The use of bonding materials in dentistry for children.
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Biomedical subjects
Publications and source records attributed to M Houpt.
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The clinical effectiveness of Delton fissure sealant was studied in 205 children, ages 6--10 years (mean age 71/2). 993 children in grades 1, 2, 3 and 4 were screened and subjects were selected if there was evidence of previous dental caries in the mouth, and a pair of contralateral maxillary or mandibular first permanent molar teeth were free of caries. Two pedodontists independently examined the children in a mobile van equipped with two operatories, and each applied sealants to approximately half of the subjects. After 11 months, in 186 subjects there were 10 sealants partially lost, five experimental teeth carious or filled and 53 control teeth carious or filled. After 24 months, in 175 subjects there were four sealants completely lost, 12 sealants partially lost, 11 experimental teeth carious or filled and 89 control teeth carious or filled. Consequently, sealant retention was 92% after 11 months and 85% after 24 months. Percent effectiveness in caries reduction was 90% after 11 months and 88% after 2 years.
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PURPOSE: This project studied the prevalence of oral soft tissue disease in HIV-infected children treated with highly active antiretroviral therapy (HAART). METHODS: Thirty-eight HIV-infected children participated in the study. Twenty-three of these patients were treated with HAART while 14 received exclusively reverse transcriptase inhibitors (RTI) and served as controls. The children were examined three times at approximately one-month intervals while their health history and laboratory data were abstracted from medical charts. Analyses were performed to determine differences in lesion prevalence between treatment groups as well as between lesion and no lesion groups with regard to immune differences. RESULTS: Thirty patients (79%) had oral lesions detected in at least one visit. There were no differences in specific lesion prevalence between HAART compared with RTI-treated children. However, a trend for more oral candidiasis in the latter group was observed. Subjects with oral soft tissue lesions had lower CD4 counts (P = 0.04) and percentage (P = 0.01) but similar viral loads when compared to patients without oral soft tissue disease. CONCLUSIONS: HAART does not appear to significantly affect oral soft tissue disease prevalence in HIV-infected children. Presence of lesions was associated with decreased immunity and may signal advancing disease.
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The retention of autopolymerized and light-polymerized Delton fissure sealants was compared. Sealants were applied to 207 first permanent molars with 304 separate sites in 73 children 6-8 years old (mean age 6.3 years). After five years, there was complete retention in 59% of the autopolymerized and 48% of the light-polymerized sealants. The resulting 11% difference in retention rates was not statistically significant at P less than 0.05.
Project USAP was performed to examine the use of sedation in pedodontics; part one studied the use of sedative agents by pediatric dentists, and part two examined the use of sedation in postgraduate teaching programs. In part I all 2,040 members of the American Academy of Pediatric Dentistry were sent questionnaires in 1985 concerning their use of sedation, and 1,105 responded. In regard to their use of nitrous oxide alone, 55 percent of practitioners responded that they used nitrous oxide less than 10 percent of the time. In regard to other types of sedative agents, most practitioners used little, if any sedation; 88 percent of practitioners used sedation for less than 10 percent of their patients. In a typical three-month period, the 1,105 respondents performed 33,465 sedations. Of that number, almost half (14,802) were administered by only 64 practitioners. Compared with other geographic areas, there appeared to be greater use of sedation in the south/southeast and west regions of the United States. The heavier use of sedation by some practitioners was not related to the percentage of their handicapped patients who received sedation. In part II, all 59 postgraduate programs in pediatric dentistry were surveyed during 1985 to examine the use of sedation by postgraduate students. There were wide differences in frequency and type of experience of students with different drugs. It is concluded that when a healthy child receives a sedative agent for dental treatment, the type of drug and drug dosage depend more on the biases of the individual practitioner, than on the requirements of the patient.
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The retention of a self-polymerized fissure sealant applied after twenty seconds etching time was evaluated after three years. From the original 100 molars that were sealed, seventy-one teeth with 105 sites were available. The sealants were totally retained in 91 percent of the cases, after three years. The findings demonstrate that the retention rates of fissure sealants using twenty seconds etching time are comparable to those reported with the more conventional sixty seconds.
A review of the current use of sedative agents by pediatric dentists indicates that agents other than nitrous oxide have rather limited use, in that less than 10% of patients treated by pediatric dentists receive sedative agents. However, a small but significant number of practitioners use sedation with more than 10% of their patients, and 8% of practitioners account for almost half of sedations administered. Practitioners use a variety of agents which probably reflect the training programs that teach the use of a variety of techniques. There appears to be no general agreement on dosage levels or methods for monitoring. There is a need for research to establish dosage levels for drugs and proper methods to monitor patients treated with sedation.
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