"Evaluation of Silver Diamine Fluoride Modified Atraumatic Restorative Treatment (SMART) on hypomineralized first permanent molar"- a randomized controlled clinical study.

BACKGROUND: Restoring first permanent molars affected with molar incisor hypomineralization (MIH) is challenging. Focusing on improving the quality of life for children affected by MIH, at least until the complete eruption of first permanent molars to receive full coverage, to decrease the hypersensitivity and to be able to perform proper oral hygiene measures, the purpose of this study was to compare silver modified atraumatic restorative technique (SMART) versus the conventional restoration and fluoride varnish application on moderate to severe hypomineralized molars. The comparison considered the restoration survival, hypersensitivity, and digital surface area changes after one year follow up. METHODS: Twenty-eight children were selected (20 girls and 8 boys) with at least 2 MIH molars with the same defect severity. The study comprised 2 groups; MOD group (moderate hypomineralized molar severity) and SEV group (Severe hypomineralized molar severity) (n = 28 tooth). Each group was further subdivided into 2 subgroups according to the technique of restoration: SMART subgroup and CONV subgroup (high viscosity glass ionomer restoration and fluoride varnish application) (each = 14 tooth). Evaluation was done in terms of the restoration survival (6 months and 12 months), hypersensitivity at 1 weak, 6 months and 12 months and occlusal surface area changes at 12 months). Professional Fluoride varnish application and home prophylaxis using MI paste were the protocol for each child patient. RESULTS: There was no significant difference between the 4 subgroups, regarding tooth restoration integrity at 6-months vs. 12-months. However, a statistically significant difference in tooth restoration integrity between the 4 subgroups at 12-months (P = .049). Also, the hypersensitivity score, there was a statistically significant difference between the 4-time intervals (P < .001) and a statistically significant difference in surface area changes between the 4 subgroups. CONCLUSIONS: Selective removal of carious tissue and SMART restoration, combined with dental home and professional preventive measures every 3 months maintained the integrity of restorations in severely and moderately affected permanent molars up to 1 year. TRIAL REGISTRATION: The study protocol was retrospectively registered on Clinical Trials (NCT05931822-05/ 07/2023).

Eruption and caries status of first permanent molars in children aged 6-7 years in Shijingshan District, Beijing, China.

BACKGROUND: Dental caries is still a major disease that affect the oral health of people in China. First permanent molars (FPMs) are the most caries-susceptible teeth among school-aged children. The aim of this study was to investigate the eruption and caries status of first permanent molars in children aged 6-7 years in Shijingshan District, Beijing, China, to provide information for oral health promotion. METHODS: The study was a cross-sectional survey conducted in 6-7-year-old first grade children from public elementary schools in Shijingshan District, Beijing. Participants were invited to receive a clinical oral examination. The eruption status and caries experience of FPMs were recorded. Questionnaires assessing children's sociodemographic information and oral health-related behaviors were completed by the children's parents or guardians. RESULTS: A total of 3,176 children, including 1,644 boys (51.8%) and 1,532 girls (48.2%) were included in the oral examination and questionnaire. Eruption status of FPMs was as follows: 37.5% fully erupted, 28.3% partially erupted, 34.2% not erupted. Girls had more erupted FPMs than boys (70.1% VS 61.8%, P < 0.001). The prevalence of dental caries in FPMs was 5.5% (174/3,176) in studied children. The mean decayed missing filled teeth score of FPMs was 0.11 and the mean decayed missing filled surface score of FPMs was 0.19. Binary Logistic regression analysis demonstrated that girls had more tooth decay than boys and father's educational background also associated with the caries experience of the studied children (P < 0.05). CONCLUSIONS: Around two-thirds of FPMs were fully erupted or partially erupted among children aged 6-7 years old in Shijingshan District, Beijing. Approximately 5% of the newly erupted FPM established dental caries. Effective intervention should be applied in this age group for oral health promotion.

Comparative evaluation of retention, marginal adaptation and marginal discoloration of hydrophilic and hydrophobic pit and fissure sealants: A split-mouth randomized controlled trial.

BACKGROUND: Pit and fissure sealants are the most commonly used preventive measure against caries in permanent molars. Advancements in dental materials have led to the development of hydrophilic sealants. However, their clinical efficacy must be evaluated and compared with that of conventional hydrophobic sealants. OBJECTIVES: This study aimed to clinically evaluate and compare the retention, marginal adaptation and marginal discoloration of hydrophilic and hydrophobic pit and fissure sealants over a 12-month follow-up period. MATERIAL AND METHODS: The study was a split-mouth, double-blind, randomized controlled trial. A sample size calculation was performed, and 120 first permanent molars (60 in each group) were selected for inclusion in the study. According to the split-mouth design, the sample was randomly divided into 2 groups. Group A was treated with a hydrophilic sealant (UltraSeal® XT Hydro), while Group B was treated with a hydrophobic sealant (Conseal F). The sealants in both groups were applied in accordance with the manufacturer's instructions by a single operator. The sealants were evaluated clinically using visual and tactile methods by 2 independent examiners who were blinded to the procedure in accordance with the modified United States Public Health Service (USPHS) clinical rating system at placement and at 1, 3, 6, and 12 months. RESULTS: After 12 months of follow-up, the Conseal F sealant showed significantly better retention (p = 0.001), marginal adaptation (p = 0.023) and reduced marginal discoloration (p = 0.004) in comparison to the UltraSeal XT Hydro sealant. CONCLUSIONS: The Conseal F (hydrophobic) sealant demonstrated superior retention, marginal adaptation and marginal discoloration compared to the UltraSeal XT Hydro (hydrophilic) sealant.

Ectopic eruption of maxillary first permanent molars: Risk factors and association with alveolar and maxillary characteristics on children.

Background/purpose: The etiology of the ectopic eruption (EE) of the maxillary first permanent molars (FPM) remains unclear and controversial. This study was designed to explore the dental and skeletal factors for EE of the FPM in children. Materials and methods: Children aged 6-10 years were recruited to this study. Subjects were assigned to the ectopic eruption group (EEG) and the normal eruption group (NEG). Lateral cephalometric radiographs and panoramic radiographs were measured by angular and linear indices. Results: The prevalence of EE of maxillary FPM was higher in males and at younger ages. Subjects with skeletal class III malocclusion were more likely to be diagnosed with EE of maxillary FPM. The SNA, ANB, FMIA, Wits, Ptm-A, ANS-PNS, overbite, and overjet were significantly different between the EEG and the NEG. The length of the posterior region of the maxillary alveolar bone, U6-OP, and eruptive angulation of the maxillary FPM were statistically different between the two groups. Conclusion: Male sex, skeletal class III malocclusion, mesial inclination of the maxillary FPM, hypoplasia of the maxilla, and insufficient length of the posterior region of the maxillary alveolar bone were related to EE of the maxillary FPM.

Prevalence and Patterns of Positional Dental Anomalies in First Permanent Molars: Insights from a Study in Oradea, Romania.

Tooth position anomalies, influenced by both genetic and environmental factors, can significantly impact oral health and play a critical role in establishing proper occlusion. The aim of this study was to identify the most prevalent tooth position anomalies in first permanent molars among Romanian patients and to evaluate additional variables as well. This retrospective study utilized digital study models to identify all existing tooth position anomalies. The study included patients aged 12 to 40 years with complete permanent dentition. Axial changes (buccal tilting, oral tilting, mesial tilting, and distal tilting) as well as rotational changes (mesio-buccal rotation and disto-buccal rotation) were investigated. After applying the exclusion criteria, 103 patients remained in the study. Our findings revealed a notable prevalence of positional anomalies, with disto-buccal rotations being most common in upper molars (tooth 1.6-22.3%, tooth 2.6-31.1%) and oral tilting predominating in lower molars (tooth 3.6-6.8%, tooth 4.6-14.6%). Interestingly, neither gender nor malocclusion type significantly influenced the occurrence of tooth position anomalies. Symmetrical patterns in positional changes were observed, with patients having tooth position anomalies at 1.6 significantly more frequently associated with anomalies at 2.6. Similarly, anomalies at 3.6 were significantly more frequently associated with anomalies at 4.6. Additionally, for molars 2.6 and 3.6 on the left side, the differences were statistically significant, with patients having anomalies at 2.6 significantly more frequently associated with anomalies at 3.6. This pattern was not observed for the molars situated on the right side of the dental arches. While this study provides insights into positional anomalies in first permanent molars among the Romanian population, its retrospective design and focus on a specific demographic may limit generalizability. In conclusion, the study underscores the significant prevalence of positional anomalies in first permanent molars among adolescents and adults in Oradea, Romania. Early detection and targeted interventions are crucial to address these anomalies and improve orthodontic outcomes. Comprehensive assessment and treatment planning are essential to achieve optimal dental harmony and function. Further research is needed to elucidate the underlying factors contributing to these positional changes and their long-term impact on oral health and occlusal stability.

Home / Archives / Vol. 12 No. 1 (2024) / Articles SPATIAL DISTRIBUTION OF MOLAR INCISOR HYPOMINERALIZATION (MIH) OPACITIES IN FIRST PERMANENT MOLARS

Aim: To evaluate the spatial distribution of MIH opacities in first permanent molars (FPM). Materials and methods: an analysis of intraoral photographs of FPM with demarcated MIH opacities was conducted. The presence of opacity was computed in a digital matrix, discriminating the anatomical regions of the FPM surfaces. The frequencies of distribution of the opacities were descriptively analyzed through 227 FPM digital images of 89 children built in GIMP and Python and by Spearman correlation (= 0,05). Results: the occlusal surface was the most affected one (94% to 100%). In the upper FPM, the palatine surface was the second most affected one (84%-91%). In the lower FPM, the vestibular surface was the second most affected one (85%-80%). A similar pattern of opacity distribution was observed in the contralateral teeth. On smooth surfaces, opacities were more frequent in the regions closer to the occlusal surface than to the cervical one. Conclusion: MIH opacities were mostly present on occlusal, vestibular, and lingual/palatine surfaces, respectively. There is a possibility that the occurrences are in accordance with the chronology of dental formation.

Oral Health-Related Quality of Life Following Root Canal Treatment of First Permanent Molars Among Children. A Cross-Sectional Study.

Aim: This study aimed to assess the Oral Health-Related Quality of Life (OHRQoL) of pediatric patients (9-18 years old) who underwent root canal treatment (RCT) on first permanent molars (FPMs). Methods: A cross-sectional study was conducted at three healthcare centers in Jeddah, Saudi Arabia. Participants (n = 482) completed the validated OHIP5-Ar questionnaire to assess OHRQoL. Responses were classified as "optimal" (no problems) or "less than optimal" (any reported problems). Logistic regression analyzed the relationship between OHRQoL and sociodemographic factors. Results: There were 66.8% children reported optimal OHRQoL after RCT. Logistic regression showed no significant association between optimal OHRQoL and gender, family income, or location of treated tooth. However, although not statistically significant. Treating only one FPM with RCT (compared to multiple teeth) and lower family income (compared to higher income) were more likely to have decreased or increased odds of optimal OHRQoL (AOR = 0.684 or 1.424; respectively). Conclusion: RCT on FPMs can be a successful treatment option for pediatric patients, offering optimal oral health-related quality of life.

Clinical Evaluation of the Retention of Four Different Pit and Fissure Sealants on the First Permanent Molars - An Original Research.

Objective: In this study, the retention rates of four different pit and fissure sealant materials on the first permanent molars were clinically assessed and compared. Materials and Methods: A total of 120 kids aged 7 to 10 participated in a randomized controlled experiment. On their first permanent teeth, the subjects each got one of the four sealant materials (A, B, C, or D). Over the course of 24 months, the retention rates were evaluated every 6 months. The Chi-square test and Kaplan-Meier survival analysis were used for statistical analysis. Results: At 6, 12, 18, and 24 months, the following retention rates were observed overall: A (85%, 78%, 65%, 52%), B (90%, 82%, 70%, 60%), C (78%, 70%, 55%, 42%), and D (95%, 88%, 75%, 62%). At each time point, the sealant materials showed significant variations in retention rates (P 0.05). While sealants A and C showed lower retention rates, sealant D showed the best retention rates, followed by sealant B. Conclusion: This study shows that different materials have different retention rates for pit and fissure sealants on first permanent molars. Higher retention rates for sealants D and B suggest that they may be superior than sealants A and C. These results highlight how crucial it is to choose the right sealant materials to guarantee long-term retention and effectiveness in avoiding dental cavities.

Economic inequalities in decayed, missing, and filled first permanent molars among 8-12 years old Iranian schoolchildren.

BACKGROUND: First permanent molars (FPM) play an important role in the masticatory function and oral health. This study aimed to assess the economic inequalities of FPM health indices among schoolchildren in the northeast of Iran. METHODS: A total of 4051 children aged 8-12 years old were included in the analyses of this cross-sectional study in 2015. Economic status was measured using the principal component analysis on home assets. Concentration index (C) was used to measure economic inequality in FPM health indices, and its contributing factors determined by Wagstaff decomposition technique. RESULTS: The prevalence of having decayed, missing, and filled FPMs among children was 40.9% (95% CI: 38.8-43.0), 1.2% (95% CI: 0.8-1.6%), and 7.8% (95% CI: 6.7-8.9%), respectively. Missing FPM was generally more concentrated among low-economic children (C=-0.158), whereas, filled FPM was more concentrated on high-economic children (C = 0.223). Economic status, mother education, having a housekeeper mother, and overweight/obesity, contributed to the measured inequality in missing FPM by 98.7%, 97.5%, 64.4%, and 11.2%, respectively. Furthermore, 88.9%, 24.1%, 14.5%, and 13.2% of filled FPM inequality was attributable to children's economic status, father education, residence in rural areas, and age, respectively. CONCLUSION: There is a significant economic inequality in both missing and filled FPM. This inequality can be attributed to the economic status of individuals. To reduce FPM extraction, it is important to target low-income and rural children and provide them with FPM restoration services. Additionally, it is necessary to provide training to less-educated parents and housekeeper mothers to address the observed inequalities.

Prevalence, Severity and Associated Risk Indicators of Molar Incisor Hypomineralization amongst 8-13-year-old Children of Vadodara District Gujarat: A Cross-sectional Study.

Context: Molar incisor hypomineralization (MIH) is an emerging clinical problem as the affected tooth is prone to dental caries with the lapse of time. Aims: To assess the prevalence, severity, and associated risk indicators of MIH amongst 8-13 years of children of Vadodara District, Gujarat, India. Materials and methods: A cross-sectional study with a sample size of 3,000 government schoolchildren. A total of 1,500 children each from urban and rural areas were randomly selected and examined. Only permanent incisors and first molars were examined. MIH was diagnosed clinically based on the diagnostic criteria established by the European Academy of Paediatric Dentistry (EAPD), 2003. To check the relation between the two variables-Pearson's chi-squared test was applied. Fisher's exact test was applied when less than five expected values were found. Results: A total of 286 children (9.6 %) had MIH, with 189 (rural) and 97 (urban) children. MIH was significantly higher in the rural population as compared to the urban. In the rural area, the cause was found to be a child suffering from an illness (>15 days) which was 35.98%, and in the urban area was due to prolonged use of antibiotics before 4 years of age, which was 28.87%. Conclusion: The overall prevalence rate of MIH among the screened children between the age-group 8 and 13 was found to be 9.6%. Males were more affected. The severity of MIH was more in molars compared to incisors and more in children of rural areas. Clinical significance: Protocol for early diagnosis and follow-up to access the squeal of breakdown should be undertaken along with parents and health workers. How to cite this article: Shah VU, Dave BH, Chari DN, et al. Prevalence, Severity and Associated Risk Indicators of Molar Incisor Hypomineralization amongst 8-13-year-old Children of Vadodara District Gujarat: A Cross-sectional Study. Int J Clin Pediatr Dent 2023;16(2):280-286.

Bonding Technologies in Young Permanent Molars: A Case Series.

Introduction: Dental caries has been the most common disease affecting the human population. Once cavitated, the disease requires restoration. Dental adhesives used to bond composite resins to tooth structure have evolved over the last several decades. Composites were developed to meet the requirements of durable esthetics restorative material. The process of bonding occurred due to micromechanical interlocking between hydroxyapatite of enamel and resin. Over a period of time, bonding to enamel has become a reliable procedure. However, bonding to dentin has proven to be less predictable. In order to overcome the challenges, dental adhesive systems have evolved through several generations with changes in chemistry, mechanism, number of bottles, application techniques, and clinical effectiveness. Case details: The "self-etch" system is especially attractive to pediatric dentistry because of its "fewer steps" and "lesser time." One product launched as a self-etching self-adhesive flowable composite Constic (DMG, Germany), a new three- in -one flowable composite that combines etching gel, bonding agent, and flowable composite in one single product which has multiple benefits over conventional products. Such a material can be of true advantage as it allows for single-step application, less technique sensitivity, and reduced chair time. In light of this knowledge, this paper will focus on two commonly performed procedures in the general practitioner's office, that is, the placement of small class I composite resin restorations and the placement of pit and fissure sealants on permanent molars in pediatric patients. Clinical significance: The advantage of this material is less technique sensitivity and reduced chair time. How to cite this article: Pruthi T, Pandit IK, Gugnani N, et al. Bonding Technologies in Young Permanent Molars: A Case Series. Int J Clin Pediatr Dent 2023;16(1):159-161.

Eruption Pattern of Third Molars in Orthodontic Patients Treated with First Permanent Molar Extraction: A Longitudinal Retrospective Evaluation.

The aim of this study was to evaluate angular and positional changes in the second (M2) and third molars (M3) of orthodontically treated patients undergoing a first molar (M1) extraction. A retrospective longitudinal study with a sample of 152 pre- and post-treatment panoramic radiographs was conducted. Thirty-nine patients (51.3%) were orthodontically treated with M1 extraction and thirty-seven (48.7%) were treated without extraction. Angulations of M2 and M3 relative to the infraorbital (IOP) and the palatal planes (PP) were measured and compared between the groups before orthodontic treatment (T1) and after the completion of orthodontic space closure (T2). The prognosis of M3 eruptions was evaluated by assessing their horizontal and vertical position (inclination) using different classification systems. The angular (p < 0.001) and inclination improvement (p < 0.01) of the maxillary M3 was significant for the M1 extraction group. The mandibular M3 inclination significantly improved (p < 0.01), whereas the groups' angulation and vertical position were not significantly different. These findings suggest that extraction therapy has a favorable effect on the maxillary M2 and M3 angulation, but not on the mandibular. M1 extraction showed a signi- ficant effect on the horizontal position of M3 and thus may improve the eruption space and prognosis.

Radiographic Assessment of Permanent First Molars Among Adults in Riyadh: A Retrospective Study.

Introduction The first permanent molars (FPMs) are the first permanent teeth to emerge in the oral cavity, which have an important role in dentition, dental development, and occlusion. FPMs are the most susceptible teeth to caries due to early eruption. There are many adverse consequences related to losing FPMs. Many of the previous studies focused on younger age groups. To the best of our knowledge, there needs to be more newly updated data reported in the literature regarding the status of FPMs in adults in Saudi Arabia. The study aimed to assess the status of permanent first molars among adults in a sample of patients in Riyadh. Methods A cross-sectional retrospective study was conducted from the records of patients in the Dental University Hospital, College of Dentistry, King Saud University (KSU), after obtaining ethical approval. Panoramic images of 810 patients ages 18 and above who were seen at KSU, College of Dentistry, were examined to assess the status of FPMs. A panoramic examination was undertaken for various dental reasons in the time between the years 2017 and 2022. Patients were divided into three age groups: 18-30, 31-50, and >50 years. Data were collected in a particular form and analyzed. The prevalence of missing teeth, as well as restored and carious teeth, were recorded. In addition, further information regarding the type of restoration was recorded. Correlations of the findings regarding age, gender, side, and jaw were determined for all cases and were performed using the chi-square test. P-values less than 0.05 were considered statistically significant. Results A total of 810 patients' panoramic radiographs were studied. Panoramic male study subjects were 382 (47.2%), and females were 427 (52.8%). Three-hundred thirty-nine (339; 41.9%) of them were of less than 30 years of age, 327 (40.4%) were in the age group of 31-50 years, and the remaining 144 (17.8%) were above 50 years of age. The prevalence of missing first molar teeth was 145 (17.9%) for teeth 16, 147 (18.1%) for teeth 26, 207 (25.5%) for teeth 36, and 188 (23.2%) for teeth 46. No statistically significant association was found between the age groups and gender and the first molar missing teeth (p=0.848 & p=0.159). Nineteen point thirteen percent (19.13%) of patients had only one missing FPM, 12.3% of patients had two, and 6.29% of them had three missing FPM teeth. Five point fifty-five percent (5.55%) of patients had four missing FPMs. A total of 56.8% (242) radiographs in the overall sample did not show any missing teeth. The mandibular FPMs (35.2%) were found missing more frequently than their maxillary counterparts (14.8%), and the left mandibular quadrant showed a slightly higher rate of missing FPM (25.55%). Statistically, a significant association was seen between the number of missing FPM among different age groups, p-value <0.0001. The most restored, carious, and replaced tooth was the mandibular left molar, and tooth-color restoration was the most commonly used restoration. Conclusion A high prevalence rate of missing first permanent molars (FPMs) was found in this study population. This calls for more awareness and preventive measures to preserve such significant teeth, therefore reducing the need for complex procedures. Further prospective studies on a larger population are needed to comprehensively evaluate the status of FPMs.

Combined orthopedic-orthodontic treatments of adolescent skeletal open-bite with severe molar-incisor hypomineralization: a case report and literature review.

The treatment of adolescent skeletal open-bite malocclusion with severe molar-incisor hypomineralization (MIH) remains challenging. Though conducive to open-bite treatment and endodontic management, early molar extraction may trigger a series of negative impacts on occlusion and stomatognathic development. In addition, molars' crown restoration was shown to worsen open-bite malocclusion considering the intrinsic vertical increment of hyperdivergent growth. This case report describes the successful multidisciplinary therapy combined with orthopedic and orthodontic treatment of a 10.2-year-old girl with mixed dentition, a protruding profile and skeletal open-bite malocclusion with severe MIH and crowding. During the mixed and early permanent dentition, function regulator-4 (FR-4), resin-bonding transpalatal arch (TPA) and modified spring-loaded bite blocks were implemented to correct abnormal swallowing and control the facial vertical growth. Radiographic results, including the counterclockwise rotation of the occlusion plane, decreasing mandibular angle and increasing posterior-anterior face height ratio accompanied by obvious mandibular vertical growth, indicated that the performed orthopedic treatments efficiently controlled hyperdivergent open-bite growth during puberty. After the maxillary and mandibular second molars were occluded, all first permanent molars were extracted, and fixed appliances combined with implant anchorage were used to correct malocclusion and convex profile. Ultimately, a stable Class I functional occlusion and satisfying facial improvement were achieved and maintained following a 2-year follow-up.

Classification of furcation involvement of endodontically treated mandibular first permanent molars based on cone beam CT / 口腔疾病防治

Objective @#To classify the furcation involvement (FI) of endodontically treated mandibular first permanent molars based on cone beam computed tomography (CBCT), provide reference for individualized treatment of FI. @*Methods@#CBCT images of the FI of 164 endodontically treated mandibular first permanent molars from 163 patients in Nanjing Stomatological Hospital, Medical School of Nanjing University were collected retrospectively. On the CBCT images, the shape and extent of periapical and periodontitis bone resorption, the thickness of residual dentin in the pulp floor and root canal wall, and the periodontal bone resorption of the complete dentition were evaluated. The FI was classified into periodontal, periapical, perforated and mixed types.@* Results@#Among the 164 FIs of endodontically treated mandibular first permanent molars, the periapical type was the most common (41.5%), followed by the mixed type (26.2%), perforated type (18.3%), and periodontal type (14.0%). Among the 68 periapical-type FIs of endodontically treated mandibular first permanent molars, 48.5% were proper root canal filling, 44.1% were insufficient filling and 7.4% were overfilling. Among the 43 mixed-type FIs, the periodontal mixed periapical type was the most common (72.1%).@*Conclusion @#Detailed evaluation and classification of furcation involvement could be performed using CBCT images; therefore, the study has guiding significance for clinical treatment.

Effect of Fluoride Varnish in Preventing Dental Caries of First Permanent Molars: A 24-Month Cluster Randomized Controlled Trial.

BACKGROUND: Caries is a prevalent health problem. This study evaluated the effect of fluoride varnish in preventing dental caries of first permanent molars. METHODS: The study was designed as a stratified cluster randomized controlled trial, with classes as the unit of randomization. Classes stratified by district were followed for 24 months. All eligible children of the selected classes were included for the trial. The children in the test group were biannually applied fluoride varnish. The outcomes were measured at an individual level. RESULTS: In total, 107 classes (51 in the test group, 56 in the control group) were recruited for the trial. Of the 5397 participants, 5005 children (2385 in the test group, 2620 in the control group) completed the study. At the 24-month follow-up, the mean decayed and filled surface increment of the first permanent molars of the children in the test group was significantly lower than that of the children in the control group (0.38 versus 0.61). The caries incidence of the first permanent molars in the test group was 17.0%, while that of the control group was 23.7%, with a PF of 28.3%. CONCLUSIONS: Semi-annual application of fluoride varnish is effective in reducing the caries increments of first permanent molars.

Ectopic Eruption of First Permanent Molars in Children from North-Western Romania.

Ectopic eruption of first permanent molars can lead to complications if left untreated. The aim of this study was to determine the prevalence of the ectopic eruption of first permanent molars in a sample of children from North-Western Romania, and to identify the characteristic of this anomaly in the studied population. We included patients aged between 5 and 9 years, and patients who needed a radiological examination for the diagnosis and treatment of dental or dento-maxillary diseases. The following exclusion criteria were applied: unclear or poor-quality radiographs; radiographs that belonged to patients who benefited from an orthodontic treatment before the panoramic radiograph was taken; patients who were undergoing orthodontic treatment when the radiograph was taken; and patients with local or general diseases that could influence dento-facial growth and development. Three degrees of severity were selected (moderate, severe, and very severe). The sample consisted of 438 patients, and 61 patients were diagnosed with ectopic eruption of first permanent molars (13.92%). Out of the 1752 analyzed molars, 103 were affected (5.87%). Patients with a moderate degree of ectopy were more frequently boys (56%, n = 14), while patients with a severe degree of ectopy were more frequently girls (52.8%, n = 19). Patients with a moderate degree of ectopy had significantly more frequently a unilateral position (57.1%, n = 16), while patients with a very severe degree of ectopy had significantly more frequently a bilateral position (36.4%, n = 12). The ectopic eruption was diagnosed at the level of the upper-right first permanent molar in a percentage of 18.4% (n = 19), at the level of the upper-left first permanent molar in a percentage of 17.5% (n = 18), at the level of the lower-right first permanent molar in a percentage of 32% (n = 33), and at the level of the lower-left first permanent molar in a percentage of 32% (n = 33). Although not very frequent, the ectopic eruption of first permanent molars is an important anomaly that should be early diagnosed, monitored and treated.

Treatments Performed on First Permanent Molars in a Sample of Lebanese Children: A Five-Year Retrospective Analysis.

Background: Dental caries remains one of the most prevalent worldwide chronic diseases and an expensive burden to healthcare services despite significant preventative measures Objective: Dental caries is a multifactorial chronic disease that occurs in early childhood and persists until adulthood. The first permanent molars (FPMs) are the earliest permanent molars to erupt what makes them vulnerable to caries among children and adolescents. Objective: The aim of this study is to determine the prevalence of different types of treatments performed on FPMs in 7-10-year-old Lebanese patients. Methods: In this retrospective study, a convenience sample obtained from the dental electronic health record system of 753 patients, aged between 7 and 10 years old who attended the department of Pediatric Dentistry at the Faculty of Dental Medicine-Lebanese University, between 2015 and 2019 was assessed. Preventive procedures (fissure sealants and preventive resin restorations) as well as therapeutic ones (apexogenesis, composite restoration, extraction, pulp capping, radicular treatment, pulpotomy, stainless steel crown, surgery and emergency) were investigated. Data collected was statistically analyzed using SPSS version 25.0 (Armonk, NY: IBM Corp). Results: The 753 patients were divided into 364 girls (48.3%) and 389 boys (51.7%). These patients underwent a total of 2145 procedures. Procedures were equally divided between therapeutic procedures and preventive ones (51.6% versus 48.4%, respectively). The most commonly performed procedure was composite restoration (41.9%), followed by fissure sealant (34.5%) and preventive resin restorations (14%). Treatments corresponded to a similar sex distribution with slightly higher male patients (53.6%). No statistical association was found between sex and procedure type (p=0.7). Conclusion: In the present study, therapeutic treatments prevalence is relatively high. Thus, educating the parents and teachers on the importance of FPMs would reflect in increased preventive treatments at the expense of decreased therapeutic ones.

Effectiveness of Silver Diamine Fluoride in Arresting Caries in Primary and Early Mixed Dentition: A Systematic Review.

Dental caries is a painful condition that could lead to nutritional problems which affects the overall health of the child, as well it is expensive to treat. The effectiveness of silver diamine fluoride (SDF) in primary and early mixed dentition is systematically reviewed in this study. This systematic review utilized the Preferred Reporting Items for Systematic reviews and Meta- Analysis statement (PRISMA, 2020). A literature search conducted using the common electronic databases (from 2010-2021). Based on the inclusion and exclusion criteria, ten randomized clinical trials (RCT) have met the inclusion criteria and were considered for the qualitative assessment. Critical appraisal of these studies was done. This systematic review found that using SDF is a successful and effective method in arresting dentin carious process in the primary teeth and first permanent molars in children. Additionally, when compared to the commonly used topical fluoride products and materials, SDF showed to have better cariostatic effect. However, these findings must be cautiously viewed since more research is required to support them.