Swiss paediatric dentists' preferences and experience on the use of articaine and other local/topical anaesthetics.

PURPOSE: This study was conducted to explore the preference and experience of paediatric dentists based in Switzerland regarding the use of articaine and other local and topical anaesthesia. METHODS: An 18-question survey was developed, piloted, and distributed to the members of the Swiss association of paediatric dentistry (n = 460). The following information were collected: most used local anaesthetic in different age groups, time needed to inject a full ampule, frequency of observed local and systemic side effects, application of topical anaesthetic prior to injection, time waited between application and the injection, and perceived effectiveness of topical anaesthetic. The dentists' responses were analysed with logistic regressions reporting odds ratios (OR) and 95% confidence intervals (CI) at 5%. RESULTS: The response rate was 37% (n = 168) out of the 460 questionnaires sent, with the responders being predominantly female (67%) and 47-year-old on average. More than 80% of the dentists used articaine in all age groups. 45% of responders took longer than 60 s to inject a full ampule. Local and systemic side-effects were observed by 82% and 28% of respondents respectively, although the nature and the significance of those were not detailed due to the anonymous nature of the questionnaire. Significantly less local adverse effects were seen for older children (p = 0.04) and among dentists with more years of experience (p = 0.01). Most responders applied topical anaesthetic and half of them waited longer than 60 s before injection. CONCLUSIONS: Articaine is a widely used local anaesthetic by the studied group of Swiss paediatric dentists regardless of patient's age. The use of topical anaesthetic before injection is a common practice with good perceived effectiveness.

European Society of Endodontology position statement: endodontic management of traumatized permanent teeth.

This position statement represents a consensus of an expert committee convened by the European Society of Endodontology (ESE) on the endodontic management of traumatized permanent teeth. A recent comprehensive review with detailed background information provides the basis for this position statement (Krastl et al. 2021, International Endodontic Journal, https://doi.org/10.1111/iej.13508). The statement is based on current scientific evidence as well as the expertise of the committee. Complementing the recently revised guidelines of the International Association of Dental Traumatology, this position statement aims to provide clinical guidance for the choice of the appropriate endodontic approach for traumatized permanent teeth. Given the dynamic nature of research in this area, this position statement will be updated at appropriate intervals.

Endodontic management of traumatized permanent teeth: a comprehensive review.

The pulp plays a key role in the treatment of traumatic dental injuries (TDIs) and is strongly associated with the outcome, particularly in severe cases. A correct pulp diagnosis is essential as it forms the basis for developing the appropriate management strategy. However, many TDIs are complex, and their treatment requires a profound knowledge of the physiological and pathological responses of the affected tissues. This comprehensive review will look at the dentine-pulp complex and its interaction with the surrounding tissues following TDIs. The literature up to 2020 was reviewed based on several searches on PubMed and the Cochrane Library using relevant terms. In addition to the recently revised guidelines of the International Association of Dental Traumatology, this article aims to provide background information with a focus on endodontic aspects and to gather evidence on which a clinician can make decisions on the choice of the appropriate endodontic approach for traumatized permanent teeth.

Rare case of generalised aggressive periodontitis in the primary dentition.

BACKGROUND: Generalised aggressive periodontitis (AP) in the prepubescent age is an exceptionally rare disease in the primary dentition of otherwise healthy children. Characteristics of AP are gingival inflammation, deep periodontal pockets, bone loss, tooth mobility and even tooth loss. The most common way of treating this disease is the extraction of all the involved primary teeth. CASE REPORT: A 4-year-old girl presented with signs of severe gingival inflammation. Clinical examination revealed deep pockets, increased tooth mobility and bone loss. Microbiological testing revealed the presence of a typical periopathogenic flora consisting of Aggregatibacter actinomycetemcomitans and the typical members of the red complex (Porphyromonas gingivalis, Prevotella intermedia and Treponema denticola). The patient underwent tooth extraction of all primary teeth except the primary canines, followed by thorough root debridement and treatment with systemic antibiotics (amoxicillin plus metronidazole). FOLLOW-UP: Regular clinical and microbiological examinations over 4 years showed no signs of recurrence of a periodontitis, even in the erupted permanent teeth. CONCLUSION: Early diagnosis and consequent early treatment of aggressive periodontitis can stop the disease and therefore avoid the development of a periodontal disease in the permanent dentition. A close collaboration between specialists of different disciplines is required for a favourable outcome.

Paradental cyst mimicking a periodontal pocket: case report of a conservative treatment approach.

A 7-year-old boy presented with a periodontal problem related to an erupting lower molar. The tooth showed a 15 mm deep periodontal pocket on the buccal aspect. A microbiological DNA test excluded a periodontal origin. The treatment consisted of local antimicrobial therapy and cleaning and filling of the pocket with Atridox. 2 years after therapy the pocket completely disappeared. Finding periodontal pockets on freshly erupted teeth with acute symptoms should suggest the diagnosis of a cyst. This could prevent surgical endodontal or periodontal therapy. This problem can be managed effectively with minimal therapy and local antibiotics.

Understanding mineral trioxide aggregate/Portland-cement: a review of literature and background factors.

AIM: This was to carry out a review of the literature concerning mineral trioxide aggregate (MTA) and Portland cement with regards to clinical, biological and mechanical findings and a possible substitution of MTA through Portland cement for endodontic use. STUDY DESIGN: Electronic literature search of scientific papers from January 1993 to January 2009 was carried out on the MEDLINE and Scopus databases using specific key words. In total, 57 papers were identified that dealt with MTA and Portland cement in a relevant way. RESULTS: The review of 50 papers conforming to the applied criteria showed that MTA and Portland cements have the same clinical, biological and mechanical properties. In animal experiments and technical characterisations both materials seemed to have very similar properties. The only difference is bismuth oxide in MTA added for better radio opacity. It seems likely that MTA materials are based on industrial Portland cements mixed with bismuth oxide. More studies, especially some long-term studies comparing MTA and Portland cement, are necessary. CONCLUSION: The existing literature gives a solid base for clinical studies with Portland cement in order to replace MTA as an endodontic material. Portland cement could be a substitute for most endodontic materials used in primary teeth.

Elective mutism: effect of dental treatment with N2/O2-inhalation sedation: review and report of case.

Elective mutism in children is characterized by a marked, emotionally determined selectivity in speaking, such that the child demonstrates his or her language competence in some situations but fails to speak in other situations. An eight-year-old boy with elective mutism had to undergo restorative dental treatment. It was chosen to use relative analgesia to perform this treatment. The sedation with oxygen and nitrous oxide resulted in complete symptom remission as long as the sedation lasted.

Three-dimensional measurement of enamel loss caused by bonding and debonding of orthodontic brackets.

A mechanical computerized three-dimensional scanner with a resolution of 1 micron was used to assess loss of enamel caused by orthodontic bonding and debonding. A total of 2646 measurements was performed on six human premolars. The results showed an average loss of enamel of 7.4 microns. The range was between 1 and 52 microns, which may account for discrepancies with earlier studies that measured only a few points per tooth surface.

Mild dental findings associated with severe osteogenesis imperfecta due to a point mutation in the alpha 2(I) collagen gene demonstrate different expression of the genetic defect in bone and teeth.

Serial intraoral photographs, radiographs, and ground sections from an extracted upper permanent canine served to characterize dental abnormalities in a 15-year-old girl suffering from severe (type III) osteogenesis imperfecta (OI) due to a point mutation that substituted glycine 688 of the alpha 2(I) chain of collagen I by serine. Dental records showed that all deciduous teeth exhibited clinical and radiographic characteristics of dentinogenesis imperfecta (DI), whereas permanent teeth including the removed canine appeared normal, although pulp chambers contained unusually large denticles. Despite the unconspicuous clinical appearance of the canine, histologic sections revealed small, canal-like, hypomineralized hard tissue patches that lacked a regular tubular structure and occupied a narrow band of the bulk of normal circumpulpal dentin at about the level of the cemento-enamel junction. The finding that a mutation in the gene for the alpha 2(I) collagen chain with serious consequences in bone has only minor effects in teeth would suggest that odontoblasts, unlike osteoblasts, can largely compensate for this particular genetic defect, possibly by excluding the abnormal alpha 2(I) chains and forming alpha 1(I) homotrimeric collagen I. The discrepant consequences in deciduous as opposed to permanent teeth and the specific localization of the dentinal abnormalities in permanent teeth lead us to speculate that the exclusion of defective alpha 2(I) chains could depend on the developmental stage and/or the rate of extracellular matrix formation.

Thalidomide treatment of mucosal ulcerations in HIV infection.

Pain relief and resolution of oral and perianal ulceration after treatment with thalidomide in a 14 year old girl with vertically acquired HIV infection is reported.

[The dental filling therapy of carious deciduous molars: materials and methods. A review]. / Füllungstherapie kariöser Milchmolaren: Materialien und Methoden. Eine Ubersicht.

There is little consensus as to which restorative material or techniques are best suited to restore primary teeth. Techniques developed for the permanent dentition can seldom be applied to the primary teeth because of morphological differences and lack of cooperation by the children. The morphological properties of primary molars are discussed in this paper in relation to their therapeutic consequences. In addition to general guidelines for dental therapy in children, current restorative materials and techniques are compared regarding their suitability for the primary dentition. Finally the goals for the development of an ideal restorative material are formulated.