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Purpose: To evaluate the efficacy of the American Academy of Pediatric Dentistry (AAPD) best practice recommendations for the diagnosis and management of deep carious lesions in primary teeth. Methods: Primary molars from four to eight-year-old children were selected for diagnosis and treatment planning independently by a pediatric dental resident using the AAPD recommendations and a pediatric dentist using his clinical expertise and experience. The analysis of the two evaluators was performed for sensitivity, specifi- city, positive predictive value, negative predictive values, and agreement scores. Results: A total of 365 primary molars from 185 children were used. Diagnosis and treatment planning by the resident demonstrated a higher sensitivity score of 92.7 percent (95 percent confidence interval [95% CI]=80.1 to 98.5) and specificity score of 96.6 percent (95% CI=94 to 98.3) for treatment planning compared to a diagnosis having sensitivity and specificity scores of 74 percent (95% CI=59.7 to 85.4) and 89.8 percent (95% CI=86 to 92.9), respectively. Lower agreement scores between the resident and the pediatric dentist were found for the diagnosis of asymptomatic irreversible pulpitis and the use of lesion sterilization and tissue repair as a treatment modality. Conclusions: The AAPD best practice recommendations showed a better consistency for treatment planning than the diagnosis of carious primary molars. [ABSTRACT FROM AUTHOR]

Purpose: To assess the characteristics of dental hard and soft tissue structures of prematurely erupted teeth in newborns. Methods: Extracted natal and neonatal teeth were assessed in ground sections for evaluation of enamel, dentin, dentino-enamel junction and cementoenamel junction. Soft tissue harvested was histologically analyzed for cellularity, vascularity and other characteristics of the dental pulp. Results: This study included 15 teeth from nine neonates, of which seven erupted at birth, eight erupted within the first month of birth. All erupted in the mandibular anterior region. The demineralized ground section revealed enamel cracks, a straight dentinoenamel junction, and S-shaped dentinal tubules along with the enamel lamellae, and enamel spindle. None of the samples showed enamel tuft or cementum. Histology of soft tissue revealed enhanced cellularity, vascularity without any fibrosis, calcification and inflammation when compared with the young healthy pulp in permanent teeth. Conclusion: The prematurely erupted teeth in newborns were almost exclusively rootless and exhibited the characteristic anatomical findings pertaining to enamel, dentin, dentinoenamel junction and cementoenamel junction. The histology of their dental pulp was characterized by increased cellularity and vascularity compared. [ABSTRACT FROM AUTHOR]