Prevalence and Characteristics of Three-rooted Mandibular Molars in Saudi Population: A Retrospective Radiographic Analysis.

AIMS: To study the prevalence of three-rooted mandibular permanent first molars (PFM) among Saudi population in Al Zulfi. MATERIALS AND METHODS: Subjects were selected from the patients' records, College of Dentistry, Majmaah University, Al Zulfi, Kingdom of Saudi Arabia. Healthy patients with the presence of both mandibular PFM, orthopantomogram (OPG) and/or intraoral periapical (IOPA) radiographs were included in the study. All patients included were evaluated by a single examiner using OPG and IOPA radiographs. The occurrence of three roots, status of the tooth and associated anomalies were considered for analysis. Descriptive statistics performed using IBM SPSS (Version 21.0) at a 95% confidence interval (p < 0.05) while the Chi-square test and Fisher test were used for the incidence, and comparison of occurrence of the third root in PFM in the mandibular arch. RESULTS: A sample of 433 subjects was selected randomly based on our inclusion criteria. Only 24 (5.5%) subjects had evidence of three-rooted mandibular PFM with the mean age of 27.67 years. The frequency of bilateral and unilateral three-rooted mandibular PFM was 2.3% (10) and 3.2% (14), respectively. Overall 41.6% of subjects were witnessed with the bilateral occurrence and unilateral occurrence was 58.4% [(57% (8) were on the right and 42% (6) were left side] (p < 0.05). However, no significant relationship was observed between the left and right occurrence of three-rooted mandibular PFM (p < 0.05). Thirty-four (7.8%) PFM were presented with three roots and among them, 70% (24) received treatment. Dilacerations (12.5%), taurodontism (37%) and hypodontia (4%) were associated with three-rooted PFM in the mandibular arch. Kappa statistics showed excellent intra-examiner reliability (κ = 0.9). CONCLUSION: The prevalence of three-rooted PFM was 5.5% in the present study and unilateral occurrence is very common. Over 70% of these PFM received dental treatment in Saudi Arabia population. Always, IOPA radiographs are required to confirm the evidence of three-rooted mandibular PFM where three-dimensional imaging is not available. CLINICAL SIGNIFICANCE: An Eagle's eye of an endodontist on three-rooted PFM is of utmost importance in the treatment protocol when the tooth is planned for root canal therapy.

Dental development in children with supernumerary teeth in the anterior region of maxilla.

OBJECTIVE: Development of human dentition has been used as a predictor for evaluating the growth and maturity of an individual. It is fairly identical in a specific population, but the effect of development on subjects with dental anomalies had not been fully explored, particularly on subjects with supernumerary teeth (ST). This study hence aims to evaluate the dental development of children with and without ST. MATERIALS AND METHODS: Sample size calculation was conducted and 320 radiographs of subjects with and without supernumerary teeth (ST) were obtained from the archives of a teaching hospital. The subjects in both groups were age and sex matched. All the subjects belong to southern Chinese ethnicity aged 2 to 14 years. The left-side dentition was scored, and dental age (DA) was estimated by obtaining scores from the southern Chinese dental reference dataset. Paired t test was used to calculate the difference between chronological age and dental age (CA-DA) for boys and girls with and without ST and further based on the number and position of ST. RESULTS: The difference between chronological age and dental age (CA-DA) was 0.10 years for boys and 0.19 years for girls with ST whilst 0.01 and 0.05 years for boys and girls without ST (p > 0.05). The boys with bilateral ST showed significant delay in dental development of 0.23 years (p < 0.05). Position of the ST did not have any influence on dental age. CONCLUSIONS: No significant difference was observed in the dental development of children with and without supernumerary teeth. CLINICAL RELEVANCE: Understanding dental development of children with supernumerary teeth may be useful in appropriate treatment planning of such conditions.

Developmental Disturbance of a Maxillary Permanent Lateral Incisor Following Trauma at the Age of 16 Months: A 6-Year Follow-Up.

A 3 year and 8 months old Chinese boy was referred for a consultation regarding his missing maxillary anterior teeth. He had a history of trauma to his primary maxillary anterior teeth due to a fall at the age of 16 months. Clinical examination of the patient indicated multiple carious lesions and inadequate oral hygiene. Radiographic examination revealed intrusion of the primary left lateral incisor, with evidence of damage to the permanent tooth germ. Subsequently, the patient was followed-up for almost six years during which his permanent maxillary left lateral incisor erupted exhibiting an unusual morphology. Clinically enamel hypoplasia and radiographically dens invaginatus were evident in affected tooth.

Reliability of panoramic radiographs for identifying supernumerary teeth in children.

OBJECTIVES. To evaluate the reliability of panoramic radiographs (PRs) for identifying supernumerary teeth (ST) and to determine whether the level of dental training of the observer influenced the identification of ST. METHODS. Seventy-five PRs were randomly selected from the patient records and 18 examiners independently rated 25 radiographs each, for specific risk factors as well as for a measure of adequacy. Subsequently, the results were paired with those of the other examiners who assessed the same set of PRs. Descriptive statistics were computed using Fisher's exact test, and kappa statistics were used to assess the inter- and intra-observer reliability. RESULTS. Four hundred and fifty PRs were available for analysis. The overall sensitivity and specificity figures were 50% and 98.3%, whereas the positive and negative predictive values were 90.6% and 83.6%, respectively. The sensitivity figures for Junior House Dental Officers and Postgraduate Paediatric Dental Trainees were 39.2% and 60.8%, whereas the specificity figures were 99.4% and 95% with slight inter-examiner and moderate intra-examiner reliability. CONCLUSIONS. Panoramic radiographs are unreliable for identifying ST, and higher level of dental training is essential for identifying ST.

Accidental Stainless Crown Ingestion During Dental Treatment in a Pediatric Patient.

Accidental ingestion of foreign bodies is very frequent in children. Ingestion of dislodged restorations, dental appliances, crowns, and teeth in dental operatory is frequently reported. Early diagnosis of foreign bodies ingestion in a dental operatory and awareness of its signs and symptoms are very crucial. A five-year-old boy accidentally ingested a stainless steel crown during the trial fit at the dental operatory. Crown retrieval was attempted but without success, and thus, the patient was further observed for possible signs and symptoms. Due to possible serious complications, ingestion of foreign bodies during dental procedures must be appropriately prevented and managed if it occurs.

Retention and effectiveness of pit and fissure sealants placed with or without bonding agent in young permanent teeth: A randomized clinical trial with a year follow-up.

BACKGROUND AND AIMS: The aim of this study is to evaluate the clinical efficacy of pit and fissure sealants (PFS) placed on young permanent teeth with or without the application of the bonding agent. METHODS: A.total of 100 permanent first molars from 25 children between 6-9 years of age were included and randomly allocated into 2 groups. In group A, the teeth received sealant with the bonding agent, and in group B, without a bonding agent. All the sealed teeth were evaluated for retention of the sealant at regular intervals of 3, 6, and 12 months. The difference in the retention rate with and without bonding was analyzed using Chi-square test. RESULTS: After 12 months, the clinically acceptable retention rates for PFS placed with and without bonding agent were 80% and 72%, respectively. No statistically significant difference was observed in relation to marginal integrity, marginal discoloration, and anatomic form among the PFS placed with and without bonding agent (Ps > 0.05). CONCLUSIONS: Sealant application with bonding agent showed an increased retention rate than without the use of a bonding agent. However, an additional step of bonding may be excluded in children, as it did not show any statistically significant difference in clinical retention rate compared to PFS application without bonding.

Efficacy of Licorice Lollipops in Reducing Dental Caries in a Paediatric Population: A Systematic Review.

PURPOSE: To assess the efficacy of licorice lollipops in reducing dental caries in children. MATERIALS AND METHODS: A literature search was confined to the English language using MeSH terms congruent with PICO format in 'PubMed', 'Cochrane Library' and 'Ovid', covering the period from April 1967 to December 2017. Searches in Google Scholar, grey literature and hand search of cross-references were performed to find additional data. Suitable studies were selected based on the predefined inclusion and exclusion criteria. Quality analysis and risk of bias of the selected studies were performed using the Cochrane Collaboration's tool for risk of bias. RESULTS: Overall 519 articles were retrieved, 516 (electronic databases) and 3 (Google scholar). 516 publications were excluded due to non-availability of abstracts, or because they were unrelated studies, narrative reviews, and systematic reviews as well as letters to editors. Only three studies were included for final analysis. Quality analysis of these three studies showed that only one was of high quality, whereas the other two were rated as low. CONCLUSION: Licorice lollipops showed a promising effect in reducing caries by decreasing Streptococcus mutans counts in the saliva. Further research using randomised controlled clinical trial (RCT) designs with large sample size are recommended.

Dental treatment under general anesthesia for special-needs patients: analysis of the literature.

The aim of the present review was to identify the studies published on dental treatment under general anesthesia for special-needs patients. A comprehensive search of the reported literature from January 1966 to May 2012 was conducted using PubMed, Medline, and Embase. Keywords used in the search were "dental treatment under general anesthesia", "special-needs patients", "medically-compromised patients", and "children", in various combinations. Studies published only on dental treatment under general anesthesia and in English were included. Only 10 studies were available for final analysis. Age range from 1 to 50 years, and restorative procedures, were most prevalent. Only two studies discussed repeated general anesthesia, with rates of 7.2% and 10.2%. Over time, the provision of general anesthesia for special-needs patients has changed from dental clinics to general hospitals. The demand for dental treatment for special-needs patients under general anesthesia continues to increase. Currently, there are no certain accepted protocols for the provision of dental treatment under general anesthesia.

A comprehensive review of the literature and data analysis on hypo-hyperdontia.

The objectives of this study were i) to conduct a comprehensive review of the literature on hypo-hyperdontia, and ii) to categorize the reported cases based on occurrence. An extensive search of the literature covering the period from January 1966 to January 2014 was conducted using the Embase, Google Scholar, Medline, and PubMed databases. The key words used in the search strategy were "concomitant", "agenesis", "hypodontia", "hyperdontia", "supernumerary teeth", "syndromes", and "hypohyperdontia" in various combinations. The retrieved data were analyzed based on gender, occurrence, and occurrence of both hypodontia and hyperdontia. Descriptive statistics were carried out using the chi-squared test. For hypo-hyperdontia overall, seven case studies and 40 cases involving 103 patients were reported. Our comprehensive review revealed that hypo-hyperdontia occurs most commonly in males (P < 0.05), and the bimaxillary type (65%) was reported most commonly in comparison with the maxillary, pre-maxillary and mandibular types (P < 0.001). Twenty syndromic cases and two case studies on familial occurrence of hypohyperdontia were reported. Almost 57% of cases affected the anterior region, whereas 43% of cases affected the anteroposterior region. The anterior region was most commonly affected by hyperdontia whereas the posterior region was most commonly affected by hypodontia. Hypo-hyperdontia is commonly seen in males, and the most common type is bimaxillary occurrence. G/BBB syndrome is commonly associated with hypo-hyperdontia, being relatively frequent in the anterior region, where mesiodens is frequently seen, and second premolars are the most commonly missing teeth.

Biocompatibility of various dental materials in contemporary dentistry: a narrative insight.

In the past few decades, there has been an increase in demand for safety evaluation and control of dental materials used daily in dentistry; however, this task is difficult and cumbersome. Dental materials that are passive and do not react with the oral environment will be more stable and have superior durability. It is expected that dental materials will be universally accepted and will not cause harm or injury to the surrounding structures in the oral cavity. This is an entirely negative approach to the material tolerance and biocompatibility, and hides the possibility that some positive gains can be achieved. Side-effects of dental materials are believed to be rare, and generally, those that have been reported are mild. There are wide varieties of materials used in dentistry, which include liners, irrigants, intracanal filling materials, intracanal medicaments, prosthetic materials, restorative materials, subgingival implants, and mouth rinses. Therefore, in this study, the biocompatibility of various commonly-used clinical materials used in contemporary dentistry was discussed.

Schwartz-Jampel syndrome: a review of the literature and case report.

Schwartz-Jampel syndrome (SJS) is a rare autosomal recessive skeletal dysplasia associated with myotonia. The manifestations of SJS include short stature, blepharophimosis, and skeletal anomalies. The combination of skeletal and muscular abnormalities may result in oro-dental manifestations such as atypical facies, with micrognathia, microstomia, pursed lips, crossbite, cleft palate, as well as mandibular hypoplasia, the risk of dentigerous cysts, and impacted teeth. The use of general anesthesia in patients with SJS is dangerous, as there is a risk of malignant hyperthermia. The purpose of this paper is to describe a 3-year-old Chinese boy diagnosed with SJS at birth. His intra-oral examination revealed significant dental findings such as dentin defects with generalized attrition and hypodontia of the permanent dentition. Comprehensive dental treatment was provided at the same time as lower right limb surgery to reduce the potential complications with general anesthesia.

Concomitant occurrence of hypohyperdontia in a patient with Marfan syndrome: a review of the literature and report of a case.

Marfan syndrome is an autosomal dominant genetic disorder of connective tissue origin that can affect multiple organs. Various oral manifestations have been associated with this syndrome. Hypohyperdontia is a condition of mixed numeric variations that presents a combination of hypodontia with hyperdontia within a single human dentition. The purpose of this paper is to report a case of Marfan syndrome with a concomitant occurrence of hypohyperdontia. A narrative review was also included to describe the other syndromes that had been associated with concomitant hypohyperdontia.