Endodontic management of submerged roots following complicated traumatic dental injury (TDI) in children and adolescents: A systematic review.

INTRODUCTION: The International Association of Dental Traumatology (IADT) guidelines include the use of decoronation for the management of complex crown-root fractures but do not outline how this technique is best employed. The aim of this review is to reach a consensus in the management of the root canal system in decoronated permanent teeth undergoing root submergence and to determine whether this has an impact on the success and survival of the retained root. MATERIALS AND METHODS: Search included databases MEDLINE via Ebsco, EMBASE via Ovid, Web of Science via Clarivate, PubMed via PubMed.gov, the Cochrane Library via Wiley, cited reference searching and hand searching of relevant journals. Two independent reviewers performed study selection, data extraction and risk of bias assessment using Joanna Briggs Institute (JBI) Critical Appraisal Checklist. RESULTS AND DISCUSSION: In total, 18 articles were included in qualitative analysis: 17 of these were case reports and one case series. A total of 37 teeth were treated with decoronation either using the Malmgren or an alternative protocol (root submergence following endodontic treatment with gutta-percha [GP] or a calcium silicate cement and vital root submergence). Limited evidence from this review suggests that immediate decoronation and vital root submergence are successful in apexogenesis and preserving alveolar bone. This systematic review has been registered in the International Prospective Register of Systematic Reviews (PROSPERO: registration number CRD42022316266).

Current Applications and Future Prospects of Stem Cells in Dentistry.

Stem cells are defined as clonogenic, unspecialized cells capable of both selt-renewal and multi-lineage differentiation, contributing to regenerating specific tissues. For years, restorative treatments have exploited the lifelong regenerative potential of dental pulp stem cells to give rise to tertiary dentine, which is therapeutically employed for direct and indirect pulp capping. Current applications of stem cells in endodontic research have revealed their potential to continue root development in necrotic immature teeth and transplanted/replanted teeth. Successful application of pulp revascularization is highlighted here with support of a clinical case report. This article also discusses the role of dental stem cells as a promising tool for regeneration of individual tissue types like dentine, pulp and even an entire functional tooth.

Validation of a novel behavior prediction scale: A two-center trial.

CONTEXT: Prediction of the child's behavior can adequately equip the dentist in rendering effective and efficient dental treatment. AIM: This study was planned to evaluate and validate a specially prepared questionnaire as a child behavior prediction scale. DESIGN: A two-center cross-sectional study was done to validate the new scale. MATERIALS AND METHODS: Children aged 3-12 years (n = 296), from two different centers participated in this study. The questionnaire used was a 10-point observational scale. Observations involved perceiving overt and subtle behavioral characteristics of a child, to assess the child's behavior in the dental office before treatment. An independent observer approached the children and their parents in the waiting room. The child's behavior was then evaluated by the dentist using Frankl behavior rating scale during and after treatment. The prediction of behavior compared to the Frankl scale was assessed and validated. STATISTICAL ANALYSIS: Sensitivity, specificity tests, and receiver operating curve analysis were used to validate the new scale and calculate the cut-off score for positive and negative behavior. All data were processed by SPSS software (16.0, SPSS Inc., Chicago, Ill, USA). RESULTS: The best cut-off score to predict a positive Frankl rating was ≥ 8.0 in both the centers. The sensitivity and specificity scores were 93.4% and 62.5% in center 1; 83.1% and 59.6% in center 2 respectively. CONCLUSION: This novel prediction scale can be of great importance in predicting children's behavior in the dental environment.

Concomitant hypo-hyperdontia with an endocrine etiology.

The simultaneous occurrence of hypodontia and supernumerary teeth in the same individual is termed as "concomitant hypohyperdontia" and it is an uncommon condition with the etiology still unknown. Presented here is a very rare case of simultaneous presence of multiple supernumerary teeth and multiple missing teeth (bilateral maxillary second premolars and bilateral mandibular second molars) involving both jaws with a history of subclinical hypothyroidism. Systemic diseases could probably play a role in the etiologic occurrence of co-existent partial anodontia and supernumerary teeth.

Relevance of Piaget's cognitive principles among 4-7 years old children: a descriptive cross-sectional study.

BACKGROUND: According to Jean Piaget, children between 4 and 7 years of age are under the intuitive sub-stage of preoperational stage. Children possess specific characteristics based on their age. These characteristic cognitive principles have not been assessed in a dental setting. Research on the cognitive development of the child and its application to dental health care can enable pediatric dentists to better understand, approach and deliver improved quality of care to children. PURPOSE: The purpose of this study is to assess the prevalence of Piaget's cognitive principles among preoperational children. MATERIALS AND METHODS: This cross-sectional study was conducted among 200 children, aged 4-7 years. Various characteristics, specific for this age group, such as egocentrism, concept of cardinal numbers based on centration, lack of conservation, and reversibility were assessed, using three tangible experiments and two interview questions. A comparison of the prevalence of each character was carried out among the children based on their age. RESULTS: The prevalence of egocentrism based on the three mountain experiment was 65% and the personal interview showed a prevalence of 58%. Centration was appreciated in 83% of the study sample. The beaker experiment and the interview question revealed a lack of conservation in 89% and 59% of the children, respectively. There was a gradual and uniform reduction in the prevalence of the characters with an increase in age. CONCLUSION: All the three features assessed were observed in most of the children between 4 and 7 years of age as described by Piaget and most of his principles still appear valid today.

Tooth mineralization stages as a diagnostic tool for assessment of skeletal maturity.

INTRODUCTION: The objective of this study was to determine whether dental calcification can be used as a first-level diagnostic tool for assessment of skeletal maturity. METHODS: A total of 150 healthy subjects (79 boys, 71 girls; mean age, 12.19 ± 2.03 years; range, 8-16 years) were enrolled in the study. Dental maturity was assessed through the calcification stages from panoramic radiographs of the mandibular canine, the first and second premolars, and the second molar. Determination of skeletal maturity was according to the modified middle phalanx of third finger (MP3) stages method on digital radiographs. RESULTS: Diagnostic ability was evaluated according to the dental maturation stages for each tooth for identification of the MP3 stages and the growth phases (prepubertal, pubertal, postpubertal) using positive likelihood ratios. Dental maturation stage E of the first premolars and the combination of canine stage F, first premolar stage E, second premolar stage E, and second molar stage D (FEED) gave the highest values for identification of the prepubertal growth phase, and stage H of the second molar had the highest value for identification of the postpubertal growth phase. CONCLUSIONS: Dental maturation assessment is only useful for diagnosis of the prepubertal and postpubertal growth phases.