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Objectives To assess the degree of parental acceptance of SDF treatment on their children's carious teeth and to explore different factors affecting their decisions. Methods Parents of healthy children younger than 12-year-old of both gender were asked to fulfill a questionnaire describing their perspective of Silver Diamine Fluoride SDF treatment and different factors that could modify their opinion as sociodemographic characteristics, tooth location, type of dentition, advanced management techniques as well as dental caries management during- and post-COVID pandemic. Participants’ responses were categorized according to the three-Point Likert scale as acceptable, neutral, and not acceptable. Fisher test was used to test for significant factors affecting parental acceptance of SDF treatment. The level of significance was tested at 0.05 using SPSS program. Results A total of 158 parents participated in this study. The parental acceptance of SDF treatment was found to be limited to 31.6%. The SDF acceptance rate increased significantly if SDF was used on posterior teeth, on deciduous dentition, prior to shifting to conventional restoration under general anesthesia, and to minimize chances for cross-infection particularly during- and after the recovery from the COVID pandemic. Conclusions SDF treatment on posterior teeth and deciduous dentition was found to be more accepted by the parents than anterior and permanent teeth. Although a majority of parents reported restricted SDF treatment acceptance, most parents were willing to compromise the esthetic dilemma as they understand the risks of alternative interventions. Clinical significance Dentists are encouraged to adopt SDF treatment and offer it for their patients and caregivers prior to shifting to advanced dental management techniques particularly during and following the COVID era. The dentist must provide an informed consent form, which includes clear photographs showing expected staining, especially when treating anterior teeth.

Background Stevens-Johnson syndrome is a rare medical condition with severe mucocutaneous lesions due to adverse drug reactions characterized by exudative multiform erythema, stomatitis, and conjunctivitis. Long-term oral consequences of such cases include xerostomia, caries, impactions, and multiple dental developmental aberrations as short root anomalies. Aim and objective To highlight the role of pedodontist in early diagnosis and treatment planning of dental abnormalities due to Stevens-Johnson syndrome (SJS) using a cone-beam computed tomography (CBCT). Case description A 16-year-old male reported a chief complaint of decayed posterior teeth. Past medical history revealed adverse reactions to an unknown drug at the age of 4 to 5 years. In addition to carious teeth, clinical examination revealed that all canines were missing along with mandibular incisors. On CBCT examination, abnormal short, plump roots with normal crown were seen in all permanent first molars and incisors along with impacted canines and mandibular incisors. This condition was diagnosed as a "Short root anomaly" (SRA) due to SJS. He was found positive to allergy tests for NSAIDs such as ibuprofen and paracetamol. Conclusion NSAIDs can cause a severe adverse reaction resulting in SJS. If this hypersensitivity reaction occurs early during the development of a permanent tooth it may cause dental anomalies such as short roots, root dysmorphia, agenesis, and multiple impacted teeth. Clinical significance This report highlights a unique case of multiple dental aberrations due to SJS and the role of a pedodontist in the early diagnosis and treatment planning of such cases with the help of CBCT. Short root anomalies can be misdiagnosed as root resorption or immature apex. Medical history, clinical and CBCT findings are essential for diagnosis and treatment in SJS patients. Careful orthodontic treatment planning is required in cases of short root anomalies. How to cite this article Katyal S, Yadav V. Diagnostic and Treatment Approach in the Management of Dental Anomalies Associated with Stevens-Johnson Syndrome: A Case Report. Int J Clin Pediatr Dent 2021;14(4):569-574.

Outcome expectations of direct pulp capping in carious teeth are obscured by a clinically unknown infiltration and breakdown of the dental pulp tissue. Histologic studies showed that this soft tissue breakdown is related to the innate immune system. We hypothesized 1) that a neutrophil biomarker could predict the outcome of direct pulp capping and 2) that using sodium hypochlorite (NaOCl) as a lavage solution to remove necrotized infected pulp tissue could improve it. In this randomized trial in mature posterior teeth causing no or mild discomfort with carious pulpal exposures, pulpal fluid was collected to assess neutrophil gelatinase (matrix metalloproteinase 9 [MMP-9]) per total protein (TP) levels as a predictive local biomarker. Subsequently, the dentin-pulp wound was randomly washed with a 2.5% NaOCl or a physiologic saline solution (1:1 allocation), capped with mineral trioxide aggregate, and the tooth was immediately restored with a resin-based composite restoration. Ninety-six patients were included, and 84 individuals could be followed up to treatment failure or clinically confirmed pulp survival after a minimum of 1 y. The entire data were fitted to a Cox proportional hazards model to assess the influence of the observational variables MMP-9/TP and discomfort with the randomized lavage treatment on pulp survival. The Kaplan-Meier pulp survival rates after 1 y were 55% for saline and 89% for NaOCl lavage. The inflammatory state of the pulp tissue as reflected by MMP-9/TP levels and NaOCl lavage had a highly significant ( P

ObjectiveTo evaluate the effectiveness of professionally applied fluoride varnish on the incidence of dental caries amongst older adults resident in LTCFs in Northern Ireland.BackgroundThe oral health status of older adults within Long-Term Care Facilities (LTCFs) is significantly worse than their community living peers. Whilst evidence suggests an important role for fluoride varnish in preventing caries in this population, very few studies have evaluated this intervention.Materials and MethodsA quality improvement project was undertaken with dentate residents (n = 190) in nine LTCFs who had fluoride varnish applied by Dental Care Professionals on two separate occasions during a 12-month period (intervention group). Nine LTCFs were chosen as matched controls (control group) with comparable numbers of residents of similar medical status (n = 217). For the intervention group, oral hygiene training was also provided for the care home staff.ResultsA total of 407 patients (n = 271 female) were included in the analyses (mean age [SD]: 84.1 [6.6] years). After 12 months, the intervention group recorded a significant reduction in mean number of carious teeth (mean [95% CI]: −0.85 [−1.12, −0.58]; P P = .012), mean plaque score (mean [95% CI]: 1.16 [0.28, 2.04]; P = .010) and mean DMFT score (mean [95% CI]: 0.13 [0.04, 0.22]; P = .004).ConclusionsThis study demonstrates the potential role of fluoride varnish in combination with oral hygiene training for staff in the prevention and arrest of carious lesions among older adults in LTCFs.

Objectives: In patients with end stage, renal disease a high rate of morbidity and mortality is present. Studies suggest that end stage renal disease may affect oral health. Therefore, the aim of this study was to perform a scoping review on periodontal disease, dental caries, xerostomia, and hyposalivation in end stage renal disease patients. Materials and methods: A literature search (in PubMed and Embase.com) was performed up to September 29, 2020, in collaboration with a medical information specialist. Included outcome variables were the community periodontal index, probing pocket depth, gingival index, bleeding on probing, decayed-missing-filled-teeth, carious-absent-obturated index, Xerostomia Inventory and the (un)stimulated whole salivary flow rate. Results: Forty three out of 1293 studies were included in the final review comprising 7757 end stage renal disease patients. The average age was 58.3 ± 29.4 years. 28.2%–78.8% of patients reported xerostomia and the (un)stimulated salivary flow rates were significantly lower. Higher community periodontal index scores were measured in end stage renal disease patients. More decayed-missing-filled-teeth were recorded, but no differences were found between groups. Conclusions: Xerostomia and hyposalivation were highly prevalent in end stage renal disease patients. Patients have more deepened pockets, but an equal number of carious teeth compared to healthy controls.

Objectives This study aims to assess the impact of raising the price of sugar and/or sugar-sweetened beverages (SSBs) on caries incidence in the Indian population. Methods A tooth-level decision-analytic model was developed to evaluate a change in caries increment after increasing the price of Sugar and SSBs. The transition of a tooth from a caries-free state to the state of tooth loss in both scenarios was modelled with the help of a Markov model for a time horizon of 63 years, ranging from 2021 to 2083 for the 12-year-old population cohort of India. A conceptual framework was designed to implicate the possible effects of an increase in sugar prices on the reduction of caries incidence. Health effects were estimated in terms of the number of carious lesions and tooth-loss in both the scenarios and modelled as a product of the dose-response relationship between sugar intake and caries incidence. The model was thus used to establish the number of caries lesions prevented, and tooth-loss avoided. Uncertainties in the parameters were assessed using probabilistic sensitivity analysis. The Monte Carlo method was used for simulating the results 1000 times. Results A 20% rise in the price of sugar is expected to result in the prevention of an average of 1.32 teeth in a lifetime of an individual and prevent 27.96 million tooth-loss incidents among the population cohort of India that will eventually lead to a saving of INR (₹) 3116.32 billion (US$ 42.69 billion) on account of dental caries treatment. Similarly, increasing-price of SSBs by 20% will lead to a 0.86% reduction in carious teeth incidence in an individual's lifetime. Conclusion Increasing the cost of sugar and/or SSBs will reduce the daily intake of sugar, which will reduce caries incidence and subsequent progression, thereby preventing caries-attributed tooth-loss and saving treatment costs.

Pulpal blood supply can be measured noninvasively and objectively via laser-Doppler fluxmetry. The aim of the study was to measure and compare pulpal laser-Doppler (LD) flux values for permanent non-carious teeth and carious teeth with different degrees of caries progression. Conventional sensitivity tests were also conducted for a comparative analysis to clarify the difference between tooth sensitivity and vitality. Carious lesions were detected and assessed in 15 adult subjects using the International Caries Detection and Assessment System (ICDAS) criteria. Pulpal sensitivity of selected carious teeth (without previous prosthetic restoration or endodontic treatment) and suitable caries-free teeth were then tested with a cold stimulus and subsequently with a weak electric current, whereas their pulpal LD flux was recorded at a separate visit using individually designed silicone probe holders. The LD flux values for teeth with an ICDAS score 6 were significantly lower compared to the values for teeth with an ICDAS score 1 (p

The aims of this article are to review and analyse oral health in Libyan children, based on the epidemiological studies conducted in the country and to explore the present trends and future challenge. A bibliographic study of prevalence of dental caries research and publications has been carried out. The results showed that the prevalence and severity of dental caries in Libyan school children are high. There is an indication of an upward trend in its prevalence in Libya representing a high rate of unmet treatment needs. A significant proportion of children were affected by dental caries which emphasizes the importance of preventive measures needed to control the caries process, before the need for invasive involvement to restore carious teeth. These findings contribute to the overall picture of Libyan schoolchildren’s dental health and will provide a clearer picture regarding the prevalence of dental caries to determine if these dental conditions a cause of concern in terms of public oral health in Libya and emphasizes the importance of effective detection, maintaining and evaluation strategies in the prevention of these conditions. Also it highlighted the importance of educating parents in relation to dental diseases and their potential risk factors, so that they can include healthy practices in their family on a daily basis.

Developmental dental hard tissues disorders are rarely diagnosed both in children and adults, and their treatment is a problem for dentist. Despite the fact that molecular genetics studies allow to discriminate some dentine disorders, pathogenesis of radicular dentin dysplasia is still obscure. Type I dentin dysplasia is characterized by normal or slightly coloured crowns with no roots or only rudimentary roots, reduced pulp space in permanent teeth and incomplete or total obliteration of the pulp chambers, and periapical radiolucent areas or cysts which might result in premature loss of tooth. Fortunately, teeth demonstrate higher resistance to caries than normal teeth do. Dentin dysplasia type II is characterized by yellow, brown, grey, translucent primary teeth with complete pulpal obliteration. Permanent teeth are normal or might be slightly coloured. Roots are normal in size, but pulp chamber has pulp stones. A third type of dentine dysplasia or focal odontoblastic dysplasia has radiographic aspects of the other two types of disease. Also dentine dysplasia type I has subtypes Ia, Ib, Ic and Id. Dentine dysplasia Ia is characterized by complete obliteration of the pulp, disorder of root development, and many periapical radiolucent areas. A single small horizontally oriented and half-moon shaped pulp is presented in case of dentine dysplasia Ib, roots have a few millimetres length and frequent periapical radiolucencies. Dentine dysplasia Ic is characterized by the presence of two horizontal or vertical semicircle-shaped pulpal remnants which surround dentine in pulp chamber. Also teeth have shortened roots and variable periapical radiolucencies. Dentine dysplasia Id is characterized by the distinct pulp chambers with pulp stones in the coronal third of the root canal; periapical radiolucencies are possible as well. Aim of this study was to analyse clinical case of dentine dysplasia in 8,5-year-old boy. A 8,5-year old boy patient with parents came to a dental office due to caries cavity in tooth 62. Shape of tooth crowns was not changed and teeth with no signs of mobility; white lines and spots on teeth are were detected. Based on age, the decision of orthopantomogram was made to evaluate status of primary and permanent teeth. The image showed almost obliterated pulp chamber in both erupted and developing teeth and considerably shortened, blunted and malformed roots without a visible lumen of root canals in primary teeth. Periapical lesions were found about roots of primary molars and follicles of teeth 12 and 14 without caries lesions. Patient's medical history revealed no disturbance in general health. Clinical examination of the patient's mother did not show dental hard tissues disorders, but radiograph examination revealed such disorder in the orthopantomogram. Thus, history, clinical and radiographic findings revealed this case as dentine dysplasia type I subtype 1c inherited from mother. Oral rehabilitation of patients with dentine dysplasia type I require effective prevention and a complex approach. Thus, meticulous oral hygiene measures and dietary instructions, regular check-ups twice a year were established for this patient; orthodontic consultation was recommended. Varnish «Ftoplen-LC» was applied on the permanent teeth 3 times. To prevent early exfoliation, plan of preventive measures was developed included application of fluoride varnish twice a year and fissure sealing in the premolars in 9-10 years and in the second premolars in 12-13 years. Treatment of dentine dysplasia I type that depends on patient age and severity of disease may include also filling of carious teeth, orthodontic, surgical and orthodontic treatment. In this regard, dentist has to know developmental dental hard tissues disorders and select measures to prolong the retention of affected teeth maintaining them as long as possible.

AIM This article describes the craniofacial and dental features of an individual with Gordon syndrome. The dental management implications and considerations of treating patients with Gordon Syndrome and similar conditions resulting in limited mouth opening are discussed. METHODS A 14-year-old South African male was referred to the Dental Genetics Clinic with the main complaint of carious teeth. His craniofacial characteristics included low set and posteriorly rotated ears, down-slanted palpebral fissures, sloping shoulders, and a broad neck. A prognathic mandible and mild facial asymmetry were noted. He had a significant limitation of mouth opening (2 cm at incisors). Radiographic examination revealed multiple carious teeth, missing mandibular premolars, impacted maxillary premolars, taurodontism of the 44 and 34, and enlarged coronoid processes of the mandible. Dental extractions and restorations have been performed under local anaesthesia. CONCLUSION Gordon syndrome and similar conditions, may result in limited oral opening and impaired manual dexterity. The severity of limitation of mouth opening determines management. Dental management should focus on ensuring that the patient is able to maintain good oral hygiene by customising homecare for the individual and regular dental visits.

Dental caries is a largely preventable disease, yet the extraction of carious teeth is the most common reason for the hospital admission of children in England. This raises concern over the perceived failure of current preventive strategies. Despite a number of national and local preventive strategies, childhood caries remains most prevalent among the lower socioeconomic groups and ethnic minorities, especially in northern England. Often overlooked is the social and emotional impact of caries and dental treatment on the children and their families. More long-lasting can be the emotional, psychological and developmental impact on children of dental treatment and extractions under general anaesthesia, especially in unfamiliar hospital settings. Yet, the number of hospital admissions for the 5-9-year-old age group continues to rise and was 26,000 in England in 2018. The aim of this paper is to review the demographic and socioeconomic factors related to hospital admission of children for dental extractions, focusing on the localities with the highest proportions of hospital admissions. It is suggested that a reappraisal of the caries-preventive strategy in those areas of England with the highest proportion of hospital admissions is now urgently needed and the case is forcefully made for targeted water fluoridation.

Clinically, the use of photo-activated polymer-based dental composites is the preferred method to restore carious teeth due to their esthetics and ease of application. However, the longevity of these resin-based composite tooth restorations can be compromised by the sensitivity of the bonded interface between the composite and the tooth surface. The objective of the current study was to modify the tooth surface with novel fluorinated polyphosphazenes (PPZs), thereby improving the stability of the interface. Binding isotherms of PPZs with collagen (CLG) and hydroxyapatite (HA), two of the primary components of teeth, were established and indicate significant and stable adsorption to the surfaces of these materials. PPZs were also shown to protect CLG against acidic dissolution in a model system. A composite material consisting of the fluorinated polymer and CLG demonstrated three-dimensional stability and significant hydrophobicity. Additionally, no hemolytic activity was observed when evaluated using a porcine red blood cells (RBC) assay. Bovine dentin treated with PPZs demonstrated increased contact angle (hydrophobicity) compared with control samples and resisted fluid penetration when assessed using a dye penetration study. Finally, microhardness evaluation of bovine dentin treated with PPZs and exposed to an acidic challenge showed that treated dentin resisted demineralization. The hardness of the untreated control was significantly reduced after exposure when compared with the PPZ-treated samples. This study represents a novel approach to overcoming the current limitations of composite restorations. These results are promising to improve the longevity of composite dental restorations and may have wider use in sealants, varnishes, and other dental applications. Tooth decay remains a prevalent problem worldwide. Polymer-based composites are the most frequently used tooth restorative used in the clinic. The longevity of these fillings is limited due to conditions in the mouth that can weaken the adhesive used to bond the composite to the natural tooth. The current study uses novel polyphosphazenes (PPZs), hybrid organic-inorganic macromolecules with tunable hydrophilic-hydrophobic properties to coat the tooth surface to achieve better compatibility with the adhesive, thereby improving the longevity of the restoration. Results indicate that PPZs have significant and stable adsorption onto teeth, which may lead to a more stable bonded interface.

Summary. Introduction: The necessity to assess, prevent and correct element-dependent diseases, increase the level of safety, predict and reduce the risk of exposures to industrial contaminants in the development of dental diseases in the child population is an important and promising area of modern hygiene. The objective of our study was to establish concentrations of trace elements in dental tissues of children exposed to various levels of industrial pollution. Materials and methods: We used atomic absorption spectrophotometry to measure 13 trace elements in extracted healthy and carious primary teeth in two groups of children aged 7–11. The first group consisted of 56 children living in the area with a significantly high level of anthropogenic burden (Caveraged total = 1.17 units) and a high prevalence of caries (86.9 %) while the second group consisted of 68 children living in the area with a relatively high level of anthropogenic burden (Caveraged total = 0.68 units) and a mean prevalence of caries (77.1 %) according to WHO criteria. Results: Our findings indicate that accumulation of toxic microelements in hard dental tissues of children in the first group was higher than in children of the second group: concentrations of lead, bismuth, cadmium and strontium were 2.6, 1.8, 2.5, and 1.2 times higher, respectively. We also observed higher accumulation of environmental toxicants in carious teeth compared to healthy ones. Thus, lead, cadmium and bismuth levels in carious teeth were 3.04, 1.2 and 3.13 times higher than in healthy teeth, respectively, while the level of strontium was, on the opposite, 2.5 times lower. Conclusions: The study revealed specific features of the interaction of essential trace elements in children in the form of antagonistic effects between cadmium and zinc, copper and manganese, and synergism in the content of copper, iron, nickel, zinc, and cobalt in healthy teeth, the mechanism of which is based on competition for a bond with a carrier substance and replacement of one element with another. In addition, we established that changes in the microelement balance in the hard tissues of healthy and carious teeth are not unidirectional in nature, thus reflecting complex interactions between the child’s organism and anthropogenic factors. The results proved that accumulation of toxic trace elements in hard dental tissues promotes caries development and causes a sharp decrease in the content of essential trace elements, especially chromium, manganese, iron, and copper. The study showed that hard dental tissues are a depot for lead, cadmium, bismuth, and strontium in children environmentally exposed to high levels of industrial chemicals. Features of developing an imbalance of biotic concentrations of essential elements and accumulating toxic microelements in children with pollution-related tooth pathology were also established.

Introduction: The nature and progression of acute and chronic carious lesion are extremely variable on different tooth surfaces. Early detection of dental caries is challenging for clinicians and involves careful visual and tactile examination. Caries detection dyes and chemomechanical caries removal solutions guide the clinicians in the removal of infected dentin. This study aims to prepare and analyze the physical, chemical, and thermal characterizations of novel bioactive caries detecting dye solution (BCD) and its effectiveness in caries removal from the tooth structure. Materials and Methods: BCD is a combination of contrast agent (iobitridol), chitosan (CS), nanohydroxyapatite (nHAP), and coloring agent. It is synthesized, lyophilized, and subjected to Fourier transformed infrared spectroscopy (FTIR), X-ray diffraction (XRD), and differential scanning calorimeter (DSC) analysis. Pilot study was conducted by applying BCD on two extracted carious teeth for evaluating caries removal efficiency under a microscope (10x). Scanning electron microscopy (SEM) image analysis was done to assess the percentage of dentinal tubules occlusion. Results: FTIR, XRD, and DSC analysis revealed that BCD has compatible interfacial bond between the components and is endothermic. Effective caries removal was seen under a microscope and SEM analysis revealed mean 77.66% of dentinal tubules occlusion. Conclusion: BCD is a stable solution without exothermic reaction, has caries identifying potential, and helps in caries removal. BCD is also bioactive in nature due to the presence of CS and nHAP as ingredients.

Dental pulp can initiate its damage repair after an injury of the pulp–dentin complex by rearrangement of odontoblasts and formation of newly differentiated odontoblast-like cells. Connexin 43 (Cx43) is one of the gap junction proteins that participates in multiple tissue repair processes. However, the role of Cx43 in the repair of the dental pulp remains unclear. This study aimed to determine the function of Cx43 in the odontoblast arrangement patterns and odontoblastic differentiation. Human teeth for in vitro experiments were acquired, and a pulp injury model in Sprague-Dawley rats was used for in vivo analysis. The odontoblast arrangement pattern and the expression of Cx43 and dentin sialophosphoprotein (DSPP) were assessed. To investigate the function of Cx43 in odontoblastic differentiation, we overexpressed or inhibited Cx43. The results indicated that polarized odontoblasts were arranged along the pulp–dentin interface and had high levels of Cx43 expression in the healthy teeth; however, the odontoblast arrangement pattern was slightly changed concomitant to an increase in the Cx43 expression in the carious teeth. Regularly arranged odontoblast-like cells had high levels of the Cx43 expression during the formation of mature dentin, but the odontoblast-like cells were not regularly arranged beneath immature osteodentin in the pulp injury models. Subsequent in vitro experiments demonstrated that Cx43 is upregulated during odontoblastic differentiation of the dental pulp cells, and inhibition or overexpression of Cx43 influence the odontoblastic differentiation. Thus, Cx43 may be involved in the maintenance of odontoblast arrangement patterns, and influence the pulp repair outcomes by the regulation of odontoblastic differentiation.

To date, there is a theory that increased resistance to caries is observed in the teeth, which for any reason underwent destructive changes in the pulp. That is why there is a need to study the impact of pulp vitality on the development of the carious process. The aim of the research was to study the microscopic structure of epoxy sections of intact and carious third molars. We studied 4 intact and 6 carious third molars. For this purpose, specimens were made taking into account the free penetration of the fixative solution into the pulp. To this end, immediately after the tooth was removed, we cut off its roots almost near the crown, preserving the integrity of the latter. The method relied on the impregnation of specimens with epoxy resin, according to the method of epoxy plastination of tooth specimens, developed at the Department of Human Anatomy of Ukrainian Medical Stomatological Academy. The epoxy blocks were cut with a disk into two halves until the hard tissues of the tooth crown were exposed together with the pulp. We found that the hard tissues (dentin and enamel coating) of intact third molars did not have any structural defects. However, their pulp chamber contained mainly an amorphous substance, devoid of any typical pulp tissue structures. That is, the pulp was in a state of complete devolution. Quite the opposite presentation was observed in specimens of carious teeth. We found that their pulp chamber contained quite noticeable tissue structures typical of the dental pulp. It is interesting that in the subodontoblastic layer, in front of the carious alteration of the enamel, there was compaction of the pulp, which may be due to infiltration of perivascular connective tissue by immunocompetent cells. It was found that on the border with carious destruction of enamel, there was a compacted spot of altered dentin, whose matrix was intensely pigmented in brown colour, due to the accumulation of melanin on the dentino-enamel junction. Its excessive formation is associated with the destruction of protein-carbohydrate complexes of organic matter in the deep layers of dentin. We found that the pulp compaction and the focus of carious alteration of the enamel are projectively connected by a radial cord of altered dentin, known in the literature as “dead tracts”. Hence, there is reason to believe that the identified changes indicate a latent form of caries, with a pulpogenic mechanism of development. Thus, it can be argued that the teeth, which for any reason underwent degenerative changes in the pulp, are not prone to carious lesions, whereas in carious teeth, the pulp is active and involved in the pathogenesis of the carious process.

Depending upon the site of the tooth, accessibility of oral hygiene products like toothbrush, tooth floss etc. different teeth have varying susceptibility to getting infected by cariogenic bacteria. Plaque accumulation, occlusal morphology, oral hygiene practices etc. play an important role in determining the susceptibility of teeth towards caries. A retrospective cross-sectional study was conducted using patient records from the Dental College, Chennai after reviewing and analysing the data of 86000 patients between June 2019 and March 2020. The variables involved were age, gender and site of carious teeth. Data were then exported to the Statistical Package for Social Sciences (SPSS) for Windows (Version 19, 2010) for further analysis. The total sample size was 19014. The sample had a gender distribution of 55.56% males and 44.44% females. Class 1 dental caries was found to be most prevalent in sextant 6 that is the lower right posterior teeth region. Least incidence of class 1 DC was noted in sextant 5, which is the lower anterior teeth. Young adults (18-35 years) had the highest incidence of class 1 dental caries (p

Relevance. Effective preventive programs cannot be developed without studying the issue using population epidemiological survey. Purpose – improving efficiency of dental diseases prevention basing on the information obtained during an epidemiological survey of Izhevsk citizens.Materials and methods. Visual and instrumental examination of teeth and periodontium was performed in 107 residents according to WHO criteria in representative age categories: n = 57 (63.3%) in the category from 35 to 44 years old; n = 50 (46.7%) - from 65 to 88 years; n = 83 (77.6%) women (54.9 ± 1.9 years); n = 24 (22.4%) men (53.7 ± 3.7 years). The study was random and voluntary, the conclusions are based on the results of statistical analysis.Results. Examination revealed that most of the intact teeth were located on the left side (n = 617; 51.0%) of the jaws. Examination confirmed the hypothesis that on the opposite side hygienically caused diseases of the teeth and gums should prevail. On the right side of the jaw carious teeth (n = 91; 53.2%), secondary absence of teeth (n = 482; 53.2%), bleeding gums (n = 166; 51.9%), pathological gingival pockets (n = 178; 59.5%) were more common. The observations complex (n = 49) showed significantly more often (p Conclusion. The detected side property is not accidental. It occurs due to the varying effectiveness of individual hygiene. Most people are right-handed and the right side of their jaw requires more complex movements from their right hand. Permanent hygiene defects slowly turn into an additional cariogenic and periodonto pathogenic factor. The authors believe that informing right-handed (or left-handed by analogy) people about the need to control movements of their hand will help to balance the quality of hygiene on both sides of the jaws and make the teeth and periodontium diseases more rare.

Background/purpose: The use of cavity treatments may help in the reduction of bacteria remaining in dentinal tubules after selective carious tissue removal. This study aimed to investigate the effect of selective carious tissue removal and treatment with either 35% phosphoric acid +0.12% chlorhexidine or dentine conditioner on the residual intratubular bacteria in coronal dentine of deep carious lesions. Materials and methods: Thirty carious human molars were randomly divided into three groups; group 1: untreated carious teeth (positive control), group 2: carious teeth treated with 35% phosphoric acid and chlorhexidine disinfectant after selective carious tissue removal and group 3: carious teeth treated with dentine conditioner after selective carious tissue removal. Another six non-carious teeth was used as negative control. The presence of bacteria and depth of bacteria remaining in dentinal tubules were determined by scanning electron microscopy (SEM). Chi square test and one-way, repeated-measures analysis of variance were used for statistical analysis. Results: Using SEM, coronal dentine of group 1, 2 and 3 revealed cocci, rod and filamentous bacteria within dentinal tubules. Positive rates of bacteria detection in coronal dentine of group 1 were significant higher than those of group 2 and 3 (P

Postoperative testing plays an important role in evaluating clinical effect of treatment of caries by filling the decayed teeth with resin composites, which mainly depends on the detection of defec...

Fixed orthodontic appliances are widely used in the correction of dentoalveolar anomalies. Examinations prior the beginning of orthodontic treatment revealed numerous cases of dental caries of moderate intensity; moreover, caries prevalence increases with age that is the number of carious teeth goes up, while the number of filled teeth and the level of oral hygiene become lower. A voluminous body of reports indicates that children and adolescents wearing orthodontic appliances have a significantly higher incidence of caries than patients who do not wear them. Plaque microflora is one of the main risk factors for the development of caries. According to the researchers, caries is initiated by streptococci, lactobacilli, actinomycetes, and Candida fungi. To assess the content of cariogenic microorganisms (Streptococcus mutans and Lactobacillus), there are special microbiological tests available. Kits for rapid tests are manufactured in different countries around the world. In 2013, the researchers of the Department of Therapeutic Dentistry and the Department of Microbiology, Virology and Immunology, Ukrainian Medical Stomatological Academy investigated the microbiocenosis in the oral cavity in young people aged 19-25 years with different intensity of the carious process. The percentage and quantitative content of microflora was studied. The results of the study showed that an increase in the intensity of dental caries is accompanied by changes in the balance in the composition of the oral microflora. This study elaborated the indicators for identifying lactobacilli, streptococci (including haemolytic streptococci, which include S. mutans), fungi of the genus Candida and actinomycetes. But the results obtained did not match the application range of the above mentioned tests. It means the tests reflecting the number of representatives of the studied microbiocenosis in order to determine their activity, are not sufficiently objective. However, rapid tests assessing the indices of cariogenic microflora are in demand in dental practice that allows us to recommend their application in orthodontics. Further study of microbiocenoses should be carried out to determine their functional properties.

Introduction: Oral and dental health isthe standard of the oral and related tissue, which enables an individual to eat, speak, and socialize without active discomfort and embarrassment and which contributes to general well-being of the individual Objective: To find out Pattern of oral and dental diseases among children attending Dental Department in Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh Materials and Methods:This was a cross sectional hospital based study carryout among 443 childrens (242 males and 201 females) attending in the Department of Paediatric dentistry in Dhaka Shishu (Children) Hospital.All the new patients attending to Dental OPD with the complained of oral and dental problems were included in this study. Old patients and those who were not willing to participate in the clinical examination for study were excluded from the study. The study period was October 2018 to December 2018 Results: The study was carried out among (443) children were 242 (54.6%) males and 201 (45.4%) females a male-female ratio of 1.2:1.The age range of children were 224 (50.6%) below the, age of 5 years, 200 (45.1%) at the age of 5-10 years and 19(4.3%) above 10 years (10- 14 years).Out of 443 children 157 (22.7%) showed presence of dental caries, 138 (19.9%) had grossly destructed carious teeth, 79 (11.5%) had dentolveolar abscess, 53 (7.7%) had retained broken root, 52(7.6%) were suffering from pulpitis, 108 (15.7%) of the children presented with stomatitis, 34 (4.8%) had retained decidous teeth,24(3.5%) geographical tongue , 24(3.5%) oral thrush, 7(1.0%) gingivitis 7(1.0%) presented with traumatic injury of tooth, soft tissue and bony tissue, 4(0.5%) had pericoronitis, 1(0.1%) had natal tooth and 4(0.5%) were others like extra oral swelling, apthus ulcer , mucoceale. The total Association of dental disease with different age 10 yrs. 4.4%. Among them Caries disease all group average high rate so p-Value (0.010*). So grossly destructed due to caries 49 cases of 5 yrs. 35.5%, 85 cases of 5-10yrs. 54.1%, and 7 cases of under 15yrs. 5.1% significant. Conclusion: Dental caries was the most predominant disease in the children followed by dentoalveolar abscess. Oral health promotion and planning programs directed towards the oral health should be conducted at regular intervals. Update Dent. Coll. j: 2020; 10 (2): 6-9

Relevance.Skeletal malocclusion stands at the head of all oral diseases and is encountered in 32-35% of children and adolescents in Russia [7;12;15]. The number of malocclusions has increase due to various reasons, one of which is early extraction of deciduous carious teeth resulting in impaired vertical dimension and occlusion of teeth [1;14]. Diagnosis with due regard to caries resistance degree and planning of respective operative and orthodontic treatment are indispensable in children with skeletal malocclusion. Purpose– to increase effectiveness of functional treatment of malocclusion in children with various degree of caries resistance.Materials and methods.There were examined 108 patients aged between 6 and 16 with Class I malocclusion according to Angle, abnormal arch-to-arch relationship and tooth position and various degree of caries resistance. 4 groups were formed: high, sufficient mean, decreased mean and low caries resistance of dental enamel. Intensity of carious process was detected in all patients before and after orthodontic treatment. The effectiveness of reminerlization administered by removable orthodontic appliances was evaluated by electrometrical testing of hard dental tissue. Surface EMG was used to assess normalization of tone of maxillofacial muscles in children by average amplitude of biopotentials of superficial masseter and temporalis muscles.Results.Сhanges in caries intensity in children after treatment with removable orthodontic aligners indicate the necessity for remineralization of hard dental tissues during orthodontic treatment and it is confirmed by decrease of electroconductivity of enamel in children with sufficient mean, decreased mean and low degree of dental enamel caries resistance. Increase of biopotential mean amplitude during «total mastication» for masseter and temporal muscles confirms effectiveness of preformed elastic positioner along with myodynamic exercises.Conclusions.The conducted study proves the necessity of comprehensive approach with procedures increasing the degree of caries resistance of hard dental tissues during orthodontic treatment of skeletal malocclusion in children.

Aim The aim was (1) to study the cytotoxicity of novel Bioactive Caries-detecting Dye solution (BCD) and its antimicrobial activity against Streptococcus mutans, Lactobacillus acidophilus, Actinomyces naeslundii, and Candida albicans and (2) comparative assessment of BCD and Carie-Care for efficient removal of caries (stereomicroscope) and dentin tubule occlusion (scanning electron microscope [SEM]). Materials and Methods For BCD cytotoxic study (direct contact method), colorimetric MTT assay, and cell line study(L929 mouse fibroblast NCTC clone 929 strain L) was performed. Xenetix 350, chitosan, nanohydroxyapatite (nHA), BCD, and Carie-Care solutions were subjected to the antimicrobial activity through blood agar well diffusion method, and the minimum inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) were determined. On 20 extracted human carious teeth a comparative pilot study was done for BCD (Group A, n = 10) and Carie-Care (Group B, n = 10), and evaluated visually and radiographically. After mechanical excavation of caries with a spoon excavator, teeth sectioned longitudinally and stereomicroscopically were evaluated (8x–40x) by two observers. The percentage of dentinal tubule occlusion was evaluated with SEM for both solutions. Statistical kappa analysis of agreement was 0.7–0.8 (P < 0.01). Mann–Whitney test ranks and Wilcoxon signed-rank test (P = 0.01) were applied. Results Cytotoxicity test revealed BCD to be nontoxic and biocompatible. Antimicrobial tests (zone of inhibition) showed BCD > chitosan > chlorhexidine > Carie-Care > Xenetix 350 > nHA. MIC and MBC values suggested chlorhexidine > BCD > Carie-Care. Stereomicroscopic analysis showed effective mechanical removal of caries in BCD without residual dye in the dentinal tubules as compared to Carie-Care. Dentinal tubule occlusion (SEM analysis) was 80%–85% for BCD and 10% for Carie-Care. Conclusions Profound synergistic effect for BCD was observed with advantage of radiographic assessment.

Introduction Radiation-induced xerostomia can result in increased caries incidence, necessitating more dental extractions and a resultant increased risk of debilitating osteoradionecrosis (ORN). Patients undergoing head and neck radiotherapy are routinely treated with a topical preventative regime consisting of fluoride and CPP-ACP (Tooth Mousse). There is limited evidence specifically relating to fluoride prevention regimes in head and neck cancer patients. Other novel remineralising aids using calcium and phosphate have been proposed for use in head and neck cancer patients, but again, there is limited evidence.Aims To retrospectively analyse head and neck cancer patients treated with radiotherapy and placed on a fluoride/CPP-ACP prevention regime at a single institution. To assess the incidence of caries, extractions and ORN.Materials and methods Case records for 95 patients were retrospectively assessed. This involved review of paper and computerised clinical notes, correspondence letters and radiographs.Results The mean number of carious teeth was 6.63 (SD 6.81) and the mean number of extractions was 4.88 (SD 5.84). The teeth most frequently affected by caries and extractions were the mandibular incisors, and 28.4% of patients developed ORN (81.5% of cases occurring in the mandible).Conclusion Development of caries and extraction was a very common event. There is a need for further research into the efficacy of topical prevention regimes.

The worldwide incidence of ECC was found to be 1.76 billion. If left untreated, these carious lesions have high possibility to progress into oro-facial swellings. The purpose of this study was to evaluate the carious teeth in primary dentition, which causes oro-facial swelling. This observational study is carried out by observing the oro-facial infection in children and describing the associated carious teeth using GV Black's classification, ICDAS Criteria for carious teeth and also categorizing the caries index of the patient using dmft index. A total of 189 case sheets were reviewed, and cross-verification was done by photographs. Among the 189 case sheets, a total of 70 cases were selected after proper review. Out of 70 patients, 51 patients had Class 1 carious lesion, and 19 had Class 2 carious lesion all the teeth were categorized under ICDAS score 5 and 6, the mean dmft score was 8.64. Class 1 carious lesions with visible dentin were most commonly associated with Oro-facial Swelling in children. The carious teeth, which were ICDAS-6, were treated by extraction and which were ICDAS-5, were rendered pulp therapy.

Common irrigants used by pediatric dentists for permanent molar root canal therapy Maintenance of the deciduous teeth before exfoliation is necessary. The two most common oral diseases are caries and periodontal disease, and they often begin in childhood. Root canal treatment is the best treatment of choice for extensively carious teeth. Endodontic therapy with proper biomechanical preparation, irrigation, and obturation helps in removing the bacterial biofilm and preventing the loss of primary carious teeth. To effectively clean and disinfect the root canal, remove the smear layer, and irrigants are necessary. The main objective of the present study is to know the common irrigants used by pediatric dentists for permanent molar root canal therapy.All the cases reported in Jun 2019 to Mar 2020 for permanent molar RCT in pediatric patients, was chosen for the study. Information was collected from the dental hospital management system, and the result data was tabulated in excel and imported to SPSS for correlation and association. P

The case was 57-year-old male with the past history of post-operation of Tetralogy of Fallot (TOF) at 11 years old. For dental problems, he visited a dentist and was diagnosed as periodontal diseases (PD) and Type 2 diabetes mellitus (T2DM) with 7.8% of HbA1c. His teeth showed moderate to severe PD and chronic periapical periodontitis due to carious teeth. He was treated for PD and T2DM in dental and internal medicine departments of the hospital. As our formula meal, super low carbohydrate diet (LCD) with 12% of carbohydrate ratio was started. Then, his weight decreased from 100kg to 90 kg in 3 months and HbA1c decreased from 7.8% to 5.4% in 4 months with normalized C-reactive protein (CRP) value. His clinical progress was satisfactory with effective results of dental treatment and LCD. Recent consensus guidelines by International Diabetes Federation (IDF) and European Federation of Periodontology (EFP) recommend the both treatments of PD and diabetes by dentist and internist together. Authors have continued clinical practice and research for years concerning LCD through Japan LCD promotion association (JLCDPA). This case would become some reference from PD and diabetic points of view.

Objective: The Minimata Convention on mercury includes amalgam phase-down and eventual phase-out from dentistry. To aid its subsequent evaluation it is important to have baseline data of amalgam use in a locality prior to implementing a phase-down. Methodology: Records of patients spanning 5 years from January 2011 to January 2016 were analysed to determine and the compare frequency of amalgam usage with other dental materials for carious teeth restorations in a Nigerian university teaching hospital. Classes of cavities restored and cadres of operators who employed the different materials were included. Institutional ethics committee approval was obtained prior to commencing the study. Results: 2,058 patients’ records were retrieved, 59% females and 41% males. Their ages ranged 19–80 years, mean 33.5 ± 12.7 years, young adults 20–39 years old were the majority (62.9%). Filling materials included 57.5% amalgam, 17.6% glass ionomer cement (GIC) and 24.9% resin composite. Class I restorations constituted 70.5% of amalgam restorations, while Class II restorations made up 29.4% and Class V restorations accounted for 0.1%. Undergraduate dental students placed most of the amalgam restorations (60.5%), and 78.9% of all their restorations were amalgam. Less experienced dentists used all materials equally; the more experienced dentists placed more composite resin and GIC (43.3%). Conclusion: Amalgam fillings constituted nearly 60% of the restorations of carious teeth. Training of dental students in placement of non-mercury alternatives to amalgam and Minimum Intervention Dentistry needs to be emphasized in dental schools. Phase-down of amalgam should be intensified in Nigeria with the ultimate aim of a phase-out in line with the Minamata Convention.

Introduction: in Colombia, educational and preventive strategies to improve oral health in early childhood have been developed, but few evaluative studies have been conducted to assess their results. The aim of this study was to assess the knowledge on early childhood oral care acquired by education agents after participating in an educational strategy, and to evaluate the results of the implementation of the Ministry of Health’s preventive protocol “I am a more smiling generation” (Soy una generación más sonriente). Methods: this was a mixed-focus study. The qualitative component was a participatory assessment of learning. It involved 45 education agents registered in a state program, who participated in workshops and focus groups. The quantitative component was a longitudinal study with the participation of 54 mother-child pairs belonging to the same program. The preventive protocol was applied three times over a twelve-month period. It included educational reinforcement and application of fluoride varnish to the children, using oral examination and assessment of their dental caries risk, as well as a survey to identify the families’ social conditions. Results: after applying the preventive protocol, the average carious teeth in children decreased from 3.1 teeth in the first examination to 2.2 in the third one. Prior to application of the preventive protocol, 49% of children had a high risk of developing cavities and in the last visit 63% were at low risk while 5.6% were at high risk. A number of positive aspects result from this learning assessment, including the adoption of new pedagogical strategies to accompany children during oral care practices; there are also some aspects to improve in relation to the persistence of conflicting knowledge concerning children’s rights to oral health. Conclusion: following the application of the preventive protocol, the children’s average carious teeth decreased, as well as their risk for dental caries. Educational agents acquired new knowledge, but uniform knowledge in terms of children’s health rights is still lacking. RESUMEN Introducción: en Colombia se han desarrollado estrategias educativas y preventivas orientadas a mejorar la salud bucal de la primera infancia, pero son pocos los estudios evaluativos para valorar sus resultados. El objetivo de este estudio consistió en evaluar los aprendizajes en cuidado bucal durante la primera infancia, adquiridos por agentes educativos luego de su participación en una estrategia educativa, y valorar los resultados de la implementación del protocolo preventivo “Soy generación más sonriente” del Ministerio de Salud. Métodos: estudio con enfoque mixto. El componente cualitativo fue una evaluación participativa de aprendizajes con 45 agentes educativos pertenecientes a un programa estatal, quienes participaron en talleres y grupos focales. El componente cuantitativo fue un estudio longitudinal. En este participaron 54 binomios madre-hijo pertenecientes al mismo programa. Se aplicó el protocolo preventivo en tres momentos por un periodo de doce meses, el cual consistió en refuerzo educativo y aplicación de barniz de flúor al niño. Se utilizaron como herramientas el examen bucal y la valoración del riesgo de caries dental del niño, y se aplicó una encuesta para identificar la posición social de las familias. Resultados: luego de la aplicación del protocol preventivo disminuyó el promedio de dientes cariados en el niño, pasando de 3,1 dientes en el primer examen a 2,2 en el tercero. Antes de la aplicación del protocolo preventivo, el 49% de los niños presentó riesgo alto de caries, y en la última visita el 63% pasó a bajo riesgo y el 5.6% quedó en alto riesgo. Como resultados de la evaluación de aprendizajes se destacan aspectos positivos, entre ellos la adopción de nuevas estrategias pedagógicas para el acompañamiento al niño durante la realización de las prácticas de cuidado bucal, y aspectos a mejorar, en relación con la persistencia de saberes contradictorios frente a los derechos en salud bucal de la niñez. Conclusión: luego de la aplicación del protocolo preventivo disminuyó el promedio de dientes cariados y el riesgo de la caries dental en los niños. Los agentes educativos incorporaron nuevos aprendizajes, pero aún no hay conocimientos unificados en el tema de derechos en salud de la niñez.

Purpose: The boron and fluoride mainly accumulate in the bones and teeth of the human body. The purpose of this study is to determine boron or fluoride levels in the whole tooth, to evaluate the correlation between their levels and to compare these levels in primary/permanent, carious, and non-carious groups. Materials and Methods: The boron and fluoride levels of thirty-six teeth, separated such as primary carious (n=9) and non-carious (n=9), permanent carious (n=9) and non-carious (n=9), were determined by ICP-MS and ion-selective electrode, respectively. Results: While boron levels were between 0.001 and 5.88 ppm, the fluoride levels were between 21.24 and 449.22 ppm. The boron level of non-carious teeth was higher than those of carious teeth in primary and permanent tooth groups. However, this difference was not statistically significant (p>0.05). The fluoride level of non-carious teeth was higher than those of carious teeth in primary (p=0.062) and permanent teeth groups (p=0.046). Negative correlation, found between boron and fluoride in all groups, was significant only in non-carious teeth group (r=-0.488, p=0.040). Conclusion: The results of our study proved the importance of fluoride as a protective factor for dental caries once more. The boron levels in non-carious teeth were also higher than carious teeth. However, it was not significant. Moreover, there was negative correlation between teeth boron and fluoride levels. Therefore, it is necessary to conduct more detailed studies on the tooth boron level and its relation with caries formation and with fluoride levels.

Purpose: compare the chemo-mechanical method of caries removal (CMCR) using Carie-Care™ and conventional technique (Drilling) in normal and disabled Egyptian children. Materials and Method: A total of 40 children were divided into two equal groups .Group A: 20 healthy and normal children. Group B: 20 children with different types of disabilities, either intellectual disability, hearing impairment or visual impairment. Their age ranged from 5-8 years .Two primary carious teeth were chosen in each child according to inclusion criteria (total 80 teeth). The eighty primary teeth from forty children were further subdivided equally into two subgroups (40 teeth in each subgroup) according to caries removal technique. Subgroup Ӏ: caries was removed with CMCR using the Carie-Care system. Subgroup ӀӀ: caries was removed with the conventional drilling technique. Then all teeth were restored with Activa kids bioactive restorative material and followed up at baseline, one month, three months and six months intervals. Results: Results of this study showed that there was no significant difference between patients’ groups regarding complete caries removal, total time taken for complete caries removal, pain and patient comfort, but there was a statistically significant difference between both techniques regarding complete caries removal in disabled children group (Group B), and a significant difference was also found in the time taken for complete caries removal , pain and patient comfort in both patients’ groups. Also, there was no statistically significant difference between patients’ groups regarding the longevity of Activa kids bio-active restorative material at base line, one month, three months and six months follow up periods. Conclusion: Carie‑Care™ gel was an efficacious alternative method to treat carious lesions in both normal and children with different disabilities since it allies atraumatic characteristics. Activa kids bioactive restorative material had an excellent performance as a permanent restorative material in vital primary teeth in both normal and disabled children in a period of 6 months.

Background: Many oral bacterial species forming the normal flora present as a biofilm in the oral cavity. Dental caries results when there is an imbalance of pathogenic bacteria within these biofilms. Aim: This study sought to isolate and identify the bacterial species associated with extracted carious teeth and their susceptibility pattern towards commonly employed antimicrobial agents used at the Komfo Anokye Teaching Hospital (KATH). Methodology: A descriptive cross-sectional study carried out on thirty-three extracted carious teeth samples collected by convenient sampling from patients attending the Oral Health Directorate-KATH. All samples were collected from the 11th of March 2019 to the 6th of April 2019. Data was collected using 5 ml peptone water and a case study form. Analysis was done using SPSS version 25 and Microsoft Excel version 10. Results: Twenty (61%) samples were obtained from female patients and thirteen samples (39%) from male patients. Streptococcus spp had the highest occurrence (32.25%) with the least isolated being Pseudomonas and E. coli spp (6.45%). Antibiotic susceptibility test revealed Pseudomonas spp was resistant to all the eight antibiotics used in this study. All bacterial isolates were resistant to Cefuroxime and penicillin except Staphylococcus and Streptococcus spp. Conclusion: The commonest isolates associated with dental caries in KATH were Streptococcus, Bacillus and Staphylococcus spp. In this study most of the isolated species were resistant to common antibiotics employed in the Oral Health Directorate in KATH (amoxicillin/clavulanic, ampicillin and penicillin). From the current study the most effective antibiotic observed was meropenem (23%) with penicillin (3%) being least effective in treating infections of caries.

Dental caries is still the most common pathology in childhood, caused mainly by lack of adequate prevention. The aim of this project was to evaluate the dental caries profile in children and the importance of multidisciplinary practice in dental caries. Material and methods: 1st stage- meetings were held with the teachers of the child education network and conferences addressed to parents and those responsible for the children. 2nd stage- Assessment and examination of oral health with education process and motivation for dental hygiene. Results: A total of 3390 children were analyzed, of which 859 had carious teeth, that is, 25.34% of the children had caries disease. There is a large presence of caries in the PRE II level, whose highest prevalence of caries is 41.73%, and the lowest recorded in Kindergarten I with 3.11%. This is mainly due to age, directly related to the period in which the basic oral health care program began in day care centers, as older children already had high caries rates when the preventive program was institutionalized to control the occurrences of caries and health promotion. Conclusion: The prevalence of caries in preschool children is still high, but the multidisciplinary approach has shown to be effective and able to reach the levels recommended by ONU 2030 appointment book for dental caries control.Keywords: Dental Caries. Oral Health.Oral Hygiene. ResumoA cárie dentária é a enfermidade mais comum na infância, causada essencialmente pela falta de prevenção adequada. O objetivo deste estudo foi avaliar o perfil da cárie dentária em crianças e a importância da ação multidisciplinar no controle da mesma. Na primeira fase, foram realizadas reuniões com os professores da rede de educação infantil e conferências dirigidas aos pais e responsáveis das crianças. Na 2ª fase: avaliação e exame de saúde bucal com orientação e motivação para higiene bucal. Foram analisadas 3390 crianças, das quais 859 apresentaram cárie dentária (25,34%). Obervou-se grande presença de cárie no nível PRE II, cuja maior prevalência de cárie é de 41,73%, e a menor registrada no Jardin I com 3,11%. Isso se deve principalmente à idade, relacionada diretamente ao período em que iniciou o Programa Básico de Atenção a Saúde Bucal nas creches, uma vez que as crianças mais velhas já apresentavam altas taxas de cárie quando o programa preventivo foi institucionalizado para controlar ocorrências de cárie e promoção da saúde bucal. Ainda existe alta prevalência de cárie em pré-escolares, entretanto, a abordagem multidisciplinar mostrou-se efetiva e capaz de alcançar os índices preconizados pela Agenda 2030 da ONU para o controle e prevenção da cárie dentária. Palavras-chave: Cárie Dentária. Saúde Bucal. Higiene Bucal.

Background: The possible histological changes in dental pulp in teeth of diabetic patients are important to be understood, as the clinician will consider the best treatment choice for those teeth, especially if they are affected by decay. The aim of this paper is to assess if there are effects of diabetes-associated hyperglycemia on the nervous and vascular system of the dental pulp. Methods: Twenty-three dental pulp specimens of patients aged 36–70 years old were analyzed. All patients had been diagnosed with type 2 diabetes for at least 5 years. Results: Most of the patients had poorly controlled hyperglycemia, deep caries, but no clinical signs of pulpitis. The histological aspects of pulp specimens included frequently seen inflammatory infiltrate, degeneration of the nerves, thickened blood vessel walls, pulp sclerosis and frequent pulp calcifications, and even small necrotic areas. Conclusion: The analyzed dental pulp specimens of carious teeth of type 2 diabetic patients show fibrotic transformation of the dental pulp, with the presence of calcifications, arteriosclerosis and inflammatory infiltrate. In this situation, the attitude of the dentist in pulp vitality preservation in the case of carious teeth of diabetic patients should be limited.

Background Supervised tooth brushing is an important part of leading national oral health improvement programs in different countries. With the cessation of water fluoridation in 2014, a new program was immediately required to provide community-based caries prevention, especially amongst young children. The aim of this study was to determine whether a supervised tooth brushing program (STBP) in kindergartens could reduce dental caries amongst preschool children, when compared with children from the same community who did not participate in the program. The study was performed 2 years after the start of the program. Methods Two Jewish and two Arab local authorities (one participating and one control) were randomly chosen. In each local authority, 4 kindergartens (children aged 5) were randomly chosen, giving a total of 16 kindergartens. Children in the intervention group brushed once daily at kindergartens, with fluoridated toothpaste, for two school- years. All the children were examined using the WHO Oral Health Survey Methods Ed.4. Results Two hundred eighty-three five-year-old children were examined, 157 of them Jewish (86 participants in STBP, 71 non-participants) and 126 Arab (59 vs 67 respectively). Among Jewish children, the fraction of untreated decayed teeth was 61% in the participant group and 65% for non-participants, and amongst the Arab children 69% vs. 90% respectively. The fraction of treated decayed teeth for the participant group was 37% compared to 29% for the non-participants among Jewish children, whilst for the Bedouin group it was 23% vs. 8% respectively. Conclusions After 2 years, supervised tooth brushing with fluoride toothpaste shows a favorable effect. This study suggests that dental health of children participating in STBP was better than the control group. Fewer carious teeth and more treated carious lesions were recorded in this group. This program can be applied to low SES communities nationwide. Guidelines for fluoride concentration in toothpaste for children should be re-considered based on high caries levels.

The aim of this report was to advocate early childhood caries (ECC) and share strategic management in Thailand, despite over two decades of free Universal Health Coverage including oral healthcare. The recent Thai national oral health survey in 2017 indicates the very high prevalence of ECC, with an average of three carious teeth affected in 53% of 3-year-old children. This is despite the efforts of the Ministry of Public Health that has launched several interventional programs ranging from an upstream policy that prohibits sugar additions in baby formula milk to downstream remediations such as advocating and encouraging toothbrushing with fluoride toothpastes. Nevertheless, ECC is strongly predicated by other key factors including the family and community commitment and participation, as embodied in the current World Health Organization guidelines. These encompass three different tiers of community-level prevention: primary, secondary, and tertiary. Accordingly, the following strategies for ECC management in Thailand should be based at primary care clusters (PCC) in sub-district health centers, with the assistance of inter-professional health teams. These include community education on the importance of deciduous teeth and effective toothbrushing with fluoride toothpaste (primary prevention), regular examination and detection of ECC lesions and early intervention (secondary prevention), insertion of non-invasive preventive restorations using cost-effective atraumatic restorative treatment (ART) or simplified and modified ART (SMART) (tertiary prevention), and, finally, effective follow-up and monitoring systems. It is anticipated that this triple tier approach to ECC management will improve not only the oral health but also the overall children's health.

Background/aim Osteopetrosis is an inherited disease characterized by increased bone density. Its genetic variability results in various phenotype expressions, whereas clinically are classified in three types: malignant infantile, intermediate and adult. The various oral manifestations of the disease give a crucial role to the pediatric dentists in diagnosis. Case presentation A 7-year-old girl with persistent swelling on right cheek visited a pedodontic clinic. After extra- and intra-oral examination/findings, the patient was referred for further investigation concerning a possible general pathological background. An extraction, included in the initial dental treatment plan, led to the diagnosis of osteopetrosis. Various medical examinations co-led to the diagnosis of osteopetrosis but without genetic identification. Extractions of carious teeth, under general anesthesia, and full cover or sealants, on chair, of unaffected teeth were conducted respectively to minimize the microbial load and to prevent from osteomyelitis relapse and new caries. Two more general anesthesia sessions took place due to relapse of lower jaw osteomyelitis. Follow-up was conducted every 3 months for 2 years. Conclusion Osteopetrosis' diagnosis can be triggered by its oral manifestations (rampant caries, osteonecrosis, enamel defects, malformed roots/crowns, missing teeth), for which the pediatric dentist could be the first observer. Management of these patients needs multidisciplinary approach and follow-up appointments should be very frequent.

Background Research has identified significant gaps in preventive oral health care among certain subpopulations of US children. The authors of this study sought to estimate children’s preventive oral health care use and oral health and investigate associations with child, family, and health care characteristics. Methods Data for this observational, cross-sectional study came from the 2016 National Survey of Children’s Health. Children aged 2 through 17 years were included (n = 46,100). Caregiver-reported measures were preventive dental visits, prophylaxis, toothbrushing or oral health care instructions, fluoride, sealants, fair or poor condition of the teeth, and problems with carious teeth or caries. Univariate, bivariate, and multivariable logistic regression analyses were conducted. Results As reported by parents or caregivers, 8 in 10 children had a preventive dental visit in the past year but lower rates of specific services: 75% prophylaxis, 46% fluoride, 44% instructions, and 21% sealants. In addition, 12% had carious teeth or caries and 6% had fair or poor condition of the teeth. In adjusted analyses, young children (aged 2-5 years), children with no health insurance, and those from lower-income and lower-educated households had decreased likelihood of a preventive dental visit as well as specific preventive services. Children with preventive health care visits and a personal physician or nurse had increased likelihood of receiving preventive oral health care. Conclusions Preventive oral health services are lagging among young children and children from lower socioeconomic backgrounds. Further studies are needed to identify interventions that encourage use of specific preventive services. Practical Implications Dentists should work with caregivers and primary care providers to promote preventive oral health care, especially among young children and those from lower socioeconomic backgrounds.

Background Radiation-related caries (RRC) is one of the most significant oral toxicities of head and neck radiotherapy (HNRT); however, the potential of radiation to directly cause harmful dentin and pulpal effects and impair response to caries progression is controversial. Material and Methods Therefore, the aim of this study was to characterize the reactions of the dentin-pulp complex in teeth affected by RRC. Patients and methods: Twenty-two carious teeth extracted from 22 head and neck cancer (HNC) patients were divided into control (conventional caries; n=11) and irradiated (RRC; n=11) groups and paired matched by dental homology, clinical patterns of caries progression following the Post-Radiation Dental Index (PRDI) and microscopic depth of carious invasion. Histopathological characteristics based on morphological hierarchy, cell populations of dental pulp, blood vessels, neural elements, extracellular matrix components, inflammation, patterns of carious invasion and reactionary dentin presence were evaluated by optical light microscopy and histomorphometry. Results Mean PRDI scores were 3.2 for the control group and 3.8 for the irradiated group. Dentin demineralization patterns were also similar between the groups and the mean depths of demineralization were 1,158.58µm and 1,056.89µm for the control and irradiated groups, respectively. Conclusions Pulp histopathological changes and dentin reaction patterns were similar between groups and varied according to the PRDI scores and carious lesions depth. Dentin and pulp reactions are highly preserved in RRC teeth. Key words:Cancer, radiotherapy, radiation-related caries, teeth, pulp.

Full mouth reconstruction, full mouth rehabilitation and full mouth restoration are terms often used interchangeably to describe the process of rebuilding or simultaneously restoring all of the teeth in both the upper and lower jaws. Full mouth rehabilitation creates smile that is not only esthetic but also functionally comfortable. A systematic and organized approach is essential in order to evaluate, diagnose, and resolve esthetic and functional problems predictably in a complex restorative case. This clinical report discusses the oral rehabilitation of a 25-year-old man with multiple carious teeth and missing upper and lower back region teeth. The aim of this treatment was to restore esthetics and masticatory function which further improved and strengthened the self- esteem of the patient.

Aim To study whether dental caries, periodontal disease, and stomatitis, and the related inflammatory burden associate with diagnosed Alzheimer's disease (AD) and dementia among older people. Methods The study population included 170 individuals aged ≥75 years. The primary outcome was diagnosed AD and the secondary outcome was any types of diagnosed dementia. Information about participants' oral diseases and the related inflammatory burden was based on the clinical oral examination. Relative risks (RRs) and confidence intervals (CIs) were estimated using regression models. Results Dental caries, the presence of ≥3 carious teeth (RR: 3.47, 95% CI: 1.09-11.1) and the number of carious teeth (RR: 1.24, CI: 1.11-1.39), and inflammatory burden (RR: 1.44, CI: 1.04-2.01) were associated with a higher likelihood of having AD. Also, periodontal disease and stomatitis were associated, although nonstatistically, with AD and dementia. The risk estimates for any type of dementia were in most cases lower than for AD. Conclusion Oral diseases and the related inflammatory burden were in most cases associated more strongly with diagnosed AD than dementia in general. Of the oral diseases studied, the strongest association was between dental caries and AD.

Svrha: Analizirati podatke o stomatološkom liječenju u općoj anesteziji (OA-i) provedenom na Klinici za stomatologiju KBC-a Zagreb s naglaskom na osobitosti pacijenata, vrste zahvata i postoperativne komplikacije. Ispitanici i postupci: Retrospektivna analiza kartona 100 pacijenata liječenih u OA-i na jednodnevnoj kirurgiji Klinike za stomatologiju KBC-a Zagreb. Registrirani su demografski (spol, dob) i klinički podatci bolesnika (osnovna bolest, tehnika OA-e, vrsta intubacije, trajanje zahvata, broj karioznih zuba, broj pečatnih ispuna, ispuna, ekstrakcija i endodontskih liječenja, vrijeme do otpusta i postoperativne komplikacije). Rezultati: U OA-i je zbog nesuradnje iz različitih razloga liječeno 80 pacijenata, a 20 zbog teškoga fizičkog stanja ili preopsežnog zahvata za lokalnu anesteziju. Medijan KEP indeksa iznosio je 9 (0 – 21). Sanaciji svih zuba podvrgnuto je 89 pacijenata, a 11 drugim vrstama zahvata. Isti dan otpušteno je 97 pacijenata. Četvero su imali postoperativne komplikacije, pa je troje hospitalizirano zbog daljnjeg praćenja od 24 do 48 sati. Zaključak: Pacijenti s fizičkim i/ili mentalnim oštećenjem imaju veću aktivnost karijesa i povećanu potrebu za stomatološkom skrbi u odnosu prema općoj populaciji. Stomatološko liječenje u OA-i u sustavu jednodnevne kirurgije siguran je i učinkovit način liječenja za pacijente koji ne mogu surađivati sa stomatologom., Objective: To analyze data on full-mouth rehabilitation under general anesthesia (GA) performed at the University Clinical Hospital Zagreb with emphasis on patient characteristics, type of procedure and postoperative complications. Materials and methods: Retrospective chart review of 100 patients treated under GA at the Dental clinic’s day care surgery. Patient’s demographic (sex, age) and clinical data (diagnosis, GA technique, intubation type, procedure duration, number of carious teeth, presence of visible calculus, number of sealed teeth, fillings, extractions and endodontic treatments, discharge time, postoperative complications) were registered. Results: Eighty patients were treatedunder GA because of noncompliance due to different reasons and twenty patients because of either their poor physical condition or extensive dental procedure. Median DMFT per patient was 9(0- 21). Eighty nine patients underwent full-mouth dental restoration and 11 patients underwent other types of procedures. Ninety seven patients were safely discharged the same day. Four patients experienced postoperative complications and three of them were hospitalized for another 24-48 hours for postoperative follow-up. Conclusion: Patients with physical and/or intellectual disabilities have higher caries activity and increased dental treatment needs compared to the general population. Dental treatment under GA in day care service is a safe and effective way of providing dental care for noncompliant patients.

A nine-year-old girl was presented to the dental clinic at King Abdulaziz Medical City in Jeddah with carious posterior primary teeth and discolored teeth. She was referred to a pediatric geneticist to rule out any medical conditions. She was suspected to have ectodermal dysplasia (ED). DNA testing was requested and sent to Germany to confirm the clinical findings. Afterward, full-mouth rehabilitation was done including prophy and fluoride application, composite restorations, stainless steel crowns, and pulp therapy. The treatment was planned to be carried out under local anesthesia due to the cooperative behavior of the child and the parents’ request. Treatment objectives were oriented to achieve esthetic and functional rehabilitation of all carious teeth, maintain occlusion, in addition to maintaining spaces for the missing permanent teeth for future replacement. The patient became caries-free. Oral hygiene was improved which resulted in gingival inflammation resolution. Spaces were maintained and the behavior of the child was improved during recall visits from positive to definitely positive. Multidisciplinary approach in the management of oral and dental manifestations associated with ED including pediatric dentists, prosthodontists, and orthodontists is of paramount importance. How to cite this article Gholman RR, Kassar WM, et al. Dental Rehabilitation of a Child with Ectodermal Dysplasia: A Case Report. Int J Clin Pediatr Dent 2019;12(4):362–365.

Aim: The present study aimed to assess the microleakage in primary teeth restored with tooth-colored materials using the dye penetration method. Materials and methods: A total of 60 healthy primary molar teeth were included in this study and standardized class II mesio-occlusal cavities were prepared on the samples. Consequently, these teeth were randomly divided into three experimental groups (n = 20 each group) such as group I: nano-filled resin-modified glass-ionomer, group II: nanocomposite resin, and group III: Cention N. After completing all the restorations, the restored teeth were subjected to 100 cycles of thermocycling. Next, all the surfaces of the tooth, except the restoration and a 1-mm zone adjacent to the restoration’s margins, were covered with two coats of nail varnish. The coated teeth were then submerged in a 0.5% basic fuchsin dye solution. The teeth were then sectioned along the center of each restoration mesiodistally. Each part was visualized under a stereomicroscope at ×40 magnifications to assess microleakage. Results: Out of all the included restorative materials, the least microleakage was demonstrated by teeth restored by the nano-filled resin-modified glass-ionomer (RMGI) group (1.05 ± 0.21) followed by the Cention N group (1.84 ± 0.14) and the nanocomposite resin group (3.10 ± 0.03). A statistical method involving the analysis of variance revealed a statistically significant difference among the different restorative materials. Multiple comparisons among the restorative materials showed a statistically significant difference between groups I and II and groups II and III restorative materials (p < 0.05). The dye penetration score 1 was more [11(55%)] for the nano-filled RMGI group, score 3 was more [12(60%)] for the nanocomposite resin group, and score 2 was more [9(45%)] for the Cention N group. Conclusion: The present study showed significantly less microleakage associated with the nano-filled resin-modified glass ionomer group than nanocomposite resin and Cention N groups. Clinical significance: Since many years, dentists have encountered a challenging problem with cervical lesions. Thus, an interdisciplinary treatment approach is the appropriate option in the management of carious teeth that involve gingival recession and cervical extension.

Leukemia is the cancer of blood cells and bone marrow and it is the most common cancer in children. The cause of acute lymphocytic leukemia is unknown, but many predisposing risk factors could be associated, such as an exposure to radiation, chemical or viral infections. A six-year-old boy was presented with multiple carious teeth and severe pain related to his lower left teeth. Regarding medical history, the child was diagnosed with acute lymphocytic leukemia and after consultation with patient's physician; dental treatment was planned to be accomplished under general anesthesia. The aim of treatment was to eliminate sources of infections, restore carious teeth, relief pain, and improve oral hygiene and patient's parents’ education regarding general and oral health. Full-mouth rehabilitation was accomplished after preparing the patient with pediatric hematology/oncology team under general anesthesia. During recall visits, good oral hygiene and caries-free teeth were obtained. It is important to have solid knowledge regarding the medical conditions, the necessary consultations with medical subspecialties and the appropriate timings for treatment. How to cite this article Gholman RR, Felemban EH, El Meligy OAES. Dental Rehabilitation of a Child with Acute Lymphocytic Leukemia: A Case Report. Int J Clin Pediatr Dent 2019;12(6):582–586.