Comparing the relative influence of obesity and ancestry on timing of dental development.

INTRODUCTION: The dentition is one of the most accurate features for age estimation in children. However, there is some evidence that timing of dental development varies across populations. Recent research suggests that dental development may also be susceptible to influence by environmental factors, such as obesity. Given that there are also population differences in average body mass, it is possible that this may be a confounding variable that was not accounted for in prior work. We aim to compare the relative association between body mass index (BMI) and ancestry with timing of dental development. METHODS: A retrospective cross-sectional chart review was undertaken using panoramic radiographs of 6- to 12-year-olds (n = 281). Age, ancestry, sex, height, and weight were obtained. Dental development was assessed using the Demirjian method, and chronological age was subtracted from estimated dental age to determine relative timing of dental development (ΔAge). BMI was calculated based upon recorded height/weight within 6 months of time of radiograph. RESULTS: We found no difference in timing of dental development (accelerated/delayed) across ancestry groups (African-American, Euro-American, Hispanic, Asian; P = .15). Overweight/obese subjects had statistically significantly advanced (precocious) dental development (P < .001). Compared to normal-weight subjects, children who were overweight's age were overestimated by 5.76 months (0.48 years) and children with obesity by 5.97 months (0.49 years) on average. CONCLUSIONS: BMI appears to have a greater impact on relative timing of dental development than ancestry in this population. Our results support other findings that obesity results in accelerated growth and development.

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.

Articaine Infiltration Versus Lidocaine Inferior Alveolar Nerve Block for Primary Mandibular Molars: A Double-blind Randomized Controlled Clinical Trial.

Purpose: To compare the effectiveness of articaine local infiltration with lidocaine inferior alveolar nerve block (IANB) for restorative treat- ment of primary mandibular molars (PMMs). Methods: In this double-blind, parallel-design, randomized, controlled, clinical trial, participants were enrolled according to specified inclusion criteria (four to 10 years of age, need of PMM restorations, Frankel four behavior) and randomly assigned into either an articaine or lidocaine group. One investigator administrated all local anesthesia (LA). Nineteen trained and calibrated exam- iners, blinded to LA type, evaluated participants' reactions during LA administration and treatment using Modified Behavioral Pain Scale (MBPS). Participants rated their experiences using Wong-Baker FACES Pain Rating Scale (WBFS). The subjects' blood pressure and pulse were recorded throughout procedures. Statistical analysis employed Mann Whitney-U test, repeated measures analysis of variance (P<0.05), and Cohen's kappa. Results: A total of 110 participants (n equals 55 per group; mean age equals 6.42 years; 60 percent males) were enrolled. The mean MBPS rating during LA administration was higher for lidocaine IANB (3.89) compared to articaine infiltration (2.24; P<0.001). The mean MBPS rating through- out treatment was higher for the lidocaine group (2.51) compared to articaine group (1.69; P=0.012). The lidocaine group had a mean WBFS score of 1.64, while for the articaine group WBFS was 0.872 (P=0.089). All physiological measurements were within normal limits with no difference between groups. Conclusions: This study demonstrated that local infiltration with articaine was less distressing upon administration and may be considered safe and effective alternative to lidocaine IANB for restorative treatment in PMMs.

Evaluation of the (hu)MANid program for sex and ancestry estimation in a diverse, contemporary CT scan-based sample.

Human remains from forensic and bioarcheological contexts are often fragmentary, requiring methods for estimating a forensic profile that are based upon limited skeletal features. In 2017, Berg and Keryhercz created an online application, (hu)MANid, that provides sex and ancestry estimation from mandibular morphoscopic traits and linear measurements. In this study, we examine the utility of the (hu)MANid application in a diverse, urban US adult sample (aged 20-45; n = 143) derived from computed tomography (CT) scans. We secondarily conduct a preliminary analysis of the program's utility in a sample of adolescents (aged 15-17; n = 40). Six morphoscopic, and eleven morphometric traits were recorded as directed by the literature associated with the (hu)MANid program. Percent correct classification and posterior predictive values were calculated for the sex and ancestry estimations output by the program; chi-squared tests were employed to compare self-reported and predicted ancestry. In the adult sample, sex was accurately predicted for 75.52% of the sample. Ancestry prediction, however, was less favorable ranging from 19.3% to 50% correct. For the adolescent sample, correct sex estimation (45%) did not surpass what could occur by chance alone, though ancestry prediction fared better than in the larger adult sample (percent correct prediction overall average: 47.5%, range 35.71%-71.43%). The (hu)MANid application shows utility for use with CT scan-derived adult samples for sex estimation, but caution is warranted for ancestry estimation and use with samples that may not have reached full adult maturity.

A Randomized Controlled Trial Comparing the Success of Mineral Trioxide Aggregate and Ferric Sulfate as Pulpotomy Medicaments for Primary Molars.

Purpose: To evaluate and compare the clinical and radiographic performance of a new type of mineral trioxide aggregate (MTA, NuSmile® NeoMTA®) and ferric sulfate (FS) as pulpotomy medicaments for primary molars over 12 months.
Methods: Fifty participants (25 per group) were enrolled, according to specific inclusion criteria. Each participant received a single primary molar pulpotomy either with MTA or FS, depending on random digit table method allocation. Fifteen pediatric dental residents completed all pulpotomies, supervised by specialist faculty. Two calibrated examiners performed outcome assessments according to standardized criteria. Every six months, the study teeth were evaluated clinically and every 12 months radiographically. The inter- and intraexaminer reliability was assessed using Cohen's kappa, and the chi-square test was used for statistical analysis.
Results: At six months, 42 participants (21 in each group) returned for evaluation. The FS group showed 95.2 percent clinical success compared to 100 percent for the MTA group. At the 12-month clinical and radiographic evaluation, the return sample consisted of 29 participants (14 in the MTA group, 15 in the FS group). FS had 86.6 percent clinical success and 60 percent radiographic success, while MTA showed 100 percent clinical and radiographic success. At 12 months, MTA showed a statistically significantly higher success rate compared to FS (P = 0.008). Examiner reliability was excellent with a kappa score greater than 0.88.
Conclusion: At 12 months, MTA showed superior success as a pulpotomy medicament in primary molars compared to FS.

Articaine Infiltration Versus Lidocaine Inferior Alveolar Nerve Block for Anesthetizing Primary Mandibular Molars: A Randomized, Controlled, Double-Blind Pilot Study.

Purpose: The purpose of this study was to compare the effectiveness of articaine local infiltration to lidocaine inferior alveolar nerve block (IANB) for restorative treatment of primary mandibular molars (PMM). Methods: Four- to 10-year-old children who needed PMM restorations were enrolled according to inclusion criteria and randomly allocated into the articaine or lidocaine group. One operator administered all local anesthesia. Using the Modified Behavioral Pain Scale (MBPS), 15 trained and calibrated examiners, blinded to LA type, evaluated the subjects' reactions during LA administration and treatment. Children rated their experience using the Wong-Baker FACES Pain Rating Scale (WBS). Subjects' blood pressure and pulse throughout the visits were recorded. Statistical analysis included independent t-tests, Mann Whitney-U, and repeated measures analysis of variance (P<0.05). Examiner reliability was determined by Cohen's kappa score. Results: Thirty subjects (53 percent male; mean age: 6.3 years) participated. While the mean total scores for articaine (2.13 MBPS; 0.53 WBS) were better than for lidocaine (3.07 MBPS; 1.33 WBS), there were no statistically significant differences between groups. All physiological measurements were within normal limits. Conclusions: This pilot study indicated that articaine infiltration might be as effective as a lidocaine inferior alveolar nerve block for restorative treatment of primary mandibular molars; however, a larger sample is required to confirm these findings.

Effect of Overlying Material on Final Setting of Biodentine ® in Primary Molar Pulpotomies.

Purpose: The purpose of this study was to evaluate and compare in vitro the effect of overlying materials, including zinc oxide eugenol (ZOE), resin-modified glass ionomer cement (RMGIC), and stainless steel crowns (SSC) cemented with glass ionomer cement (GIC), on the setting of Biodentine ® (BD) used as a pulpotomy agent in primary molars that were restored definitively in a single visit. Methods: Forty extracted primary molars were prepared to replicate pulpotomy procedures. The teeth were randomly allocated to four restorative groups: (1) BD, ZOE, SSC; (2) BD, RMGIC, SSC; (3) BD, SSC; (4) BD only (control). All samples were incubated for 24 hours, sectioned mesial-distally, and polished. BD setting was measured as a function of Knoop hardness value (HK) using a Leco Microhardness Tester. Each sample was tested in three zones with 50 gf load force and 30 seconds dwell time and at one, two, and three mm distance from the BD-material interface. A one-way analysis of variance was used to determine statistical significance between groups (P<.05). Results: There was no statistically significant difference between the mean HK value among the four groups and three zones. Conclusions: Overlying materials, including zinc oxide eugenol, resin-modified glass ionomer, and stainless steel crowns cemented with glass ionomer cement, showed no effect on the BD final set. This in vitro study found no evidence against immediate definitive restoration of Biodentine ® pulpotomies.

Age estimation of Hispanic children using the London Atlas.

PURPOSE: To test the accuracy of the London Atlas for age estimation of Hispanic children and to determine if there is any difference in age accuracy between Hispanic males and females. METHODS: The London Atlas was used to estimate age from panoramic radiographs of 17 males and 17 females for each year of age from six to 15.99 years, using the electronic patient database of a dental school. Exclusion criteria included gross pathology, hypodontia, hyperdontia, and previous orthodontic treatment. RESULTS: There were 332 panoramic radiographs evaluated. In all age groups, 34 radiographs (from 17 males and 17 females) were reviewed, except for the age bracket 6-6.99 years, for which only 26 radiographs were available. The mean age estimated of the entire sample by the London Atlas (11.44 years) was greater than the mean chronological age (11.09 years), which was statistically significant (P<.001). The mean difference between chronological and estimated ages for males was .30 years and for females was .40 years, but the difference between sexes was not significant (P=.324). One hundred sixty-two radiographs (49%) were estimated to the exact age interval while 45 (14%) were under-estimated and 125 (38%) were over-estimated. Two hundred and forty radiographs (72%) were estimated to a value within one year of the actual age. CONCLUSION: There was no difference in age estimation prediction accuracy between Hispanic males and females but an age overestimation of three percent in the cohort was seen. The London Atlas accuracy is suitable for use in forensic investigation.

Dental stories for children with autism.

PURPOSE: To investigate caregivers' preference regarding dental stories to prepare children with autism for dental visits. METHODS: Caregivers of children with autism were allowed use of dental stories available via different media (paper, tablet computer, computer) and image types (comics or drawings, photographs, video). Caregivers completed pre- and postintervention surveys. Fisher's exact tests were used to determine associations between predictive factors and preferences. RESULTS: Forty initial and 16 follow-up surveys were completed. Subjects were primarily male (85%). Mean child age was 6.7 years. Nine (64%) caregivers found the dental story useful for themselves and their child. Two (14%) caregivers found the aid only helpful for themselves. Preferred media type was associated with language understanding (p = .038) and home media preference (p = .002). CONCLUSIONS: Practitioners should consider using dental stories to help prepare families and children for dental visits. Individual preferences for dental stories vary; using prior history can aid in selection.