primary molars.

BACKGROUND: Due to limited aesthetics of stainless-steel crowns, the demand for tooth-coloured crowns has recently risen. Few studies have investigated the marginal integrity and wear behaviour of tooth-coloured primary molar crowns under subcritical load in vitro. AIM: This in vitro study evaluated the marginal quality and wear of newly introduced resin composite and hybrid ceramic crowns compared with metal and zirconia crowns. DESIGN: Metal, resin composite, hybrid ceramic (CAD/CAM), and various zirconia crowns were investigated. After thermomechanical loading (2,500 thermocycles/100,000 × 50N), marginal quality of luting gaps and wear of crowns/antagonists were evaluated using replicas under a light or 3D laser scanning microscope. Results were analysed with the Mann-Whitney U test or one-way ANOVA (p < .05). RESULTS: Marginal quality of the new resin composite and hybrid ceramic crowns performed well in comparison with SSC and zirconia crowns. Adhesive bonding of crowns resulted in superior marginal seal compared with conventional GIC (Mann-Whitney U test, p < .05). Regarding wear, zirconia crowns exhibited significantly worse results than resin composite or hybrid ceramic crowns and SSCs (ANOVA, p < 0.05). CONCLUSION: The new resin composite and hybrid ceramic crown exhibited good performance in comparison with SSCs and zirconia crowns considering both wear and marginal quality after subcritical loading.

Impact of hypomineralised second primary molar on preschoolers' oral health-related quality of life-A hierarchical approach.

BACKGROUND: Hypomineralised second primary molar (HSPM) is a developmental enamel defect associated with dental caries. AIM: To evaluate the impact of HSPM on oral health-related quality of life (OHRQoL) in preschoolers through hierarchical analysis. DESIGN: This population-based cross-sectional study assessed 834 5-year-old preschoolers, in Teresina, Piauí, Brazil, using sociodemographic questionnaires and Early Childhood Oral Health Impact Scale (ECOHIS). Dental examination was performed by two calibrated examiners (κ ≥ 0.80) for the diagnosis of HSPM (EAPD), dental caries (dmft and pufa indices), and malocclusion (Foster and Hamilton criteria). Analysis of the determinants of OHRQoL was stratified at three levels (P < .05). RESULTS: Severe HSPM was associated with OHRQoL in bivariate analysis (P < .05). In adjusted final multivariate analysis (model 1), the presence of dental caries with or without clinical consequences was associated with worse OHRQoL (P < .05). In model 2, after the removal of dental caries, preschoolers with severe HSPM had greater probability of having a negative impact on OHRQoL in the child impact section (RR = 2.14; 95% CI = 1.26-3.65), family impact section (RR = 1.99; 95% CI = 1.16-3.42), and total score (RR = 2.09; 95% CI = 1.25-3.49) of the ECOHIS. CONCLUSION: Severe HSPM had a negative impact on the OHRQoL of preschoolers and their families, but the presence of dental caries neutralised this impact.

Prenatal, perinatal and postnatal events associated with hypomineralized second primary molar: a systematic review with meta-analysis.

OBJECTIVE: The etiology of hypomineralized second primary molar (HSPM) appears to be multifactorial but remains uncertain. Thus, the objective was to systematically review studies that investigated adverse health conditions in the prenatal, perinatal and postnatal periods associated with HSPM. MATERIAL AND METHODS: The search was carried out in five databases and in gray literature. The risk of bias of observational studies was analyzed according to the Newcastle-Ottawa scale. RESULTS: A total of 1878 studies were identified. Fourteen were eligible, and seven were included in the meta-analysis. Maternal smoking (OR = 2.88; 95%CI: 1.62-5.15) and presence of maternal hypertension (OR = 2.91; 95%CI: 1.35-6.28) were significantly associated with higher odds of HSPM. In the perinatal period, factors associated with HSPM were low birth weight (OR = 1.50; 95%CI: 1.15-1.96), prematurity (OR = 1.93; 95%CI: 1.37-2.71), delivery complications (OR = 2.42; 95%CI: 1.52-3.83) and need for an incubator (OR = 1.65; 95%CI: 1.01-2.70). Not breastfeeding (OR = 1.26; 95%CI: 1.01-1.58), use of antibiotics by the child (OR = 1.24; 95%CI: 1.04-1.48), fever (OR = 1.37; 95%CI: 1.10-1.72) and asthma (OR = 1.91; 95%CI: 1.16-3.13) were the postnatal factors associated with HSPM. CONCLUSION: Maternal smoking, maternal hypertension, low birth weight, prematurity, delivery complications, need for incubation, not breastfeeding, antibiotic use, fever and childhood asthma were associated with HSPM. Well-designed prospective cohort studies are needed. Clinical relevance Understanding the etiological factors can be guiding aspects for individual clinical approaches, as well as guiding the design of preventive interventions for HSPM.

Success of Biodentine and Ferric Sulfate as Pulpotomy Materials in Primary Molars: A Retrospective Study.

OBJECTIVE: To determine the clinical and radiographic success of Biodentine® (BD) and Ferric Sulfate (FS) as primary molar pulpotomy materials and to compare their outcomes. STUDY DESIGN: Retrospective data was obtained from the electronic health records (EHR) of a university-based pediatric dental clinic. Participants were enrolled according to specified inclusion and exclusion criteria. Two trained and calibrated examiners evaluated the EHR using validated criteria for clinical and radiographic outcomes. Study data was numerically coded and analyzed. Cohen's Kappa and Chi-square tests were used (p<0.05). RESULTS: Eighty-three participants (62.7% females, age range two to eight years, average age of 4.5 years) with 102 pulpotomies were enrolled. FS was used in 78% (n=79) and BD in 22% (n=23) of the cases. Follow-up periods ranged from six to 36 months (mean of 17 months). BD showed 100% clinical and radiographic success, while FS demonstrated 84% clinical and 70% radiographic success. The two groups were compared at one year with no statistically significant differences. At 18 months, BD outperformed FS clinically (p=.012) and radiographically (p=.001). Intra-rater and inter-rater agreement were κ>0.88. CONCLUSIONS: Both materials can be recommended for clinical practice, however BD may be the preferred choice for its better outcomes at 18 months.

Comparison of two pediatric rotary file systems and hand instrumentation in primary molar: An ex vivo cone-beam computed tomographic study.

BACKGROUND: Pulpal involvement, secondary to dental caries, is not uncommon and is a challenging task for pediatric dentists. Morphological differences in root canal of deciduous teeth increases the complexity of management. The aim of this study was to compare two rotary file systems and hand instrumentation for root canal preparation in regard to canal transportation, centering ability ratio, and dentin thickness using cone-beam computed tomography (CBCT). METHODS: A total of 72 canals from 24 freshly extracted mandibular deciduous second molars were divided into a set of 8 teeth, then prepared using 2 rotary files systems: the Kedo-S pediatric file system (Group A) and Pro AF Baby Gold file system (Group B) were compared to hand instrumentation (Group C). CBCT scans before and after root canal preparation were used to evaluate tested parameters. Instrumentation time for all three techniques was also measured using a chronometer. RESULTS: Although rotary file systems have shown superior results in root canal preparation as compared to hand instrumentation, no significant differences were observed between all the groups for canal transportation and dentin thickness at all three levels of prepared canals. A comparison of centering ability ratio between all the groups was found to be statistically significant only at the cervical level. A significant difference was observed between hand instrumentation using K-files (117.3 s) and both rotary systems (Kedo-S (81 s) and Pro AF Baby Gold (81.5 s)) in terms of canal preparation time (P < 0.001). CONCLUSIONS: Both tested rotary systems and hand instrumentation demonstrated comparable canal preparation results, with differences that were statistically non-significant in most tested parameters, without shaping errors. However, both the rotary systems were more efficient and faster than hand instrumentation.

Evaluation of success of stainless steel crowns placed using the hall technique in children with high caries risk: A randomized clinical trial.

OBJECTIVE: This study aimed to compare the clinical efficacy and survival rates of the hall technique (HT), and conventional restoration (CR) for the management of occlusoproximal carious lesions in primary molars. MATERIALS AND METHODS: This clinical study observed 35 children (aged 4-8 years). Exclusion criteria included symptoms of pulpal or periradicular pathology or systemic conditions requiring special dental considerations. For each child, at least one tooth was treated with HT and one with CR. The primary outcome measures were minor and major clinical failure rates. Plaque and gingival scores of the teeth were also evaluated. Friedman test and Wilcoxon signed ranks test were used to compare the plaque and gingival index scores for each arm. Chi-square tests were used for comparisons of clinical outcomes, plaque-gingival index, and distribution of ICDAS categories among treatment arms (P < 0.05). RESULTS: Thirty-three of 35 (94.2%) participants returned for 1-year follow-up. HT showed statistically significantly higher treatment survival rate and fewer minor failures than CR (P = 0.040). The rate of major failures was minimal (2 of 84 teeth) and did not differ between treatments (P = 0.092). In both treatment groups, the gingival score and plaque score were significantly decreased at the 1-year follow-up (P < 0.05). CONCLUSION: HT was a more successful method for managing caries in primary molars than CR, both for symptoms of pulpal disease and longevity of the restorations. HT is a simplified method of managing carious primary molars using SSCs cemented with no local anesthesia, caries removal, or tooth preparation.

Delayed Spontaneous Eruption of Severely Infraoccluded Primary Second Molar: Two Case Reports.

Infraocclusion occurs at an early age and becomes worse with age, causing increased damage in young children. Extraction of affected teeth is the preferred treatment modality for prevention of possible complications. It is rare for a primary molar to temporarily exhibit secondary failure of eruption, followed by regeneration of full eruptive capacity. This report was written to describe two patients who experienced spontaneous eruption of an infraoccluded primary molar at approximately 7 years of age. While watchful waiting is not always a suitable treatment option, we propose that extraction be deferred until the first permanent molar erupts, unless significant problems occur.

Association between developmental dental anomalies, early childhood caries and oral hygiene status of 3-5-year-old children in Ile-Ife, Nigeria.

BACKGROUND: To determine the association between developmental dental anomalies (DDA), early childhood caries (ECC) and oral hygiene status of 3-5-year-old children resident in Ile-Ife, Nigeria. METHODS: This was a cross-sectional study. We analyzed data for 3-5-year-olds extracted from the dataset of a household survey collected to determine the association between ECC and maternal psychosocial wellbeing in children 0-5-year-old. The outcome variables for the study were ECC and poor oral hygiene. The explanatory variable was the presence of developmental dental anomalies (supernumerary, supplemental, mesiodens, hypodontia, macrodontia, microdontia, peg-shaped lateral, dens evaginatus, dens invaginatus, talons cusp, fusion/germination, hypoplasia, hypomineralized second molar, fluorosis, amelogenesis imperfecta). The prevalence of each anomaly was determined. Poisson regression analysis was conducted to determine the association between presence of developmental dental anomalies, ECC and oral hygiene status. The model was adjusted for sex, age and socioeconomic status. RESULTS: Of the 918 children examined, 75 (8.2%) had developmental dental anomalies, 43 (4.7%) had ECC, and 38 (4.1%) had poor oral hygiene. The most prevalent developmental dental anomalies was enamel hypoplasia (3.9%). Of the 43 children with ECC, 6 (14.0%) had enamel hypoplasia and 3 (7.6%) had hypomineralized second primary molar. There was a significant association between ECC and enamel hypoplasia (p < 0.001) and a borderline association between ECC and hypomineralized second primary molars (p = 0.05). The proportion of children with poor oral hygiene (PR: 2.03; 95% CI: 0.91-4.56; p = 0.09) and ECC (PR: 2.02; 95% CI: 0.92-4.46; p = 0.08) who had developmental dental anomalies was twice that of children with good oral hygiene and without ECC respectively, although the differences did not reach statistical significance. CONCLUSIONS: Enamel hypoplasia and hypomineralized second primary molars are developmental dental anomalies associated with ECC. developmental dental anomalies also increases the probability of having poor oral hygiene in the population studied.

[Clinical efficiency and cost-effectiveness of standard metal crowns for primary molars]. / Meditsinskaia i sotsial'no-ékonomicheskaia éffektivnost' primeneniia standartnykh stal'nykh koronok dlia restavratsii vremennykh moliarov u detei.

The aim of the study was to assess clinical efficacy and cost-effectiveness of standard metal crowns for primary molars restoration. The paper contains the results of 3-year study of 2 groups of children aged 3-9, whose molars were restored using different techniques after treatment of chronic fibrous pulpitis. In the first group (42 children) 128 temporary molars were restored using filling materials (glass ionomer cements, compomers), in the second group (35 children) 106 temporary molars were restored using standard metal crowns (3M ESPE USA). Follow-up examinations were performed every 6 months. Clinical efficacy was valued using the following criteria: number of repeated restorative procedures because of restorations failure and rate of extracted teeth in each group after 3 years follow-up. Cost-effectiveness and financial burden for healthcare providing system was assessed according to the cost of each procedure, number of repeated procedures and additional cost associated with restoration failure and teeth extractions. The results of the 3-year study proved that despite the higher cost of initial restorative procedure when using stainless steel crowns the method shows higher clinical success and cost-effectiveness in a long-term run.

Mineral Trioxide Aggregate and Diluted Formocresol Pulpotomy: Prospective and Retrospective Study Outcomes.

Mineral Trioxide Aggregate (MTA) has been used in many endodontic procedures with success. We hypothesized that MTA as a pulpotomy medicament elicits outcomes no different than that of the diluted formocresol (DFC). PURPOSE: The purpose of this study was to compare the outcomes of grey MTA and DFC in primary molar pulpotomies at a teaching institution and a pediatric dental practice. METHODS: At the teaching institution, 206 primary molars of 122 children were enrolled. At 48-months, 20 teeth treated with MTA and 25 teeth treated with DFC, were available for evaluation. At the private practice, dental records of 245 primary molars of 68 patients were available for evaluation. RESULTS: At 48 months, the results from both sites showed a radiographic success rate of 80 percent for DFC and 95 percent for MTA. The odds of radiographic failure were not affected by study sites. The Cox-regression analysis revealed that patient's age at the time of pulpotomy impacted the "hazard of exfoliation." Each year following the completion of DFC or MTA pulpotomy, there is a 4.6-times-more-likely chance for early exfoliation of the pulpotomized tooth. CONCLUSION: Grey MTA is an acceptable alternative for primary molar pulpotomies.

Microleakage of Different Adhesive Systems in Primary Molars Prepared by Er: YAG Laser or bur.

BACKGROUND AND AIM: This study aimed to examine the microleakage of class V cavities of primary molars prepared by either a conventional dental bur or Er:YAG laser and one of two different adhesive systems. METHODS: A total of 50 tooth samples from primary molars were used in this study. They were randomly assigned into five experimental groups of 10 samples each, according to the cavity preparation technique and the type of adhesive system applied to the cavities. Following cavity preparation, etching, bonding, and filling steps, samples were dyed using basic fuchsine and were sectioned longitudinally in buccolingual direction. Percentages of dye penetration at gingival and occlusal margins were calculated for each group. RESULTS: Overall, microleakage scores of gingival margins were significantly higher than those of occlusal margins (P < 0.001). The group that underwent laser preparation, laser etch, and self-etch bonding procedures had worse microleakage scores for gingival margins. However, all groups had similar occlusal scores (P > 0.05). CONCLUSION: Self-etch bonding systems and cavity preparation with Er:YAG laser may be an alternative to conventional restoration of primary molars with compomers. Further studies are warranted to fully elucidate the effect of laser-based etching techniques in cavities prepared by laser.

Fracture resistance force of primary molar crowns milled from polymeric computer-aided design/computer-assisted manufactured resin blocks.

Purpose: To compare fracture resistance force (FRF) and failure types of crowns milled from resin nanoceramic (Lava Ultimate)-, and modified polymethylmethacrylate (PMMA) (Vita computer-aided design (CAD)-Temp)-, and PMMA (Telio CAD)-based CAD/computer-assisted manufactured (CAM) blocks. Materials and Methods: Three experimental groups of 10 milled crowns were arranged: Group-1 (Lava Ultimate), Group-2 (Vita CAD-Temp), and Group-3 (Telio CAD). Crowns were machined in sizes similar to a primary second molar stainless steel crown (SSC) and stored in water at 37°C for 30 days. The crowns were seated on Cr-Co dies. Their FRFs were measured using a universal test machine until fracture. FRFs and failure types were recorded and statistically analyzed (P < 0.05). Results: There were statistically significant differences among the groups for both FRFs and failure types. The sources of significant differences for FRFs and failure types were Group-3 and Group-1, respectively. CONCLUSION: Crowns milled from different chemical structural CAD/CAM blocks may be used for restoration of primary molar teeth.