Use of the Hall technique by specialist paediatric dentists: a global perspective.

Background The Hall technique (HT) is popular with UK paediatric dentists (PDs). Global PDs perception/use of HT is unknown.Aim To investigate global PDs opinions/use of HT.Materials and methods A cross-sectional questionnaire of 26 questions was sent to specialist PDs across the globe.Results Responses of 709 PDs from six continents were obtained. The majority (n = 654, 92.32%) had heard about HT but only 50.6% (n = 358) used it, with wide country variations. Respectively, 37.5%, 31.5% and 31% were neutral, against or supportive of HT when they initially heard about it. Only 17% of HT users said it was always the treatment of choice for non-pulpal asymptomatic carious primary molars (NPACPMs), 62% would take a pre-operative radiograph, 65% would consider using high speed drills before HT, 63% would never consider HT under general anaesthesia, 56% would use HT under N2O sedation. Finally, in a clinical scenario of a NPACPM in a cooperative 6-year-old, 75% of PDs would choose conventional restorative methods over the HT.Conclusion The HT is recognised, but not used, by an outright majority of PDs across the globe. Identifiable barriers such as lack of training, perception as substandard dentistry and perceived lack of evidence reduced its use.

Human periodontal fibroblasts viability stored in Custodiol® , coconut water, and propolis. An ex vivo study.

BACKGROUND/AIMS: Successful replantation of an avulsed tooth depends on the regeneration of periodontal ligament (PDL) attachment which is affected by the transport medium, dry time, and storage time. Various storage media have been studied but the search for the optimum storage medium is still needed to determine the ideal material and storage time to maintain PDL cells. The aim of this study was to determine the ability of Custodiol® , coconut water (CW) from different stages of maturity, and propolis as storage media for avulsed teeth by evaluating the viability of PDL cells for different time intervals. MATERIALS AND METHODS: PDL cultures were subjected to Cutodiol® , immature, half mature, and mature coconut water, and different concentrations of propolis in Dulbecco's Modified Eagles Medium (DMEM). Culture plates with the tested media were incubated for 1, 2, 6, 24, 48, 72, and 168 hour. PDL fibroblast cell viability was assessed by MTT assay. RESULTS: CW showed significantly higher viability of cells than other groups at 6 hour with half mature CW being superior. Propolis at 6.25 mg/mL in DMEM resulted in 138% viable PDL and it was able to preserve PDL cells for up to 168 hour. CONCLUSIONS: Half mature and mature CW are superior storage media if replantation of avulsed teeth is within 6 hour. Propolis in DMEM could be a potential storage media for prolonged storage intervals up to 48 hour.

Comparison of Coconut Water and Jordanian Propolis on Survival of Bench-dried Periodontal Ligament Cells: An in vitro Cell Culture Study.

AIM: The aim of this study is to assess and compare the efficacy of Jordanian propolis and full concentration mature coconut water in their ability to preserve periodontal ligament (PDL) cell viability after exposure of PDL cells to up to 120 minutes dry storage. MATERIALS AND METHODS: PDL cells were obtained from sound permanent first molars which were cultured in Dulbecco's Modified Eagles Medium (DMEM). Cultures were subjected to 0, 30, 45, 60, 90 and 120 minutes dry storage times then incubated with 100% mature coconut water, Jordanian propolis and DMEM for 45 minutes at room temperature (18-26°C). Untreated cells served as controls at each dry storage time tested. PDL cell viability was assessed by MTT assay. Statistical analysis of data was accomplished by using one-way analysis of variance complemented by Tukey test and the level of significance was 5% ( p < 0.05). RESULTS: Up to 60 minutes dry storage, no significant improvement on the percentage of viable cells was found from soaking in all tested media. On the other hand, soaking in mature coconut water only resulted in higher percentages of viable cells at >60 minutes dry storage. However, this improvement was not significant (p > 0.05). CONCLUSION: Avulsed teeth which have been left dry for <45 minutes should be replanted immediately, whereas avulsed teeth which have been left dry for >45 minutes may benefit from soaking for 45 minutes in mature coconut water. How to cite this article: Al-Haj Ali SN, Al-Jundi S, Mhaidat N. Comparison of Coconut Water and Jordanian Propolis on Survival of Bench-dried Periodontal Ligament Cells: An in vitro Cell Culture Study. Int J Clin Pediatr Dent 2013;6(3):161-165.

Effect of Coconut Water Concentration on Survival of Bench-Dried Periodontal Ligament Cells.

Background : Coconut water is a biological and sterile liquid. It contains a variety of electrolytes, sugars and amino acids. The purpose of this study is to evaluate the effect of concentration and maturity of coconut water on its ability to preserve human PDL cell viability after exposure to dry time of up to 120 minutes using an in vitro cell culture model. Methods : PDL cells were obtained from sound permanent first molars which were cultured in Dulbecco's Modified Eagle's Medium (DMEM). Cultures were subjected to 0, 30, 60, 90 and 120 minutes dry periods then incubated with 100 and 50% young and mature coconut water for 45 minutes at room temperature (18-26°C). Untreated cells at 0 and 120 minutes, and cells incubated in DMEM served as controls. PDL cell viability was assessed by MTT assay. Statistical analysis of data was accomplished by using one-way analysis of variance complemented by Tukey test, and the level of significance was 5% (p < 0.05). Results : 100% mature coconut water (MCW) was better than 50% dilutions obtained from mature or young coconuts. However, no significant benefit to the cells was noticed from the addition of the soaking step prior to 30 minutes dry time. Conclusion : Avulsed teeth which are left dry for > 30 minutes may be benefited from soaking in 100% mature coconut water; further studies on simulated avulsion in animal models are needed to verify the above results.

Jordanian dental students' knowledge and attitudes in regard to child physical abuse.

The aim of this study was to investigate Jordanian dental students' educational experience, attitudes, and knowledge regarding child physical abuse. Data were collected from a self-administered questionnaire completed by 441 undergraduate and postgraduate dental students in both dental schools in Jordan. Descriptive statistics were used to report responses to each question. The chi-square test was used to analyze the relationship between students' responses and level of education; the difference was considered significant if the probability of the difference was less than 5 percent. Results indicated major lack of knowledge of social indicators, signs of physical abuse, and reporting procedure among all respondents with no significant difference between postgraduate and undergraduate students. Most students indicated that their dental school was the main source of information on this topic; however, more postgraduates reported benefit from extracurricular sources. We conclude that dental students in Jordan are not sufficiently prepared to undergo their role in protection of children from abuse. Dental curricula in both dental schools include information on the topic of child abuse; however, the content should be expanded to better prepare the students.

The importance of soft tissue examination in traumatic dental injuries: a case report.

Traumatic dental injuries (TDIs) represent one of the main oral health problems in children, with variable prevalence rates. The issue of unmet treatment needs and inadequate emergency management of TDIs have surfaced up lately in dental literature, indicating that some TDIs present late for treatment, which may complicate management of these injuries. Soft tissue injuries usually accompany other dental injuries therefore thorough clinical and radiographic inspection of soft tissue wounds can not be over emphasized, even in late presentation cases. Tooth fragments may be embedded in soft tissues, even in late presentation cases, and may go unnoticed in the presence of urgent situations. This case report presents a child with a fractured tooth fragment embedded in the lower lip for 18 months, which went unnoticed until the child presented later for treatment of the fractured incisor, highlighting the importance of soft tissue exploration even in late presentation trauma cases.

Knowledge of Jordanian mothers with regards to emergency management of dental trauma.

Studies in Jordan indicated that delay in seeking emergency management of dental trauma leads to unfavorable outcome of even mild forms of trauma. The purpose of this cross-sectional study was to assess, by means of a structured questionnaire, the level of general knowledge of mothers in Jordan with regards to the immediate emergency management of dental trauma, and its relation to socioeconomic variables. The questionnaire surveyed mothers' demographic data, basic knowledge of immediate management of tooth fracture, avulsion, and loss of consciousness. It also investigated the participants self assessed knowledge, attitude to public education, and knowledge of availability and priority of emergency services for trauma in Jordan. The sample consisted of 2215 mothers who attended mother and child care centers in the capital Amman, and in Irbid (the second largest city in Jordan) over a period of 3 months (July to September, 2003). Overall the participants' basic knowledge with regards to the emergency management of the trauma cases presented in the questionnaire was deficient regardless of age, level of education, socioeconomic class, or number of previous encounters with dental trauma. Generally, the attitude to public education on the topic was positive and chi-square test indicated that the level of education of mothers positively affected their knowledge of 'during working hour' emergency services and the importance of immediate management of dental trauma. Educational programs that can be added to the mother and child care advice protocols may help improve the knowledge and awareness of mothers and therefore improve the outcomes of dental trauma.

Knowledge and attitude of Jordanian school health teachers with regards to emergency management of dental trauma.

The purpose of this study was to assess, by means of a self administered structured questionnaire, the level of knowledge of school health teachers in northern Jordan with regards to the immediate emergency management of dental trauma. The questionnaire surveyed teacher's background, Knowledge of management of tooth fracture, avulsion, and loss of consciousness, it also investigated teacher's attitudes, and self assessed knowledge, as well as knowledge of availability of emergency services in Jordan. The sample consisted of all school health teachers in northern Jordan (220) who attended an oral health education course held by the Jordanian dental association. Only 190 were included in the survey. Sixty-three percent were females, 44% were in their twenties, and 43% in their forties. Their school health teaching experience ranged from 1 to 7 years. Only 20% were officially trained in school health. Less than half of the teachers received first aid training only once in their teaching career, not necessarily as part of school health training. Only 10 teachers were trained in dental first aid, and more than half had a previous experience with handling dental trauma in children. Overall the teachers' knowledge with regards to the emergency management of the trauma cases presented in the report was deficient. Chi-square test showed that, the difference in their responses to the knowledge part of the questionnaire was not statistically significant with regards to age, gender, years of teaching experience, first aid training, or number of seen trauma cases. Generally, the attitude was positive, most teachers wanting further education on the topic, however those who were trained in first aid, thought they were able to give proper action when needed in cases of trauma (P = 0.026). Most teachers were unsatisfied with their level of knowledge, and only 30% knew of the availability of after hour emergency services for dental trauma. The present report indicated the gross lack of knowledge among school health teachers with regards to dental trauma emergency management. Educational programs to improve the knowledge and awareness of this group of adults, who are usually the first line of advice in case of dental trauma in schools, are mandatory. These programs should be properly designed to insure that proper information is retained with a positive effect on attitude, and self assessed competence.

Type of treatment, prognosis, and estimation of time spent to manage dental trauma in late presentation cases at a dental teaching hospital: a longitudinal and retrospective study.

Traumatic dental injuries are emergencies that must be treated promptly and properly in order to reduce the suffering, costs, and time for patients, parents, and health care providers. The aim of this study was to investigate the treatment, long-term prognosis, and number of visits needed to manage cases resulting from complications of late presentation of traumatic dental injuries. The sample consisted of 195 children, all presented with complications of dental trauma at the Pediatric Dentistry Clinics in the Dental Teaching Hospital of Jordan University of Science and Technology in Irbid city, Jordan. Retrospective data relied on trauma forms as well the clinical notes and radiographs in the patients' records. Prospective data was collected by examining patients at recall appointments. The treatment of traumatized teeth in this sample ranged from no active treatment to extraction and prosthetic replacement. It was estimated that the number of visits needed to carry out the planned treatment for these patients ranged between 3 and 17.2 visits according to the type of treatment. Apexification procedure was the most time consuming. Thirty-two per cent of teeth with apexification ended up with root fracture mainly subsequent to another minor trauma episode (in 85%), the rest were reported to be spontaneous fractures. Almost half of the teeth with luxation injuries became necrotic after 3 years. Teeth with avulsion actually kept on deteriorating even at the 36-month follow-up appointment. The long-term prognosis of teeth with middle root fracture was favorable in (80%) of the teeth in the sample, despite the fact that they were splinted late. Luxation injuries led to more necrotic teeth (50%) than uncomplicated crown fractures. Multiple dental trauma episodes (MDTE) were reported in about 30% of the patients in the sample and were responsible for some of the complications noticed in this report. As all cases followed up in this report are late presentation of dental trauma, the findings may emphasize and highlight predictors for healing and favorable long-term prognosis for such injuries. This will help selecting the treatment option that would lead to better outcomes with less expense and less time consumption for dentists and patients alike. The findings of this report also stress the importance of prevention of dental trauma and minimize its complications through proper treatment, educational programs, supervision of children during play, use of mouth guards, and orthodontic treatment of proclined incisors.

Dental emergencies presenting to a dental teaching hospital due to complications from traumatic dental injuries.

In Jordan, only two surveys of dental trauma have been carried out. The aim of this study was to determine the incidence and pattern of dental emergencies resulting from traumatic injuries, as well as treatment provided to children presenting with these dental emergencies. Over a 1-year period, 620 children presented to our pediatric dental clinics with dental emergencies; 195 (31%) of these emergencies were a consequence of dental trauma to 287 teeth and were included in the study. The average time between the trauma and the dental emergency was 5 months. Pain or sensitivity was the most frequent presenting symptom (31.3%) followed by swelling or sinus tract (17.4%). The age of these patients ranged from 15 months to 14 years, with an average age of 9.3 years. Males accounted for 75.4% of the children in the samples, whereas females accounted for only 24.6%. The main cause of dental trauma was falling during play (58.5%); the least common cause was motor vehicle accidents, accounting for only 1.5% of all injuries. Most of the dental injuries occurred at home (41.5%), around noon time. The most commonly involved teeth were permanent maxillary central incisors accounting for 79.5% of all teeth involved by dental trauma. The most frequently encountered type of trauma in this sample was crown fracture seen in 76.6% of the teeth. Soft tissue injuries were estimated to occur in 16.9% of the children. The treatment received by the children in the sample ranged from no active treatment (6.2%) to elaborate dental procedures such as pulp therapy (41.3%) and prosthetic replacement of missing teeth (5.1%).