Selective excavation and ozone therapy: new frontier of mini-invasive caries treatment in MIH paediatric patients. A case report.

BACKGROUND: The term hypomineralisation of molars and incisors (MIH), introduced in 2001 by Weerheijm et al., describes a clinical state of hypomineralisation of permanent molars with frequent involvement of the incisors. MIH is considered a global dental problem with a prevalence ranging from 2.4% to 40.2% in the entire world paediatric population. The continuous increase in the prevalence of enamel anomalies, including MIH, indicates the need to define new intervention protocols based on the technological advances that are revolutionising paediatric dentistry. The use of ozone associated with the selective and minimally invasive excavation of the dental tissue combines the antibacterial properties of the gas with an ultra-conservative approach aimed at the maximum conservation of the dental tissue. The operative protocol described can be an important tool in the prevention and treatment of MIH. The aim of this work is to illustrate an operative clinical protocol based on the combined use of selective excavation and ozone for the treatment of carious lesions in paediatric patients with MIH.

Kids Digital Crown Technique: an innovative approach to restore primary teeth.

AIM: The purpose of this clinical case is to present the Kids Digital Crown Technique (KDCT), an innovative technique to restore primary teeth with customised prosthetic crowns. METHODS: A six-year-old patient presented to our clinic with an extensive carious process affecting tooth 8.4. After assessing the patient’s conditions, a digital intraoral impression was taken and digitally sent to the dental lab to realise a customised prosthetic crown of the tooth. After the endodontic treatment and a minimal tooth preparation the crown was cemented using a dual resin-based cement. RESULTS: The procedure permitted to realise a customised prosthetic crown ready to be applied immediately after the endodontic therapy. The crown was the correct size, easy to adapt and of the correct colour. The protocol follows an easy, kid-friendly workflow, reducing the operative time and maintaining the advantages of other procedures. CONCLUSION: Kids Digital Crown Technique is a valid procedure to restore primary teeth with prosthetic crowns. Future prospective studies will be necessary to confirm the efficacy of this technique.

State-of-the-art on MIH. Part. 2 MIH clinical management using ozone.

MIH is still a challenge in paediatric dentistry, due to the high sensitivity caused to the first permanent molars, that can greatly reduce the cooperation either for home oral hygiene or for in-office treatment. In this contest the use of ozone emphasises the ART technique (Atraumatic Restorative Treatment) and introduces modern "no aerosol" concept.

Nitrous oxide analgesic effect on children receiving restorative treatment on primary molars.

AIM: Pain experienced during dental treatment increases the risk of developing dental anxiety in children who will became anxious adults, avoiding dental care. It is therefore essential to provide pain-free dental treatment. The strongest fears are often associated with injections: being able to successfully complete painless restorative treatment without the need for local anesthesia injection is therefore an important goal. Nitrous oxide administration by means of Langa's Relative Analgesia (RA) technique has been demonstrated to have both sedative and bland analgesic properties: the mechanism by which N2O exerts its analgesic effects is now understood. The purpose of this study was to test the analgesic effectiveness of Nitrous Oxide used in the RA technique as the only analgesic agent for restorative treatment of primary molars presenting caries lesions without pulp involvement. MATERIALS AND METHODS: Ninety patients aged between 3.2 and 9.4 years, 38 males and 52 females, ASA I and II, were included in the study. One hundred and thirty-four restorations were completed on primary molars with caries lesions without pulp involvement (1/3 to 2/3 into dentin): 72 restorations were completed on 48 patients under RA in the Study Group and 62 restorations were performed on 42 patients under RA and local anaesthesia (LA) in the Control Group. At the end of each session, the perception of pain experienced during treatment was rated by each patient using the Wong-Baker FACES® Pain Rating Scale. RESULTS: No statistical difference on self-reported pain perception was seen in the Study Group (treatment under RA) and in the Control Group (treatment under RA plus LA administration). The results also showed no significant difference in pain sensation between males and females; age as well as gender did not affect the results between groups. CONCLUSIONS: Nitrous oxide as used in the Langa's RA technique is effective in providing a sufficient analgesic outcome during restorations of primary molars when there is no pulp involvement, with no need for LA supplement.