Secular changes in eruption of primary teeth in Chinese infants and young children from three national cross-sectional surveys.

The eruption of primary teeth is a basic event during physical development of children, which is affected by heredity and environment. This study aimed to analyze the changes in primary teeth eruption among Chinese children with social development. A total of 249,264 healthy children under 2 years were extracted from the 1995, 2005, and 2015 National Survey on the Physical Growth and Development of Children in Nine Cities of China. Their primary teeth were examined and percentiles of primary teeth eruption age were calculated by probit analysis. The median primary teeth eruption age were 6.8 months, 6.7 months, 6.6 months in 1995, 2005 and 2015. Primary teeth eruption age of boys was 0.2 months, 0.3 months, 0.3 months earlier than that of girls in 1995, 2005 and 2015. Primary teeth eruption age was the earliest in children from northern region and was the latest in children from southern region, and this regional difference did not change over time. These findings suggest that primary teeth eruption age slightly advanced with social development, and their gender difference and regional difference have always existed, which supplied some data for understanding the secular trend of primary teeth development in stomatology, pediatrics, anthropology, and other related fields.

[Study on the antimicrobial effect of new bioactive glass against common bacteria in apical periodontitis of deciduous teeth].

PURPOSE: To study the antimicrobial effect of different concentrations of new bioactive glass(BG) on common bacteria in apical periodontitis of deciduous teeth. METHODS: The diameter (mm) of the inhibitory rings formed after treatment of Enterococcus faecalis, Porphyromonas gingivalis and Clostridium nucleatum with the new bioactive glass was detected and observed by paper diffusion method, and the minimal inhibitory concentration(MIC), minimal bactericidal concentration (MBC) and minimal biofilm eradication concentration (MBEC) of E. faecalis, P. gingivalis and C. pseudomallei were determined. The mixed plaques of the three bacteria were treated with 20, 40, 60 and 80 mg/mL of the new bioactive glass for 24 h. The results were analyzed by laser confocal microscopy. The antibacterial effect of the new bioactive glass on the mixed plaque was observed by confocal laser scanning microscopy (CLSM). Statistical analysis was performed with GraphPad Prism 10.0 software. RESULTS: The new bioactive glass showed strong antibacterial potential against the common bacteria of apical periodontitis; the MBEC of the new bioactive glass on the plaque was significantly greater than MIC and MBC of Enterococcus faecalis, Porphyromonas gingivalis and Clostridium nucleatum, and as the concentration of the new bioactive glass increased, the number of dead bacteria in the mixed plaque increased, and there was significant difference from that of the blank control group (P＜0.05). CONCLUSIONS: The novel bioactive glass shows significant antibacterial efficacy against Enterococcus faecalis, Porphyromonas gingivalis and Clostridium nucleatum, which are the common bacteria in apical periodontitis of deciduous teeth.

Current Status and Family Factors Influencing Caries in the Deciduous Teeth of Children 3-6 Years of Age in Families Residing in Rural Heishanzui Township.

PURPOSE: To determine the caries status in children's deciduous teeth and examine the influence of family oral health behaviours on the caries status. MATERIALS AND METHODS: This cross-sectional study included 329 children aged 3-6 years in rural Heishanzui Township, Hebei Province, China, and used a completely random sampling method. These children underwent physical and oral health examinations. The questionnaires were given to the parents and caregivers of the examined children. RESULTS: The prevalence of caries in the deciduous dentition among children aged 3-6 years was 80.55%, with a dmft index of 4.93. Children in the caries group ate sweets, chocolates, and carbonated drinks more frequently than did children in the caries-free group (p < 0.05). Children in the caries-free group brushed their teeth more frequently, with parents helping their children brush, more often than did those in the caries-affected group (p < 0.05). The level of parental education and annual household income also had statistically significant effects on the prevalence of caries in the two groups (p < 0.05). Logistic regression analysis revealed that the frequency of eating sweets was a risk factor for caries in deciduous teeth (odds ratio = 2.20; p < 0.05). CONCLUSION: The prevalence of caries in deciduous teeth among children aged 3-6 years in rural Heishanzui Township was high. Compared to children in the caries-affected group, the families and children in the caries-free group had better oral hygiene behaviours. Moreover, the frequency of eating sweets was shown to be a risk factor for caries in deciduous teeth in children aged 3-6 years.

Bayesian modeling of spatially differentiated multivariate enamel defects of the children's primary maxillary central incisor teeth.

BACKGROUND: The analysis of dental caries has been a major focus of recent work on modeling dental defect data. While a dental caries focus is of major importance in dental research, the examination of developmental defects which could also contribute at an early stage of dental caries formation, is also of potential interest. This paper proposes a set of methods which address the appearance of different combinations of defects across different tooth regions. In our modeling we assess the linkages between tooth region development and both the type of defect and associations with etiological predictors of the defects which could be influential at different times during the tooth crown development. METHODS: We develop different hierarchical model formulations under the Bayesian paradigm to assess exposures during primary central incisor (PMCI) tooth development and PMCI defects. We evaluate the Bayesian hierarchical models under various simulation scenarios to compare their performance with both simulated dental defect data and real data from a motivating application. RESULTS: The proposed model provides inference on identifying a subset of etiological predictors of an individual defect accounting for the correlation between tooth regions and on identifying a subset of etiological predictors for the joint effect of defects. Furthermore, the model provides inference on the correlation between the regions of the teeth as well as between the joint effect of the developmental enamel defects and dental caries. Simulation results show that the proposed model consistently yields steady inferences in identifying etiological biomarkers associated with the outcome of localized developmental enamel defects and dental caries under varying simulation scenarios as deemed by small mean square error (MSE) when comparing the simulation results to real application results. CONCLUSION: We evaluate the proposed model under varying simulation scenarios to develop a model for multivariate dental defects and dental caries assuming a flexible covariance structure that can handle regional and joint effects. The proposed model shed new light on methods for capturing inclusive predictors in different multivariate joint models under the same covariance structure and provides a natural extension to a nested hierarchical model.

Evaluation of Antimicrobial Efficacy and Clinical Outcomes of Triphala and 2.5% Sodium Hypochlorite as Intraradicular Irrigants in Pulpectomy of Primary Teeth.

A natural irrigation solution with a broad spectrum of antimicrobial coverage, triphala was selected for the pulpectomy procedure. Because of its natural ingredients, it is well-known for promoting tissue healing. It also supposedly has certain additional qualities as compared to usual irrigation solutions that are made chemically. Although 2.5% NaOCl is thought to be perfect since it meets most of the requirements for an irrigation solution but it cannot be optimized for pulpectomy procedure. Primary teeth that were recommended for pulpectomy underwent this randomized controlled experiment. Two groups of eighty-four primary teeth were randomly assigned to receive irrigations: triphala in Group A; 2.5% Sodium hypochlorite in Group B. Sample were taken from infected primary root canals. A sterile test tube with bhi broth as the transport media was used to collect pre- and post-irrigation samples using sterile absorbent paper tips. On agar media, microorganisms were cultivated and their mean colony count was assessed. Following the procedure, the patient's follow-up visits at one, two and three months were used to evaluate the clinical result. The post-microbial colony count was dramatically reduced (p<0.001) by both irrigation treatments. Triphala in Group A is demonstrating desirable efficacy. Clinical success was found satisfactory in both the groups studied (p<0.001). But statistically significant difference was not found (p=0.175). Considering undesirable properties of sodium hypochlorite triphala can be a better alternative as a root canal irrigants in pulpectomy of primary teeth.

Elimination of E. faecalis with NaOCl versus chlorhexidine gluconate from primary molar root canal systems: an ex vivo model study.

OBJECTIVES: This ex vivo human study aimed to evaluate the efficacy of NaOCl and chlorhexidine gluconate (CHG) irrigations in eliminating Enterococcus faecalis from the RCS of primary molars. MATERIALS AND METHODS: Disinfected extracted primary molars were inoculated with E. faecalis for 24 h. Then, the RCS samples were then irrigated with either 2.5% NaOCl, 0.2% and 2% CHG, or sham saline. The samples were collected immediately after irrigation; and 24 h later, the bacterial viability and counts were measured using blood agar and qRT-PCR, respectively. Histological sections were used to measure E. faecalis penetration and viability in dentin tubules using fluorescence microscopy. RESULTS: The recovery of viable E. faecalis after the irrigation of the primary molars showed more significant bactericidal effects of NaOCl and 0.2% and 2% CHG than of saline. Immediately after the irrigation, the NaOCl group showed the greatest reduction in E. faecalis; and 24 h later, all the groups had lower viable E. faecalis than the saline control. The bacterial penetration was also lowest in the NaOCl group, although there was no difference in bacterial viability in the tubules between the groups. CONCLUSION: In primary teeth, NaOCl and CHG showed similar degrees of bacterial elimination efficacy in terms of E.faecalis. CLINICAL RELEVANCE: Within the limitations of this study, NaOCl and CHG have the similar ability to perform endodontic irrigation of primary ex vivo teeth regarding the elimination of E.faecalis, but NaOCl penetrates dentin tubules better.

Infraocclusion in the Primary and Permanent Dentition-A Narrative Review.

The gradual movement of a tooth away from the occlusal plane is called infraocclusion or reinclusion. Reincluded teeth are most often deciduous molars, and permanent teeth are less frequently affected. Depending on the level of the infraocclusion, the severity of the disorder is classified as mild, moderate, or severe. The etiology of the phenomenon is not fully known. Tooth submerging can lead to serious complications, such as abnormal position of adjacent teeth, displacement of the bud of the permanent successor, shortening of the dental arch, or developmental disturbances of alveolar process. Early diagnosis of the tooth infraocclusion and regular monitoring of its progression help to avoid serious permanent sequelae. The treatment of reinclusion often involves only observation. However, in some cases, the therapeutic procedure requires interdisciplinary treatment by specialists from various fields of dentistry. This study presents current methods of diagnosis and treatment of patients with submerged teeth.

Modeling Lysosomal Storage Disorders in an Innovative Way: Establishment and Characterization of Stem Cell Lines from Human Exfoliated Deciduous Teeth of Mucopolysaccharidosis Type II Patients.

Among the many lysosomal storage disorders (LSDs) that would benefit from the establishment of novel cell models, either patient-derived or genetically engineered, is mucopolysaccharidosis type II (MPS II). Here, we present our results on the establishment and characterization of two MPS II patient-derived stem cell line(s) from deciduous baby teeth. To the best of our knowledge, this is the first time a stem cell population has been isolated from LSD patient samples obtained from the dental pulp. Taking into account our results on the molecular and biochemical characterization of those cells and the fact that they exhibit visible and measurable disease phenotypes, we consider these cells may qualify as a valuable disease model, which may be useful for both pathophysiological assessments and in vitro screenings. Ultimately, we believe that patient-derived dental pulp stem cells (DPSCs), particularly those isolated from human exfoliated deciduous teeth (SHEDs), may represent a feasible alternative to induced pluripotent stem cells (iPSCs) in many labs with standard cell culture conditions and limited (human and economic) resources.

The evaluation of effective rate and pain intensity of root canal treatment in primary teeth-a retrospective study.

Two-visit root canal treatment for children reduce the time of visits and the by-chair time in comparison with the three-visit root canal treatment. However, it is not clear whether two-visit root canal treatment increase the risk of complications. This study aimed to evaluate the clinical effects and post-operative pain intensity after the root canal treatment between two-visit and three-visit groups in primary molars from children.106 patients were screened for eligibility, of which 74 went back to the preservation visit. Therefore, 74 primary molars from 74 children that diagnosed with chronic pulp and periodontal tissue diseases in the clinics of pediatric dentistry were retrospectively analyzed, in which 37 in the two-visit group and 37 in the three-visit group. The total effective rate and postoperative pain intensity were assessed after treatment and all statistical data were carried out with SPSS software.The average age of children in the two-visit and three-visit groups was 6.4 and 7.0, respectively, with no significant difference (p = 0.056). The two-visit group consisted of 59.5% male and 40.5% female children, while the three-visit group consisted of 56.8% male children and 43.2% female children (p = 0.813). Two months after treatment, the total effective rate in the three-visit group was 97.30%, a little higher than that in the two-visit group (94.59%), but with no significant difference (p = 0.201). Besides, there was also no significant difference in pain intensity between the two-visit and three-visit groups (p = 0.692). Therefore, there were no significant difference of total effective rate and pain intensity in root canal treatment between the two-visit and three-visit groups in primary molars from children.

Comparative evaluation of volumetric changes between two pediatric rotary files (Kedo-S plus, Kedo-SG blue) and manual files (hand K-files) during canal preparation of primary mandibular molars: an in-vitro nano-CT analysis.

Pediatric endodontics has become popular due to advancements in cleaning, shaping and irrigation systems, resulting in faster and effective removal of infected pulp, saving time, and creating a pathogen-free environment. The patented rotary file system, Kedo-S, designed for primary teeth, introduced a single file generation for efficient pulp therapy. However, there are currently no studies assessing canal preparation in primary mandibular molars using nano-CT (computed Tomography). To evaluate the volumetric changes of two recently introduced pediatric rotary file systems in comparison with conventional hand file systems in primary mandibular molar using an ultra-high resolution nano-CT. This in-vitro study was performed in extracted primary mandibular molar based on certain inclusion and exclusion criteria. Samples were prepared and working length was determined before the pre-operative scan using a high resolution nano-CT device (SkyScan 2214, Bruker, Kontich, Belgium). A single well-experienced pediatric dentist prepared the canals using three file systems: Kedo-S plus, Kedo-SG blue and Hand K-files. A post-operative scan was performed similar to pre-operative scan. Image reconstruction was performed with NRecon software for 3D volumetric visualization and analysis of the root canals. Kedo-SG blue file systems had the highest mean difference in the canal volume (8.85%). Hand K-files had the least difference at (1.24%) of canal volume. Kedo-S plus file system had a mean canal volume difference (6.14%) which is closer to hand K-files. Rotary file systems resulted in a significant enlargement of canals compared to hand files.

Prevalence of most caries-susceptible area on individual primary tooth surface: an observational study.

Due to multifactorial aetiology, tooth surfaces of primary dentition are more prone to dental caries and follow the specific pattern of dental caries which is difficult to control. The proper knowledge of caries-susceptible areas on individual primary teeth surfaces guides the clinician to take early preventive measures to stop the progression of dental caries. This study aims to find the prevalence of caries-susceptible areas on primary teeth surfaces in preschool children and the most commonly affected primary teeth. The study design adopted was a cross-sectional study. A total number of 3720 teeth of 186 preschool children were examined for initial pinpoint caries lesions using World Health Organization (WHO) caries detection criteria. 33 caries-susceptible areas were examined on individual primary tooth surfaces of preschool children who visited the Faculty of Dental Sciences. Each tooth surface was recorded separately and no radiographic examination was done. Obtained data was analysed keeping the level of significance at 5%. The overall prevalence of caries-susceptible area was found significantly higher in the maxillary teeth (Maxillary teeth: 41.7% vs. Mandible teeth: 30.7%; p < 0.001) and anterior teeth (Anterior teeth: 43.7% vs. Posterior teeth: 28.4%; p < 0.001). The prevalence of caries-susceptible area on primary teeth on the right side when compared to left counterparts was similar (Right side-38.6% and left side-38.4%; p = 0.931). Area 2 was the most prevalent area on primary teeth surfaces and primary canine was more prevalent in caries-susceptible areas.

Factors influencing root resorption in retained mandibular second deciduous molars with congenital absence of second premolars: a cross-sectional study.

BACKGROUND: There are currently no studies that quantitatively compare the relationship of root resorption to the patient's systemic history or craniofacial and intraoral morphology, especially in relation to possible host factors. Thus, this study aimed to clarify the factors associated with root resorption in retained mandibular second deciduous molars with the congenital absence of second premolars and predict the prognosis of retained mandibular second deciduous molars. METHODS: A cohort of 5547 patients who visited the orthodontic clinic at Tokyo Medical and Dental University Dental Hospital between 2013 and 2022 was screened. Lateral cephalometric radiographs, panoramic radiographs, upper and lower dental models, and orthodontic treatment questionnaires were used as reference materials to apply the inclusion and exclusion criteria. Ultimately, 111 patients were included in the analyses. The patients were divided into two groups based on the root resorption levels of the retained mandibular second deciduous molars. Those with less root resorption were classified under the good condition (GC) group, whereas those with more root resorption were classified under the poor condition (PC) group. Demographic, clinical, and cephalometric parameters were compared between the groups. A multivariate logistic regression model was used to predict the probability of root resorption. RESULTS: The prevalence of congenitally missing mandibular second premolars with persistent mandibular second deciduous molars was 2.0%. In a total of 111 patients, eighty-three teeth (53.2%) were classified into the GC group, whereas 73 teeth (46.8%) were classified into the PC group. The Frankfort-mandibular plane angle (FMA) [odds ratio (OR): 0.87], Frankfort-mandibular incisor angle (FMIA) (OR: 0.93), overbite (OR: 1.38), adjacent interdental space (OR: 1.46), distance from occlusal plane (OR: 0.80), and caries treatment (OR: 7.05) were significantly associated with the root resorption of the retained mandibular second deciduous molars. CONCLUSIONS: Our findings suggest that skeletal morphology, oral morphological patterns, and history contribute to root resorption in retained mandibular second deciduous teeth with congenital absence of subsequent permanent teeth.

Effect of bottled fluoridated water to prevent dental caries in primary teeth: study protocol for a phase 2 parallel-group 3.5-year randomized controlled clinical trial (waterBEST).

BACKGROUND: Fluoridation of public water systems is known as a safe and effective strategy for preventing dental caries based on evidence from non-randomized studies. Yet 110 million Americans do not have access to a fluoridated public water system and many others do not drink tap water. This article describes the study protocol for the first randomized controlled trial (RCT) of fluoridated water that assesses its potential dental caries preventive efficacy when delivered in bottles. METHODS: waterBEST is a phase 2b proof-of-concept, randomized, quadruple-masked, placebo-controlled, parallel-group trial designed to estimate the potential efficacy of fluoridated versus non-fluoridated bottled water to prevent dental caries incidence in the first 4 years of life. Two hundred children living in eastern North Carolina, USA, and aged 2-6 months at screening are being allocated at random in a 1:1 ratio to receive fluoridated (0.7 mg/L F) or non-fluoridated bottled water sourced from two local public water systems. Throughout the 3.5-year intervention, study water is delivered monthly in 5-gallon bottles to each child's home with instructions to use it whenever the child consumes water as a beverage or in food preparation. Parents are interviewed quarterly to monitor children's water consumption and health. At annual visits, the presence of dental caries is evaluated with a dental screening examination. Clippings from fingernails and toenails are collected to quantify fluoride content as a biomarker of total fluoride intake. The primary endpoint is the number of primary tooth surfaces decayed, missing, or filled due to dental caries measured by the study dentist near the time of the child's fourth birthday. Tooth decay is assessed at the threshold of macroscopic enamel loss. For the primary aim, a least-squares, generalized linear model will estimate efficacy and its one-tailed, upper 80% confidence limit. DISCUSSION: waterBEST is the first evaluation of a randomized intervention of fluoridated drinking water in bottles to prevent dental caries in the primary dentition. This innovative method of delivering fluoridated water has the potential to prevent early childhood caries in a large segment of the US population that currently does not benefit from fluoridated public water. TRIAL REGISTRATION: ClinicalTrials.gov NCT04893681. Registered on March 2022. Last update posted on 10 October 2023. https://clinicaltrials.gov/study/NCT04893681?cond=Dental%20Caries%20in%20Children&term=fluoride&locStr=North%20Carolina,%20USA&country=United%20States&state=North%20Carolina&distance=50&rank=1.

Pulpotomy versus pulpectomy in carious vital pulp exposure in primary incisors: a randomized controlled trial.

BACKGROUND: Pulpotomy as a minimally invasive pulp therapy technique is the treatment of choice for carious pulp exposures, however many pediatric dentists perform pulpectomies in vital primary incisors. The aim of this split mouth randomized controlled study was to compare formocresol pulpotomy and zinc-oxide and eugenol pulpectomy in the treatment of vital pulp exposure in primary incisors. METHODS: Contralateral pairs of incisors were randomly assigned to receive pulpotomy or pulpectomy in children aging from 18 to 66 months old and were followed up for 12 months. RESULTS: 39 pairs of incisors were included. Clinical and radiographical success rates showed no statistical significant difference (p = 1, p = 0.8 respectively). Relative risk measures for clinical success rates (RR = 1.03, 95%CI 0.87 to 1.23) and for radiographic success rates (RR = 1.03, 95%CI 0.83 to 1.29) with CIs including number one showing no difference between the two groups. The Survival rate using Kaplan-Meier survival analysis score showed 82% for pulpotomy and 74% for pulpectomy at 12 months (P = 0.2). CONCLUSIONS: Both pulpotomy and pulpectomy techniques can be used successfully in the treatment of carious vital pulp exposure in primary incisors. TRIAL REGISTRATION: The trial was retrospectively registered in Clinicaltrials .gov with this identifier NCT05589025 on 21/10/2022.

Comparative Assessment of Marginal Micro Leakage of Different Esthetic Restorative Materials Used on Primary Teeth: An In-vitro Study.

AIM: The aim of the current investigation was to evaluate the marginal microleakage of various esthetic restorative materials applied to primary teeth. MATERIALS AND METHODS: A total of 75 noncarious primary molars that were removed for orthodontic intervention and teeth nearing exfoliation were chosen. One millimeter (mm) above the cementoenamel junction, on the buccal surface of the teeth, Class V cavities were prepared. William's graded periodontal probe was used to standardize cavity preparation on all teeth. 3 mm was the cavity's length, 2 mm in width, and 2 mm in depth. The teeth were then divided into three groups (25 samples in each group) according to the type of esthetic restorative material used. Group I: Resin-modified glass ionomer cement, Group II: Ormocer, Group III: Giomer. The samples underwent 500 cycles of thermocycling, with an immersion time of 60 seconds and a well time of 15 seconds, between 5 and 55°C. The samples were submerged in methylene blue dye for 24 hours at room temperature and dried. The samples were then divided into sections and examined with a stereomicroscope. Data was recorded and statistically analyzed. RESULTS: The least marginal microleakage was found in the ormocer group (1.22 ± 0.01) followed by resin-modified glass ionomer cement group (1.31 ± 0.07) and the giomer group (1.78 ± 0.03). There was a highly statistically significant difference found between resin-modified glass ionomer cement group and the ormocer group, resin-modified glass ionomer cement group and giomer group. And no significant difference was found between the ormocer group and the giomer group. CONCLUSION: The present study concluded that there was some amount of microleakage in primary teeth in all restorative materials examined in this in-vitro investigation. However, the marginal sealing ability of ormocer was found highest compared to resin-modified glass ionomer cement and Giomer materials. CLINICAL SIGNIFICANCE: The primary reason dental restorations fail, particularly in Class V cavities, is microleakage since the margins of these restorations are typically found in the dentin or cementum. Assessing microleakage is a crucial step in determining the marginal integrity of restorative materials. Developing methods and resources that reduce the adverse effects caused by the restorative marginal seal failing would benefit from this. How to cite this article: Al Ghwainem A, Alqarni AS. Comparative Assessment of Marginal Micro Leakage of Different Esthetic Restorative Materials Used on Primary Teeth: An In-vitro Study. J Contemp Dent Pract 2024;25(1):58-61.

Use of Vital Pulp Therapies in Primary Teeth 2024.

Purpose: The purpose of this study was to present an evidence-based guideline for primary teeth with deep caries or trauma requiring vital pulp therapies (VPT). Methods: A systematic review/meta-analysis on vital primary teeth resulting from trauma or caries was conducted using GRADE to assess the certainty of evidence for clinical recommendations. A decision tree was provided for choosing VPTs. Results: No articles on trauma VPT were found. For VPT in primary teeth with deep caries, indirect pulp treatment (IPT) or pulpotomy using the calcium silicate cement (mineral trioxide aggregate [MTA] or Biodentine®) show increased success over using direct pulp capping (DPC) and other pulpotomies. Different liners do not affect IPT success (high certainty) or DPC capping agents' success (very low certainty) after 24 months. It is strongly recommended, with high certainty from 24-month data, that calcium silicate cement pulpotomy is preferred over formocresol, ferric sulfate, zinc oxide eugenol pulpotomy, and other pulpotomies. Using selective caries removal and IPT for deep caries is strongly recommended with moderate certainty over complete and stepwise removal. Statistically, this results in significantly fewer pulp exposures. No caries removal and Hall technique crown may be used when indicated (moderate certainty at 24 months). For vital primary incisors with deep caries, pulpotomy was significantly better statistically than pulpectomy. Teeth diagnosed with/without reversible pulpitis pain showed comparable success after 12 months of treatment by IPT or calcium silicate cement pulpotomy. The following had little or no significant effect on MTA pulpotomy success: coronal pulp removal methods; irrigation solution; method to control hemorrhage; base over MTA; treatment in one or two visits; anterior or posterior teeth. Conclusions: Indirect pulp treatment or calcium silicate cement pulpotomy is likely to increase vital pulp therapy success over other VPTs such as direct pulp capping and other pulpotomies after 24 months (moderate certainty).

Hard tissue formation in pulpotomized primary teeth in dogs with nanomaterials MCM-48 and MCM-48/hydroxyapatite: an in vivo animal study.

BACKGROUND: This animal study sought to evaluate two novel nanomaterials for pulpotomy of primary teeth and assess the short-term pulpal response and hard tissue formation in dogs. The results were compared with mineral trioxide aggregate (MTA). METHODS: This in vivo animal study on dogs evaluated 48 primary premolar teeth of 4 mongrel female dogs the age of 6-8 weeks, randomly divided into four groups (n = 12). The teeth underwent complete pulpotomy under general anesthesia. The pulp tissue was capped with MCM-48, MCM-48/Hydroxyapatite (HA), MTA (positive control), and gutta-percha (negative control), and the teeth were restored with intermediate restorative material (IRM) paste and amalgam. After 4-6 weeks, the teeth were extracted and histologically analyzed to assess the pulpal response to the pulpotomy agent. RESULTS: The data were analyzed using the Kruskal‒Wallis, Fisher's exact, Spearman's, and Mann‒Whitney tests. The four groups were not significantly different regarding the severity of inflammation (P = 0.53), extent of inflammation (P = 0.72), necrosis (P = 0.361), severity of edema (P = 0.52), extent of edema (P = 0.06), or connective tissue formation (P = 0.064). A significant correlation was noted between the severity and extent of inflammation (r = 0.954, P < 0.001). The four groups were significantly different regarding the frequency of bone formation (P = 0.012), extent of connective tissue formation (P = 0.047), severity of congestion (P = 0.02), and extent of congestion (P = 0.01). No bone formation was noted in the gutta-percha group. The type of newly formed bone was not significantly different among the three experimental groups (P = 0.320). CONCLUSION: MCM-48 and MCM-48/HA are bioactive nanomaterials that may serve as alternatives for pulpotomy of primary teeth due to their ability to induce hard tissue formation. The MCM-48 and MCM-48/HA mesoporous silica nanomaterials have the potential to induce osteogenesis and tertiary (reparative) dentin formation.

Allium Sativum Oil as an Alternative Non-Vital Pulpotomy Medicament in Primary Teeth - A Randomised Controlled Trial.

OBJECTIVE: To use Allium sativum oil as non-vital pulpotomy medicament in primary teeth by evaluating its antibacterial effect (Colony-Forming Units/ml- CFU/ml), against Streptococcus mutans and Lactobacillus acidophilus. STUDY DESIGN: A double-blinded, randomised controlled trial. Place and Duration of the Study: Paediatric Dentistry Department, de' Montmorency College of Dentistry, Lahore in collaboration with the Microbiology Department, Lahore General Hospital, from October 2022 to February 2023. METHODOLOGY: Forty patients aged between 4 to 8 years, each containing at least one non-vital primary molar, were randomly divided into Group A (Formocresol) and Group B (Allium sativum oil) using the lottery method. Non-vital pulpotomy (NVP) was performed by removing the coronal necrotic pulp. Sterile paper points were dipped in the root canals and taken to the laboratory. Cotton pellets soaked in the respective medicaments were placed over the root canal orifices and filled temporarily. Patients were recalled after one week. Samples were again taken, and the tooth was restored. Comparison was made between bacterial count at baseline and after one week of treatment, and it was expressed as CFU/ml. RESULTS: There was a significant reduction in median Streptococcus mutans and Lactobacillus acidophilus bacterial count in each group after one week of treatment (p <0.001). Formocresol showed a higher average reduction (30300 ± 14060) compared to Allium sativum oil (24850 ± 9121). However, statistically, the difference was insignificant (p = 0.314) indicating both the medicaments possessed comparable antibacterial effects. CONCLUSION: Allium sativum oil was found an effective alternative to Formocresol. KEY WORDS: Formocresol, Allium sativum, Non-vital pulpotomy, Primary teeth, Randomised controlled trial.

Knowledge and Attitudes of Parents about Oral Health in the Primary Dentition Stage in a Peruvian High Andean City.

Children's oral health depends on parents' knowledge and attitudes. The primary dentition stage, in particular, plays a crucial role in the comprehensive development of children. Therefore, the objective was to evaluate parents' knowledge and attitudes about oral health in the primary dentition stage in Chachapoyas (Amazonas, NW Peru). A questionnaire was administered to 409 parents from 15 educational institutions, and the data were analyzed using multinomial logistic regression. Among the surveyed parents, 75.3% could identify at least one habit harmful to their children's teeth (such as excessive sugar consumption) and one of its effects (such as dental caries). Additionally, 77.5% reported that their children presented some dental problem, more frequent in the peripheral areas than in the city's center. Gender (odd ratio, OR = 0.484; p = 0.037), educational level (OR = 2.144; p = 0.043), and type of health insurance (OR = 2.627; p = 0.044) of the parents influenced awareness of taking care of their children's primary dental health. The geographic location of the school (1.729 < OR < 2.079; p ≤ 0.011) and family income (OR = 3.504; p = 0.028) influenced parents' identification of the different harmful effects of children's habits. Factors such as low socioeconomic status and never taking the child to the dentist increased the risk of dental problems (p < 0.05). It is suggested that peripheral areas, like rural areas, lack the same oral health programs and access to treatment as central urban areas, leading to disparities in parental knowledge and attitudes.