Factors relating to failure rates of dental procedures in children following comprehensive dental treatments under general anesthesia: A 2-year retrospective study.

Background and Aim: This study assessed the demographic, treatment, and patient characteristics relating to 2-year postoperative failure and success rate of 2 to 12-years-old healthy children that underwent various dental procedures during comprehensive dental treatment under general anesthesia (GA). Materials and Methods: A retrospective study was conducted after the completion of a 2-year postoperative follow-up examination. The hospital records of all the children were reviewed by an experienced examiner. In the follow-up appointment, the clinical and radiographic evaluations of the treatments, oral hygiene, and oral hygiene practices were recorded. A P value of <0.05 was set as statistically significant. Results: Around 221 healthy children were included in the study, with a mean (SD) age of 4.92 (1.37). The most common type of failure detected 2 years postoperatively were recurrent decay (mean = 2.68, SD = 2.50), followed by stainless steel crown (SSC) open margin (mean = 0.69, SD = 1.02). Children with good oral hygiene involved the highest number of successful procedures (mean = 5.28, SD = 1.99) (P = 0.032). Children with poor oral hygiene was the factor that involved the highest number of procedure failures (mean = 8.28, SD = 3.38) (P < 0.001). The Pearson correlation coefficient showed that the younger the mean age of children during treatment under GA, the higher the rate of dental procedure failure (r = -0.202, n = 221, P < 0.01). Conclusion: The failure rate of dental procedures performed during treatment under GA was highest among younger children and children with poor oral hygiene at the time of treatment. SSC crown restoration was the most common type of dental procedure received, and recurrent decay and SSC open margin were the most common types of failure detected.

Accuracy of the DIAGNOcam and bitewing radiographs in the diagnosis of cavitated proximal carious lesions in primary molars.

AIMS: To evaluate the diagnostic abilities of near-infrared light transillumination (using the DIAGNOcam) and bitewing radiographs in detecting cavitated proximal carious lesions in primary molars. SUBJECTS AND METHODS: The study was a cross-sectional analytical, clinical study. The proximal surfaces of primary molars of healthy 5- to 8-year-old children were radiographically screened for the presence of carious lesions in the enamel or outer third of dentin (D1). Two trained and calibrated examiners evaluated the depth of caries in bitewing radiographs and DIAGNOcam images and then verified the presence of cavitation by direct visual examination using the "International Caries Detection and Assessment System" after temporary tooth separation. RESULTS: A total of 236 proximal lesions were included in the study. Most of the clinically cavitated lesions (51.9%) were D1 radiographically and in outer dentin lesions (scores 3 and 4) by the DIAGNOcam (37% and 48.1%, respectively). Although DIAGNOcam showed higher sensitivity (0.852) compared to the radiographs (0.519), it showed slightly less specificity (0.569) compared to the radiographs (0.579). However, DIAGNOcam showed higher value of the area under the curve (AUC = 0.722; P < 0.001) compared to the radiographic method (AUC = 0.561; P = 0.308). CONCLUSIONS: The DIAGNOcam showed higher sensitivity and better accuracy than bitewing radiographs in diagnosing cavitated proximal lesions in primary molars and can be generally considered as an alternative to radiographs to detect cavitation without the hazards of ionizing radiation in children.

Low-level laser therapy in dentistry: Extra-oral applications.

Low-level laser therapy (LLLT) is considered as a recent technique in the dental field. Nowadays, it is used by many clinicians in dentistry. The stimulation of the healing process and pain relief are among its most popular uses. The purpose of this paper is to discuss and review the latest extra-oral applications of LLLT in the dental field. An electronic search of English scientific papers from 2000 to 2018 was accomplished using PubMed and Google Scholar search engines. The following key words were used extra-oral, applications, LLLT, and dental field. This review demonstrates the marked effectiveness of LLLT in the management of many conditions and how it could improve the quality of life of many patients. However, LLLT is still considered a recent alternative and requires more understanding of its mechanism of action by conducting more high-quality randomized clinical trials with larger sample sizes and longer follow-up periods.

Conservative treatment for deep carious lesions in primary and young permanent teeth.

The management of deeply carious lesion could be accomplished conservatively by two techniques: an indirect single-step and stepwise techniques. The former involves incomplete removal of carious dentin and then application of a well-sealed permanent restoration. While the latter involves incomplete removal of caries and then reentry after a period to remove the residual caries, after changing its environment. The aim of this article was to review the dental literature concerning the conservative methods available to treat deeply carious teeth. A literature search was done using electronic databases "PubMed," "Google Scholar," and "Cochrane Database" for articles in English. Several keywords were used: conservative treatment, deep caries, deeply carious lesion, indirect pulp capping (IPC), and stepwise excavation. This review mentions two operative methods for conservative treatment of deeply carious lesions, namely, IPC, including criteria for case selection and success and failure of the deeply carious lesion, and an account on various used materials. Both single-step and stepwise IPC techniques could be used for managing deeply carious lesions with maintaining pulp vitality; more longitudinal studies are needed to determine which technique is preferable to be used.

Dental fear in primary school children and its relation to dental caries.

BACKGROUND: Successful management of dental fear in children prevents its progression into adulthood. This study aimed to assess the level of dental fear among school children and to determine its relationship with dental caries. The study design was a cross-sectional analytical study. MATERIALS AND METHODS: A sample of 1,546 primary school children were randomly selected. The Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) was completed in class to assess child dental fear. Caries experience was measured as decayed, missed, and filled permanent and primary teeth (DMFT/dmft) according to the World Health Organization (WHO) criteria. RESULTS: Approximately 24% of the participated children had high dental fear, and 12.50% of them had severe dental fear. Girls had higher rate of severe dental fear than boys (20% vs. 5%). The severity of caries was significantly increased in children who had higher fear scores (P = 0.035). CONCLUSION: About one quarter of 6- to 12-year-old children had dental fear; about half of them had severe dental fear. Dental fear has a direct relationship with decayed permanent teeth and an inverse relationship with restored permanent teeth.

Treatment of oral ulcers in dogs using adipose tissue-derived mesenchymal stem cells.

AIM: Adipose tissue Derived Mesenchymal Stem cells (ADMSCs) represent a promising toolfor new clinical concepts in supporting cellular therapy. The goal of this study was to investigate the effects of ADMSCs transplantation on oral ulcer healing in dogs. STUDY DESIGN: Mesenchymal stem cells were isolated from adipose tissues of dogs obtained by suction-assisted lipectomy (liposuction), by dish adherence and were expanded in culture. Oral ulcers were induced by topical application of formocresol in the oral cavity of 18 dogs. The dogs were classified into 3 groups. Either autologous ADMSCs, Corticosteriod (Dexamethasone) or vehicle (saline) was injected. The healing process of the ulcer was monitored histopathologically. Gene expression of vascular endothelial growth factor (VEGF), platelets derived growth factor (PDGF), epidermal growth factor (EGF) and collagen was assessed in biopsies obtained from all ulcers "as healing markers'", by real time polymerase chain reaction (PCR). RESULTS: ADMSCs group showed significantly accelerated oral ulcer healing compared with the Dexamethasone and control groups. There was increased expression of VEGF PDGF EGF and collagen genes in ADMSCs-treated ulcers compared with Dexamethasone and controls. CONCLUSION: ADMSCs transplantation may help accelerate oral ulcer healing, possibly through the induction of angiogenesis by VEGF and PDGF as well as epithelial and connective tissue proliferation as evidenced by increased EGF and collagen gene expression.

Prevalence and characteristics of non-syndromic orofacial clefts and the influence of consanguinity.

UNLABELLED: The Objective of this study was to identify the prevalence and describe the characteristics of non-syndromic orofacial cleft (NSOFC) in Jeddah, Saudi Arabia and examine the influence of consanguinity. STUDY DESIGN: Six hospitals were selected to represent Jeddah's five municipal districts. New born infants with NSOFC born between 1st of January 2010 to 31st of December 2011 were clinically examined and their number compared to the total number of infants born in these hospitals to calculate the prevalence of NSOFC types and sub-phenotypes. Referred Infants were included for the purpose of studying NSOFC characteristics and their relationship to consanguinity. Information on NSOFC infants was gathered through parents' interviews, infants 'files and patient examinations. RESULTS: Prospective surveillance of births resulted in identifying 37 NSOFC infants born between 1st of January 2010 to 31st of December 2011 giving a birth prevalence of 0.80/1000 living births. The total infants seen, including referred cases, were 79 children. Consanguinity among parents of cleft palate (CP) cases was statistically higher than that among cleft lip with or without cleft palate (CL/P) patients (P = 0.039). Although there appears to be a trend in the relationship between consanguinity and severity of CL/P sub-phenotype, it was not statistically significant (P = 0.248). CONCLUSIONS: Birth prevalence of NSOFC in Jeddah City was 0.8/1000 live births with CL/P: 0.68/1000 and CP: 0.13/1000. Both figures were low compared to the global birth prevalence (NSOFC: 1.25/1000, CL/P: 0.94/1000 and CP: 0.31/1000 live births). Consanguineous parents were statistically higher among CP cases than among other NSOFC phenotypes.

Correlation between oral parafunction and temporomandibular disorders and emotional status among saudi children.

Studies on association between temporomandibular disorders and oral parafunction in preschool children are few. The aim of the present study is to investigate the relationship between the subjective and objective signs and symptoms of temporomandibular disorders (TMD), oral parafunction and emotional status in preschool children. The study is based on a clinical examination and questionnaire. Five hundred and two Saudi children aged 3 to 7 years were examined for different signs and symptoms of TMD. In addition, the parents of the children were given a questionnaire to investigate the existence of oral parafunction and evaluate the emotional status of children. The results of the study showed significant association between attrition and temporomandibular joint (TMJ) pain, muscle tenderness and restricted opening, (P Values were 0.008, 0.019, 0.037 respectively). Significant association was found between habit of grinding and pain, while eating or opening the mouth (P<0.012). Significant association was found between emotional status and multiple signs and symptoms of TMJ tenderness, TMJ pain and muscle tenderness (P<0.042). Significant association was found between emotional status and pain, while eating or opening of the mouth (P<0.048). Close to positive association was found between oral parafunction and jaw lock. The association between TMD and oral parafunction as well as emotional status should direct the attention of the dentist to the importance of considering the emotional status, oral parafunction and TMD when examining and formulating treatment plan for the child patient.

Relationship between premature loss of primary teeth and the development of temporomandibular disorders in children.

AIM: This study evaluated the prevalence of signs of temporomandibular disorders (TMD) in children with and without premature loss of primary teeth. SAMPLE: Fifty-eight children, aged 4-6 years, with missing primary molars, were compared with 58 age- and sex-matched control children with complete primary dentitions. METHOD: All the children underwent an examination that consisted of palpation and assessment of the joints and associated muscles for tenderness and joint sounds. Maximum vertical opening and deviation during jaw opening were also recorded. Children with any single anomalous finding were designated positive for TMD signs. RESULTS: There were no statistically significant differences in the prevalence of single or collective TMD signs between the two groups. CONCLUSION: The results of this study show that premature loss of primary teeth, uncomplicated by other factors, does not appear to be an aetiological factor for TMD development.

The correlation between occlusal characteristics and temporomandibular dysfunction in Saudi Arabian children.

The aim of the present study was to investigate the association between the different occlusal characteristics and signs and symptoms of temporomandibular dysfunction (TMD) in children with primary dentition in the western region of Saudi Arabia. A total of group of 502 children 4-6 years old residing in the city of Jeddah, Saudi Arabia provided the data for analysis. The result of this study showed significant correlation between signs and symptoms of TMD and some of the occlusal characteristics including posterior crossbite (P < 0.05), edge to edge (P < 0.013), anterior openbite (P < .036) and class III canine relationship and as well as asymmetrical canine relationship (P < .048 and P < .046 respectively). On the other hand, no correlation was reported between signs and symptoms of TMD and the remaining occlusal characteristics. The lack of significant correlation between TMD and some of the occlusal variants could be attributed to sampling and methodology differences. However, the present study supported the previous conclusion that temporomandibular dysfunction is multifactorial and highlights the importance of early intervention to prevent further consequences to the TMD and permanent occlusion.

The prevalence of crowding, attrition, midline discrepancies and premature tooth loss in the primary dentition of children in Jeddah, Saudi Arabia.

The aim of the present study is to evaluate the prevalence of crowding, attrition, midline discrepancies and premature loss of primary molars in primary dentition of children resident in Jeddah, Saudi Arabia. Five hundred and two (502) children aged 4-6 years old residing in the city of Jeddah, Saudi Arabia provide the data for the analysis. Crowding was found in 14.7% of the subjects crowding in the maxilla occurred in 27 (5.4%) of the children, and 67 (13.4%) in the mandible. Simultaneous crowding in maxilla and mandible was present in 20 (3.98%) of the subject. The prevalence of crowding was significantly higher in the mandible than the maxilla (P > 0.01) and higher in male (P < 0.05). Midline shift was present in 10% of the children with females showing a significantly higher prevalence than the males (P < 0.001). Attrition was present in 167 (33.3%) of the children. One hundred and sixty children (31.9%) had attrition in enamel, and only 7(1.4%) had attrition, which exposed the dentin. Thirty-one (6.2%) out of 502 children had 51 (0.5%) missing teeth out of total number of 10,040 teeth. Tooth #84 was most commonly lost tooth (P < .025). Overall premature loss of 1st primary molars was found to be significantly higher than 2nd primary molars (P < .001).

Temporomandibular disorders among school children.

A large volume of literature is available on the Temporomandibular Disorders (TMD) in adults. However, relatively little information is available on this condition in children. The present study is aimed at providing a comprehensive survey on Temporomandibular Joint Status in Saudi Arabian Children in the Western Region of the Kingdom. This is a report on the prevalence of TMDs in children. Five hundred and two children aged 3-7 years old were examined for signs and symptoms of TMDs in a classroom setting. Eighty-three (16.53%) presented with TMDs, with 34 (14.46%) males 49 (18.35%) female (This difference between sexes is significant P < 0.001); 39 (7.8%) of the children had TMJ sounds; 34 (6.77%) had associated muscle tenderness; 13 (2.59%) had pain during TMJ movement; 17 (3.39%) had deviation of the mandible during movement; and 9 (1.7%) had a restricted mouth opening. There is a general tendency for these signs and symptoms to be more significantly prevalent in females. None of the children had sought dental treatment for these conditions. The importance of TMJ examinations in the overall clinical assessment of the pediatric patient should not be overlooked. Identifying this subject early in life would allow us to follow up the patient and intervene in the appropriate time to avoid future problem in the TMJ apparatus.

Caries experience of children aged 6-9 years in Jeddah, Saudi Arabia.

This study was conducted to examine the caries experience of children aged 6-9 years in Jeddah, Saudi Arabia. Overall, 1522 children were examined from six primary schools located in different areas of the city. Results showed that the mean dmft and DFT were 4.23 and 1.85, respectively. The mean dmft and DFT values excluding caries-free children, however, were 5.71 and 2.95, respectively. Only 26.1% of the children were caries free. There was a high proportion of untreated dental caries and most of the carious teeth were treated by extraction. The need for effective preventive measures was stressed.

Mandibular bone turnover during calcium deficiency in the rat.

Bone resorption and deposition during calcium deficiency were compared in the mandible, femur, and vertebrae. While resorption did not differ markedly among the three sites, mineral deposition was lowest in the mandible, leading to a greater net loss of mineral than from femur or vertebrae.