Comparison of dmft and behavior rating scores between children with systemic disease and healthy children at the first dental visit.

PURPOSE: To evaluate and compare oral health and behavior scores at the first dental visit and dental treatment need using general anesthesia/sedation (GA/S) of children with systemic diseases (SD) and healthy children. METHODS: Data were obtained from healthy children (n = 87) and children with SD (n = 79), aged 4 to 6 years, presenting to a hospital dental clinic for a first dental examination. The total number of decayed, missing and filled teeth (dmft), dental behavior score using Frankl Scale, and dental treatment need using GA/S were recorded. Chi-square / Fisher's exact test and Mann-Whitney U tests were used for statistical analyses. RESULTS: The patients with SD were diagnosed with cardiac disease (61%), renal disease (9%), and pediatric cancers (30%). The median dmft values of the SD group (3.00) were significantly lower than those of healthy children (5.00) (p = 0.02) and healthy children exhibited significantly more positive behavior (90.8%) than children with SD (73.4%) (p = 0.002). The number of patients needing GA/S for dental treatment did not differ significantly between the two groups (p = 0.185). There was no relationship between dental treatment need with GA/S and dental behavior scores of the patients (p = 0.05). A statistically significant relationship was found between the patients' dmft scores and the need for dental treatment using GA/S; and the cut-off value was found to be dmft > 4 for the overall comparisons. CONCLUSION: The presence of chronic disease in children appeared to affect the cooperation negatively at the first dental visit compared to healthy controls, however, it did not affect the oral health negatively. Having a negative behavior score or SD did not necessitate the use of GA/S for dental treatment.

Indications and use of cone beam computed tomography in children and young individuals in a university-based dental hospital.

BACKGROUND: The aim of this study was to evaluate the indications of cone beam computed tomography (CBCT) in children and young individuals in a university-based dental hospital and their association with age, gender and field of view. METHODS: 7131 CBCT scans, taken during 3-year period, were reviewed and a total of 649 pediatric patients (0-18 years) with complete request forms were included. Data related to gender, age, referring department, CBCT indications, field of view (FOV), region of interest (ROI), need for re-exposure and patients received more than one CBCT examination were recorded. RESULTS: The mean age was 13.57 ± 3.52 years and "malocclusion and dentofacial anomaly" (28.7%) was the most common clinical indication. Facial trauma, dental trauma and supernumerary tooth in males; "malocclusion and dentofacial anomaly" and implant planning in females were recorded more frequently compared to other gender. Maxilla was the most frequently monitored ROI (35.1%) for patients. Small (≤ 10 cm) FOV was preferred in 58.1% of all patients. Large FOV was selected in the majority of patients who underwent CBCT scan for "malocclusion and dentofacial anomaly" (89.6%). The repeated scans constituted 2.3% of patients and 105 patients (16.2%) underwent multiple CBCT scans on different dates for mainly orthodontic follow-up. CONCLUSIONS: The justification of CBCT scans was not fully compatible with current guidelines and mainly larger FOV was preferred. The number of CBCT examination in children and young individuals tends to increase. TRIAL REGISTRATION NUMBER: Not applicable.

Clinical evaluation of giomer- and resin-based fissure sealants on permanent molars affected by molar-incisor hypomineralization: a randomized clinical trial.

BACKGROUND: Molar-incisor hypomineralization (MIH) is a common condition among children that significantly increases the risk of caries. The objective of this research was to evaluate the clinical success of giomer- and conventional resin-based sealants applied on first permanent molars (FPMs) affected by MIH. METHODS: One-hundred FPMs with MIH which were indicated for non-invasive fissure sealant were selected in 39 children, aged 6-12 years. Using a split mouth design, the FPMs were randomized into two groups; Group 1. Resin sealant (etch-and-rinse + Conceal F) and Group 2. Giomer sealant (self-etch primer + BeautiSealant). Clinical evaluation was performed using the modified United States Public Health Service (USPHS) criteria at 1, 3, 6 and 12 months. The Log-rank, Fisher's exact test and Kaplan-Meier analysis were used for statistical analysis. RESULTS: At 12 months, the retention rates in Group 1 and Group 2 were 68% and %8, respectively (p = 0.000). The cumulative survival rates of conventional resin sealants were significantly higher than giomer sealants for all follow-up visits (p < 0.05). In Groups 1 and 2, the distribution of unsuccessful sealants on mandibular vs maxillary FPMs were 32.1% vs 31.8% (p = 0.612) and 91.7% vs 92.3% (p = 0.664), respectively. Although the success rate was higher for teeth with white opacities or lesions with less extension in Group 1, no significant difference was found. The average survival time was found as 10.46 ± 3.21 months in Group 1 and 4.02 ± 4.43 months in Group 2. CONCLUSIONS: The conventional resin-based sealants yielded a better clinical performance over the 12-month evaluation period than the giomer sealants which were applied with self-etch primer. The high failure rate observed in giomer sealants could be explained by the possible deficiency in the etching capacity of self-etch primer on MIH-affected teeth. Trial registration ClinicalTrials.gov, NCT04929782. Registered 10 June 2021-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04929782 .

A 3-Year retrospective study of traumatic dental Injuries to the primary dentition.

BACKGROUND/AIMS: Traumatic dental injuries (TDIs) in the primary dentition are a significant public health problem, which has been neglected worldwide. Despite its high prevalence, limited studies address this injury. The aim of this study was to determine the characteristics and treatment modalities of TDIs affecting primary teeth, along with accompanying medical co-morbidities and attendance at follow-up appointments. MATERIAL AND METHODS: This retrospective analysis included all TDIs affecting primary teeth from January 2014 to January 2017. Data abstraction included demographics, time lapse prior to arrival at hospital, trauma etiology, classification of TDIs, soft tissue and supporting bone injuries, medical co-morbidities, emergency treatment, follow-up appointments and prognosis. RESULTS: Records of 283 children with 536 traumatized primary teeth were reviewed. The median age was 2 years and the maxillary right central incisor (35.1%) was the most frequently injured tooth. Almost half the patients, 46.3%, sought treatment after 24 h. Periodontal tissue injuries (97.2%) predominated TDIs for which fall accidents (82.0%) were the most encountered cause. Most patients (177/283) had accompanying soft tissue/supporting bone injuries and 67.2% had multiple traumatized teeth. Seventy percent of the patients were examined only or were prescribed medication. Survival time following TDIs was unknown in 67.7% of traumatized teeth due to non-attendance at follow-up appointments. Most patients (55.1%) did not attend the follow-up appointments. CONCLUSIONS: TDIs occurred in the primary dentition with the predominance of periodontal tissue injuries. When TDI was the presenting problem to hospital, accompanying systemic injury was rare. Treatment modalities were mostly limited to examination or extraction. The follow-up appointments were poorly attended.

Partial Pulpotomy in Immature Permanent Molars After Carious Exposures Using Different Hemorrhage Control and Capping Materials.

PURPOSE: This study compared the outcome of partial pulpotomies with mineral trioxide aggregate (MTA) or calcium hydroxide (CH) following hemorrhage control with 2.5 percent sodium hypochlorite (SH) or 0.9 percent sterile saline (SS) solutions in cariously exposed immature permanent molars. METHODS: Following removal of two to three mm of the pulp at the exposure site, 80 Class I cavities were randomly allocated to four groups according to the hemorrhage control agent and pulp-capping material used: (1) group one-SH plus MTA; (2) group two-SS plus MTA; (3) group three-SH plus CH; (4) group four-SS plus CH. Glass ionomer cement was applied over the pulp-capping material, and the teeth were later restored with composite resin. The patients were recalled at six, 12, 18, and 24 months. RESULTS: After 24 months, simultaneous radiographic and clinical success rates were 94.4 percent, 100 percent, 95 percent, and 100 percent for groups one to four, respectively (P>.05). No significant correlation was found between marginal integrity scores of restorations and partial pulpotomy failure (P>.05). CONCLUSIONS: Partial pulpotomy, performed with MTA or CH used as the pulp-capping material following hemostasis with SH or SS solutions, provided comparable and favorable outcomes in carious pulp exposures of immature permanent teeth.

Management of a Compound Odontoma in the Primary Dentition.

Odontomas are the most common benign odontogenic tumors of the oral cavity; however, their occurrence in the primary dentition is an extremely rare condition. When associated with primary teeth, odontomas may lead to disturbances in tooth eruption, which often requires a multidisciplinary treatment approach. The purpose of this paper is to review the literature on odontomas of the primary dentition and discuss the management of a compound odontoma in a pediatric patient.