Laser doppler flowmetry to detect pulp vitality, clinical reference range and coincidence rate for pulpal blood flow in permanent maxillary incisors in Chinese children: a clinical study.

BACKGROUND: A laser doppler flowmetry (LDF) test can reflect the pulp vitality caused by the change in pulp blood flow (PBF). This study aimed to investigate the PBF of the permanent maxillary incisors using LDF and to calculate the clinical reference range and coincidence rate for pulp vitality using PBF as an indicator. METHODS: School-age children (7-12 years) were recruited randomly. A total of 455 children (216 female and 239 male) were included in this study. An additional 395 children (7-12 years) who attended the department due to anterior tooth trauma from October 2015 to February 2018 were included to assess the clinical occurrence rate. The PBF was measured using LDF equipment and an LDF probe. RESULTS: The clinical reference range of PBF values for the permanent maxillary incisors (teeth 11, 12, 21, and 22) in children were from 7 to 14 perfusion units (PU), 11 (6.016; 11.900 PU), 12 (6.677; 14.129 PU), 21 (6.043;11.899 PU), and 22 (6.668; 14.174 PU). There was a statistically significant correlation between PBF and children's age (p < 0.000) without any significant gender discrimination (p = 0.395). For all incisors, for any age group, the PBF detection value of the lateral incisors was significantly higher than that of the central incisors (p < 0.05). The clinical coincidence rate of detecting PBF in the traumatic teeth was 90.42% and the sensitivity and specificity were 36.99% and 99.88%, respectively. CONCLUSIONS: The determination of the PBF clinical reference range and clinical coincidence rate for the permanent maxillary incisors in children using LDF provided a promising theoretical basis for clinical applications.

Success rate of the treatment of early childhood caries under general anesthesia: A retrospective cohort study in different periods.

Instruction: The purpose of this study was to evaluate the three-year success rate of the treatment for early childhood caries (ECC) under general anesthesia in different periods (2011 and 2018). Methods: Children (<6 years old) who had severe caries and were treated under general anesthesia in 2011 and 2018 were selected and followed up by telephone appointment and clinical examination. Success rate of each treatment was determined and possible factors associated with treatment failure were evaluated. Results: There were 153 patients (with an average age of 48.55 ± 13.37 months) and a total of 2,018 teeth included in the 2011 group. In the 2018 group, there were 273 patients with an average age of 49.01 ± 12.42 months and a total of 3,796 teeth. The success rate in the 2011 group was significantly lower than that in the 2018 group. Teeth with mineral trioxide aggregate (MTA)-capped pulp survived significantly longer than those with calcium hydroxide-capped pulp. The utilization rate of preformed crown restoration was higher than that of resin restoration, and the survival time of dental restorations with preformed crown was prolonged. For posterior teeth, the success rate of indirect pulp capping and pulpotomy was also significantly higher than those without preformed crowns. Discussion: General anesthesia is a safe and effective behavioral management method for uncooperative children's dental treatment. The use of biocompatible pulp capping materials and preformed crowns improved the success rate of treatment and prolonged the survival time of affected teeth.

Clinical characteristics and risk factors of major oral ulcers in the mandibular retromolar region in children.

OBJECTIVES: To describe the characteristics of major aphthous ulcers (MjOU) in children and analyze its potential risk factors. MATERIALS AND METHODS: Data were collected from the National Clinical Research Center for Oral Diseases of China between 2012 and 2017. Children younger than 15 years old, who had a giant mucosa ulcer (≥ 1 cm in diameter) and met the diagnostic criteria for MjOU were included in this study. Differences were compared between two subgroups of patients based on the location of the ulcerous lesions. A measurement of ratio (TBR) between the length of the mandibular second molar tooth germ and the height of the mandible was performed in children with MjOU lesions located in the mandibular retromolar pad region (MjOU-P) and their age- and sex-matched controls. RESULTS: A total of 1067 children were diagnosed with oral ulcers during the study period, of which 125 (11.7%, 95% CI: 9.8%-13.7%) met the diagnostic criteria for MjOU. More than half (n = 64, 51.2%) of the MjOU cases were MjOU-P, which had a male predilection (n = 52, 81.3%) with a significant majority at 7 to 9 years of age (n = 43, 67.2%). In comparison to the MjOU located in other regions, MjOU-P lasted longer in duration and had more comorbidities. Logistic regression analysis showed that MjOU-P was statistically significantly associated with TBR controlling age and gender. CONCLUSIONS: MjOU-P is a predominant form of MjOU in children and is a distinct subgroup of major ulcers that is likely associated with the development of the mandibular second molars. CLINICAL RELEVANCE: This study is the first to describe the demographic and clinical features of MjOU in children, which may facilitate the identification and treatment of these patients.