Development of the Training Program on Child Abuse Prevention for Citizens (TCAP-C) and Its Effects and Acceptability: Community-Based Participatory Research.

AIM: We developed the Training Program on Child Abuse Prevention for Citizens (TCAP-C) and tested its effects and acceptability among citizen leaders (CLs). METHODS: Community-based participatory research using a pretest-posttest follow-up design was conducted in Tokyo, Japan from September 2021 to March 2022. Participants completed questionnaires before, upon completion, and one month and three months after TCAP-C. Recognition, knowledge, and behaviors regarding child abuse and community consciousness were collected and compared before and one and three months after TCAP-C, and the degree of satisfaction, understanding, and meaningfulness were collected upon completion. We analyzed data using repeated-measures ANCOVA. RESULTS: A total of 111, 98, 101, and 94 participants completed the questionnaires before, upon completion, and one and three months after TCAP-C, respectively. Overall, the recognition, knowledge, and community consciousness scores significantly improved from before to one month and three months after TCAP-C. Regarding the behaviors, only the behaviors of learning and watching over were significantly improved from before to one month after TCAP-C; however, those behaviors were not different between before and three months after TCAP-C. Furthermore, 95% participants reported being entirely satisfied with TCAP-C, and 85% and 91% reported good understanding and meaningfulness of the program. CONCLUSIONS: TCAP-C is acceptable and can improve CL recognition, knowledge, and community consciousness.

Difference in Bilateral Timing of Eruption of Permanent Teeth.

The aim of this study was to obtain basic data that might serve as criteria in the diagnosis of delayed eruption of the permanent teeth. The synchronicity of the eruption of corresponding contralateral teeth was determined. Data were obtained on both the deciduous and permanent dentition based on records made every 2 months at the Department of Pediatric Dentistry of Tokyo Dental College. These data were then used to investigate bilateral differences in the timing of eruption of the permanent teeth. Over 80% of incisors, first molars, mandibular canines, and maxillary first premolars erupted within 4 months of their contralateral counterparts, while this occurred in 75% of maxillary canines, mandibular first premolars, and mandibular second molars, 70% of maxillary and mandibular second premolars, and 65% of maxillary second molars. Bilateral differences in the timing of permanent tooth eruption varied depending on type of tooth, and these differences tended to be smaller for teeth erupting at an earlier point in the order of eruption, and greater for those erupting at a later point. These results suggest that the failure of a contralateral tooth to erupt within 4 months of its counterpart might serve as a criterion in a diagnosis of suspected delayed eruption of a permanent tooth.

Intentional Partial Pulpotomy for Treatment of Immature Permanent Maxillary Incisor with Talon Cusp.

We report the successful morphological correction of a maxillary lateral incisor with a talon cusp and the preservation of vital pulp by employing an intentional partial pulpotomy. A talon cusp is a comparatively rare morphological tooth anomaly that may cause multiple clinical problems. An 11-year-old girl was referred to our department for morphological correction of a maxillary lateral incisor with a talon cusp prior to orthodontic treatment. Following a detailed CT examination of the interior morphology, the abnormal cusp was resected and an intentional partial pulpotomy performed. Five years postoperatively, the tooth showed no abnormalities. These results indicate that an intentional partial pulpotomy following a detailed CT examination is effective in correcting complicated morphological anomalies such as a talon cusp containing extended dental pulp.

Effects of different combinations of fused primary teeth on eruption of the permanent successors.

PURPOSE: The fusion of primary teeth may be associated with the absence of 1 of the 2 permanent successors. Moreover, even if both successors erupt, developmental disturbances such as microdontia or delayed tooth formation may occur. The purpose of this study was to elucidate the effects of different combinations of fused primary teeth on the eruption of permanent successors. METHODS: One hundred ninety-seven children with 247 fused primary teeth were examined. Combinations of primary teeth involved in the fusion were identified, and the effects of these different combinations on the presence, morphology, and eruption of the permanent successors were determined. RESULTS: Three types of fusion in the primary teeth were identified: (1) between the maxillary central and lateral incisors (UCI/LI); (2) between the mandibular central and lateral incisors (LCI/LI); and (3) between the mandibular lateral incisor and canine (LLI/C). The results revealed an absence of the successional lateral incisor in 65% of UCI/LI cases and 74% of LLI/C cases, whereas only 16% of LCI/LI cases resulted in a missing successor. CONCLUSIONS: Fused primary teeth are highly correlated with the absence of permanent teeth, and the prevalence depends on the combination of fused primary teeth.

Dental treatment for patients with physical or mental disability under general anesthesia at Tokyo Dental College Suidobashi Hospital.

Dental treatment for patients with physical or mental disability is often performed under general anesthesia due to level of cooperation with treatment, type and location of treatment, time required, or number of times patient is required to attend hospital. University hospitals are receiving an increasing number of requests from local private dentists and dental clinics to provide dental care for patients with physical or mental disability which can only be performed under general anesthesia. We carried out a retrospective survey of the routes of referral and types of dental treatment carried out in such patients under general anesthesia at Tokyo Dental College Suidobashi Hospital. The survey covered a 5-year, 9-month period from April 2006 to December 2011, during which 163 patients, comprising 106 men and 57 women, were treated. Their age ranged widely, from 2 to 53 years, with a high proportion (118 patients, 72.4%) being minors aged under 20. Among the total number of patients, 69 (42.3%) had disorders associated with mental retardation. One hundred and two patients (62.6%) had been referred from other medical institutions, with a particularly high number coming from public dental clinics for patients specializing in such patients. Conservative restorative procedures were performed in most cases (59.4%), with composite resin restorations being particularly frequent. After treatment, many patients returned to their referring medical institutions, which were responsible for subsequent management, but information on the posttreatment status was not available for some patients. Tokyo Dental College Suidobashi Hospital frequently collaborates with local medical institutions, and the present results suggest the importance of improving such collaboration.

Management of a supernumerary tooth fused to a permanent maxillary central incisor.

A supernumerary tooth fused to a normal tooth often causes malocclusion and esthetic problems because of malformation and large crown. This requires treatment such as sectioning and extraction of the supernumerary tooth, modification of crown shape by contouring and restoration, or extraction. Moreover, endodontic treatment is often required as part of the procedure since pulp exposure occurs frequently during sectioning and modification of crown shape. The purpose of this paper was to report the case of a supernumerary tooth fused to the permanent maxillary left central incisor in a 9-year-old boy with unilateral (left side) cleft lip and palate and describe its management. After a thorough examination employing X-ray Computed Tomography (CT), the supernumerary tooth was separated from the central incisor at the fusion site and extracted under local anesthesia. No endodontic treatment was performed on the conserved central incisor. The central incisor's rotation was corrected by orthodontic treatment, followed by modification of the crown shape with composite resin. More than 4 years have passed since the first operative treatment, and the central incisor still remains vital. This case shows that a precise diagnosis is important in sectioning a fused tooth, and that CT-based data are very useful in planning treatment.

Dental care for physically or mentally challenged at public dental clinics.

Recently, local administration bureaus have established a number of dental clinics and centers for the physically or mentally challenged (PMC) in collaboration with local dental associations. The aim of this study was to investigate dental treatment and general supportive care for the PMC in dental clinics in Tokyo. A dental clinic for the PMC located in northwestern Tokyo in a district with a population of about 680,000 was selected for the study. The variables studied based on dental records included total number of patients, type of disability, medical history, systemic condition, age, treatment regimen and type of general supportive care. The largest group of new patients was under 9 years of age. The highest total number of patients visiting the clinic belonged to the 60-69-year-olds group and the 70-79-year-olds group. We also investigated type of disability in patients treated under intravenous sedation at time of dental treatment. The most common condition was dementia resulting from Alzheimer's disease (42.74%), autism, cerebral palsy or mental retardation, in descending order. The percentage of patients referred from other medical institutions was 17.4%, including those from private dental clinics and Dental University Hospitals. Type of disability in patients transferred from other medical institutions included developmental disorders (28.2%), senile defects (26.9%), chronic and psychiatric diseases (44.9%). The number of patients who located and visited the clinic by themselves greatly exceeded the number transferred by request. This suggests that a permanent system should be put in place offering public specialized dental clinics where the PMC many obtain treatment.