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PubMedDate not supplied

Factors affecting outcomes of traumatically extruded permanent teeth in children.

PURPOSE: The objectives of the present study were to determine the prevalence of residual extrusion, pulpal necrosis, and resorption for extruded permanent teeth and to establish the effect of presentation and treatment factors. METHODS: Seventy-two traumatically extruded permanent incisors were studied at the Departments of Paediatric Dentistry in Belfast, Newcastle upon Tyne, and Glasgow. The mean age of the patients was 10.1 years (range=6 to 18 years). Clinical and radiographic outcomes were analyzed and related to presenting and treatment factors. RESULTS: The initial degree of extrusion was moderate for 46 teeth (64%), and the median delay prior to repositioning was 3 hours (range=1 to 168 hours). Pulp necrosis occurred in 31 teeth (43%), residual extrusion was present in 16 teeth (23%), and inflammatory resorption occurred in 11 teeth (15%). Residual extrusion was significantly associated with a delay in repositioning the tooth, pulpal necrosis was significantly more common in teeth with closed apices and in severely extruded teeth, and inflammatory resorption was more common after pulpal necrosis. CONCLUSIONS: Residual extrusion could be minimized by earlier presentation and repositioning. The risk of pulpal necrosis is greatest for severely extruded teeth and for those with closed apices.

Adolescent↗
PubMed2003

[Therapeutic possibilities for multiple caries in children].

The exaggerated consumption of sugars under its various associate shapes to an insufficiency of mouth and tooth hygiene could drag some tooth decays. These tooth decays, when they demonstrate, leads to a destruction of the temporary teeth, with for corollaries of the aesthetic and functional problems. The therapeutic are not always apparent especially when there is coexistence of coronary destruction to juxtapose to the gum without reaching pulp with some precocious a toothlessing. The authors, across some cases clinics treated to the breast of service of Paediatric Dentistry shows different types of therapeutic possibilities in function of the shapes clinics. He was about conservative treatments or of extraction, of prothesis restorations to the aide of the Crown order form, of infantile removable prosthesis and of composite prosthesis.

Child↗
PubMed2004

Anxiety related to dental general anaesthesia: changes in anxiety in children and their parents.

AIM: To examine the anxiety levels of children referred for dental general anaesthesia and their parents at various key points of the referral and anaesthetic procedure. METHODS: Structured interviews and anxiety measures were conducted with 50 children attending the Department of Paediatric Dentistry, Leeds Dental Institute, and progressing to general anaesthetic (GA) and their parents. Interviews were conducted with parents and children prior to initial assessment, following assessment and prior to a GA. Anxiety was measured at each interview, using the Visual Analogue Scale for parents and the Venham's Picture test for children. A fourth telephone interview was conducted with parents one week after the GA when the degree of upset caused to parents and children by the procedure was evaluated. RESULTS: Anxiety of children remained constant at each interview. Parent and child anxiety were not related. There was a rise in parent anxiety following initial assessment in those families attending in response to a routine referral and progressing to GA (p<0.05). There was a further rise in parent anxiety in these families immediately prior to the GA itself (p<0.001). Parent upset was strongly related to their anxiety at each of the three interviews prior to the GA (p<0.01, 0.05 and 0.001 respectively) and to the distress of their child (p<0.02). Child distress was strongly related to anxiety at each of the three interviews prior to the GA. CONCLUSION: The anxiety levels of children did not appear to change throughout the whole GA assessment and treatment process. Parent anxiety rose significantly following assessment and again just prior to the GA. Factors contributing to parent upset post treatment were child upset and pre treatment parent anxiety levels. Children who were most anxious prior to GA found the procedure most distressing.

Adolescent↗
PubMed2004

Surgical removal of supernumerary teeth and the fate of incisor eruption.

AIM: The aims of this study were firstly to determine the fate of unerupted permanent maxillary incisor teeth following supernumerary tooth removal and secondly to make recommendations regarding the management of such incisor teeth following supernumerary tooth extraction. STUDY DESIGN: This is a retrospective study. METHODS: Records of children attending the Departments of Paediatric Dentistry, Edinburgh Dental Institute, Lothian Primary Care NHS Trust and Dundee Dental Hospital, Tayside University Hospitals Trust between 1995 and 2002 were examined with regard to non-eruption of one or both maxillary central incisors in association with supernumerary teeth requiring surgical removal. Subsequent permanent maxillary incisor eruption was recorded and in those cases of incisor non-eruption, further surgical interventions were noted. RESULTS: In all 118 sets of patient records were included in the study (87 males, 31 females) with a mean age at presentation of 8.8 years (range 5.3-11.6 years). Failure of eruption of the associated permanent maxillary central incisor teeth occurred in 27% of cases, in relation to both conical and tuberculate supernumerary teeth. All tuberculate supernumerary teeth associated with non-eruption cases were palatally placed and 59% were adjacent to maxillary incisors with near complete apex formation. To facilitate incisor eruption in these cases, 41% required surgical exposure of the non-erupted incisor tooth and 59% required surgical exposure with bonding of an orthodontic bracket and gold chain for orthodontic traction. CONCLUSION: Non-erupted permanent maxillary incisor teeth with near complete apical formation, associated with palatally placed, tuberculate-shaped supernumerary teeth, may benefit from having an orthodontic bracket and gold chain placed at the same time as the surgical procedure to remove the supernumerary tooth to facilitate future orthodontic traction.

Child↗
PubMed2004

[Use of osteoconductive materials in pediatric dental medicine].

Osteoconductive materials are well known to have the ability to form a characteristic scaffold for bone replacement. The use of these agents is mostly described in periodontal procedures. The present study deals with the use of two different osteoconductive materials used for repairing bone defects following traumatic injuries. The materials used were Bio-Oss (Geistlich) an allogenic demineralised bone and Fisiograft (Ghimas) a synthetic co-polymer of polyglicolic and polylactic acid. These materials were used in five different clinical cases with the objective to compare their typical properties during application and to evaluate radiographically and clinically their healing ability. In three cases filling of the alveolus was performed after extraction of traumatised incisors as a consequence of root resorption or fracture; two patients suffered from periodontal defects. All cases were followed every three months for at least two years and maximum 6 years. Regarding the handling of the materials all products were well accepted. From our clinical experience all modalities are found to be suitable. After clinical and radiographical evaluation normal bone formation was found in all cases without any complaints nor clinical symptoms. These clinical findings support the use of osteoconductive agents in the field of Paediatric Dentistry in well-defined indications.

Adolescent↗
PubMed2005

Nitrous oxide inhalation sedation: what do patients, carers and dentists think about it?

AIM: To determine the acceptability and efficacy of nitrous oxide inhalation sedation for dental treatment to children and to compare these results with the responses of both the accompanying adult and the treating dentist. STUDY DESIGN: A prospective, questionnaire-based survey was used. METHODS: Fifty consecutive patients (ASA I and II) attending the Department of Paediatric Dentistry, Edinburgh Dental Institute, between 2002 and 2003 for dental treatment using nitrous oxide inhalation sedation were recruited for the study. Each patient, the accompanying adult and the dental sedationist completed a short questionnaire which sought details about the acceptability and efficacy of the sedation technique. Overall behaviour and the outcome of treatment were assessed by the dentist providing sedation using the Frankl and Houpt Behaviour Rating Scales respectively. RESULTS: Three sets of questionnaires were completed for fifty patients (M:27; F:23), mean age 10.4 years (range: 5.3-15.8 years). Acceptance of both local analgesia and dental treatment was perceived as greater amongst patients and carers compared with treating dentists (chi2 = 11.31, P = 0.004, 2 df and chi2 = 22.52, P < 0.001, 2 df respectively). Furthermore, dentists observed that inhalation sedation helped fewer male patients with local analgesia and fewer female patients with dental treatment (chi2 = 6.83, P < 0.009, 1 df and chi2 = 3.85, p < 0.050, 1 df respectively). A greater proportion of dentists observed that patients would manage treatment without sedation and would not require sedation for future dental treatment than both patients and their accompanying carer (chi2 = 8.00, P < 0.018, 2 df and chi2 = 18.61, P < 0.001, 2 df respectively). In general, the majority of patients were co-operative and successfully completed dental treatment with inhalation sedation. CONCLUSION: Dentists' perception of nitrous oxide inhalation sedation was generally less enthusiastic than that of patients and carers.

Adolescent↗
PubMed2005

Location, complications and treatment of mesiodentes--a retrospective study in children.

Out of approximately 11 500 children, who had been referred to the Department of Paediatric Dentistry at the Institute for Postgraduate Education,Jönköping, Sweden, 97 individuals had a total of 123 mesiodentes. Their dental records and radiographs were analysed in order to study the clinical and radiographic features of the mesiodentes, to record the complications caused by them and to evaluate different forms of treatment. In the present study, the predominant location of the mesiodentes was palatally with 39 per cent in an inverted position. Arrest of the permanent incisors eruption, midline diastema and displacement or rotation of the incisors, were the most common complications found. On the contrary, no follicular cysts or resorption of either the mesiodens or the adjacent teeth were found. Fourty-three out of the 97 individuals were radiographically followed and no pathological findings were recorded. This study shows that the risk of complications caused by the mesiodentes seems to be very low and therefore a more restrictive attitude towards their surgical removal can be recommended.

Adolescent↗
PubMed2005

An evaluation of the Child Perceptions Questionnaire in the UK.

OBJECTIVE: To assess the reliability and validity of the Child Perceptions Questionnaire (CPQ11-14), an oral health related quality of life measure for 11-14 year old children, for use in the UK. BASIC RESEARCH DESIGN: Cross-sectional questionnaire and clinical analytical study. CLINICAL SETTING: Orthodontic and paediatric dentistry clinics at a dental hospital and one general dental practice. PARTICIPANTS: Eighty-nine children between 11 and 14 years of age attending for an examination. MAIN OUTCOMES MEASURES: The children were invited to complete the CPQ11-14, global oral health and impact on life overall ratings. Clinical data on caries status, malocclusion and presence of dental opacities and gingivitis were collected. CPQ11-14 was summarised as the total score (sum of the item codes) and the number of impacts reported often or every day. RESULTS: The Cronbach's alpha for the total scale was 0.87 and ranged from 0.59 to 0.83 for the subscales indicating acceptable internal consistency. The intraclass correlation coefficient on repeated application of the measure was 0.83 (95% CI = 0.76-0.90) suggesting almost perfect agreement. Summary measures of CPQ11-14 correlated with the global oral health rating indicating acceptable criterion validity. Impact on life overall was related to all summary measures of CPQ11-14. Number of impacts correlated with the total number of missing teeth and missing teeth due to caries. No other relationships between clinical and CPQ11-14 data were apparent. CONCLUSION: The CPQ11-14 shows acceptable reliability, criterion and construct validity in relation to life overall. Relationships with clinical data were more tenuous. If this measure is to be used to compare the impacts of oral diseases in similar settings in the UK a large sample will be required.

Adolescent↗
PubMed2005

Enamel defects in children with coeliac disease.

AIM: This was to investigate the prevalence of enamel developmental defects in a group of children with a history of coeliac disease. METHODS: A study group of children attending the Dept. Paediatrics (Leeds General Infirmary), born between 1985 and 1986 and subsequently diagnosed and treated for coeliac disease (CD) were recruited. A group of age/sex-matched children attending the Paediatric Dentistry department were used as a control group (Cont). Examinations were carried out for enamel defects and opacities (DDE index), dmf, dmfs, DMF and DMFS (BASCD method), and a full medical and dental history were obtained. RESULTS: Significantly more children in the CD group had a greater number of enamel defects than controls for both primary (p=<0.02) and permanent (p=<0.001) dentitions. Opacities in both primary and permanent teeth were statistically significantly greater in the CD group than controls (p=<0.04 and p=<0.001 respectively). Dental caries in both primary and permanent dentitions was less in the CD group compared with the control group of children. CONCLUSION: Coeliac disease was associated with an increased prevalence of developmental enamel defects.

Case-Control Studies↗
PubMed2006

Visual input effect on EMG activity of masticatory and postural muscles in healthy and in myopic children.

AIM: The purpose of this study was to evaluate the activity of Anterior Temporal, Masseter, Sternocleidomastoid and Anterior Digastric muscles in response to changes in visual input in subjects with defective vision by means surface electromyography. METHODS: A total of 20 children, aged between 7 and 13 years, were evaluated. In the study group 10 children with myopic defects were enlisted, selected among patients afferent to the paediatric dentistry clinic. Ten subjects with normal vision, the control group, were chosen through the Pair Matching procedures, so that each myopic child had a matching age case control. Both study group and control group patients maintained mandible at rest with teeth apart and were submitted to a 15-sec electromyography (EMG) recording with closed eyes followed by a 15-sec EMG recording with open eyes. RESULTS/STATISTICS: The Root Mean Square (RMS) values were elaborated to obtain means and standard deviation. Statistical analysis was undertaken using the Student's T-test for independent samples. Analysis of the results demonstrated a marked difference in tonic activity of temporal anterior muscles at open eyes between the myopic and the normal groups. CONCLUSION: The findings suggest that in the evaluation of masticatory muscles tenderness, such as episodic tension type headaches, attention should be paid to vision defects.

Adolescent↗
PubMed2006

Dental and periodontal health status in Campanian children and relation between caries experience and socio-economic behavioural factors.

AIM: Our aim was to record oral health situation through mean value of DMFT/dmft, Significant Caries Index (SiC) and CPITN values in a young-population sample in Campania (Italy) and to determine the possible relationship between oral health behaviour, socioeconomic factors and caries experience. STUDY DESIGN: Observational study. METHODS: 101 children (age range 5-18 years) were randomly selected from 10 public schools of the Regional Campanian district and visited at the Paediatric Dentistry Department of Federico II University of Naples (Italy). Clinical examinations were conducted, under standard light, using a plane buccal mirror, a dental probe and air drying to evaluate caries experience and a WHO CPITN ball-point probe to record the periodontal health of each child. A questionnaire (investigating demographic and oral health behaviour data) was filled. X-ray bitewing were also taken. The comparison of quantitative variables among groups was carried out using the one-way analysis of variance (ANOVA). RESULTS AND STATISTICS: The caries prevalence was 81%; the sample mean values were 3.5 (SD=3.79) for DMFT and 3.8 (SD=3.39) for dmft. The variables influencing statistically DMFT/dmft values in the sample are the following: family socio-economic level, level of educational attainment of children mothers and use of the school canteen service. Most of the examined children show CPITN levels between 0 and 1. CONCLUSION: Our results confirm a high caries prevalence and also a need for preventive and educational programmes to obtain caries decrease.

Adolescent↗
PubMed2006

Therapeutic approach to intrusive luxation injuries in primary dentition. A clinical follow-up study.

AIM: This paper reports the results of a fifteen-year study carried out at the Dentoalveolar trauma study Centre of the University of Cagliari Dental Department, on treatment modes utilised for the recovery of periodontal injuries in primary dentition. MATERIALS AND METHODS: The data referred to dental injuries were collected and recorded according to Andreasen's dental trauma classification: clinical signs and symptoms, patient's age and gender, lesion site and extent of the injury, timeframe between trauma and first dental examination. The authors focused their attention on intrusive luxations in primary dentition, which are a very frequent trauma in children between 1 and 4 years of age. It is extremely difficult to treat such injuries and there is an ongoing discussion about the advisability of extracting the intruded teeth, as opposed to wait and assist their natural repositioning using non-invasive techniques aimed at the maintenance of the eruptive space in the dental arch. RESULTS: This careful conservative approach allowed the repositioning of about 60% of the 85 intruded teeth examined. It substantially reduced the number and severity of undesirable sequelae, both local (enamel-hypoplasia) and occlusal (tooth retention), so that only in about 25% of the followed-up cases damages of the successor tooth were found in the permanent dentition. CONCLUSION: The authors conclude their study emphasizing that all those involved in paediatric dentistry must be familiar with periodontal injuries and trained in their treatment, particularly as regards intrusive luxations in primary dentition.

Child, Preschool↗
PubMed1991

Osseointegrated implants in the oral habilitation of a boy with ectodermal dysplasia: a case report.

The most characteristic oral feature in ectodermal dysplasia is hypodontia. Children and adolescents suffering from ectodermal dysplasia often need extensive and complicated prosthetic treatment. The development of techniques for osseointegrated implants offers new possibilities for the oral habilitation of these children. This paper describes the oral habilitation of a boy with severe ectodermal dysplasia and where Brånemark osseointegrated implants have been used as part of the treatment. The patient was seen at the dental department at the age of 1.5 years. Two conically-shaped upper incisors were at that time the only teeth that had erupted. The treatment was planned in a multidisciplinary odontological group involving paediatric dentistry, orthodontics, prosthodontics, oral surgery and maxillofacial radiology. At the age of 3 years it was verified that the boy had four primary teeth (53, 51, 61, 63) and four permanent teeth (16, 11, 21, 26). There were no teeth in the lower jaw. The alveolar ridges in the edentulous areas were low or missing. During the period 3-6 years of age the boy used an upper partial denture adapted to allow the mesial drift of the 16 and 26 teeth. At the age of 6 years, two Brånemark implants were inserted in the lower front-cuspid region. A specially designed overdenture for the lower jaw was constructed. The overdenture was retained in contact with the male attachments by two cuffs of heat-polymerized resilient silicone. Over the next 4 years the dentures were modified due to the eruption of permanent teeth and growth. However, only minor corrections were necessary concerning the retention system of the lower denture. The implants are well osseointegrated and stable and allow the boy to use a lower denture without any complications.

Anodontia↗
PubMed1990

[New methods and new technics in pedodontics: "conscious sedation"!].

The reasons why is it sometimes necessary to resort in paediatric dentistry to the use of conscious sedation with N2O/O2 are explained together with clinical indications and applications. The excellent results obtained with this technique lead to greater cooperation of the child, to a positive emotional contact with dental treatment and the possibility of performing the necessary therapies with greater precision.

Ambulatory Surgical Procedures↗
PubMed1990

The organisation of dental care for groups of mentally handicapped persons.

One hundred and eighty-nine mentally handicapped persons attending both residential and non-residential institutions were examined during 1984/85. All were assessed for treatment need for caries; periodontal need was also assessed in 43 of the older patients. At base-line examination it was found that a high proportion of the dental caries remained untreated and most of the treatment that was provided consisted of extractions. Treatment was subsequently provided by a health board dental officer, junior hospital staff, final year undergraduate students or a consultant in paediatric dentistry. Most treatment requirements were met by the non-consultant personnel. A follow-up examination completed during 1987 showed a considerable improvement in the treatment of caries; periodontal treatment need remained unchanged. It can concluded from this study that it is feasible to set up an effective dental service for mentally handicapped groups, that improvements in the treatment of dental caries can be achieved in a relatively short period of time and that most treatment requirements can be met by non-consultant staff. Continuing care, particularly for periodontal disease, remains a problem.

Adolescent↗
PubMedDate not supplied

Dental disease, caries related microflora and salivary IgA of children with severe congenital cardiac disease: an epidemiological and oral microbial survey.

The objectives were to determine levels of dental caries, plaque accumulation, gingival inflammation, knowledge of dental health practices, and oral bacterial loading of S. mutans, Lactobacillus sp., Candida sp., and salivary IgA in the mouths of children afflicted with severe congenital heart disease. A total of 60 children from the cardiac units of the Hospital for Sick Children and Guys Hospital Paediatric Department were compared with 60 case-matched control children from the Department of Orthodontics and Paediatric Dentistry, UMDS (Guys Dental School), London. Using the methodology of the World Health Organization, the decayed, missing and filled surfaces and teeth of primary (dmft) and permanent (DMFT) were compared. There were similar levels of caries in the cardiac (dmft 3.9 and DMFT 2.7) and the control (dmft 3.7 and DMFT 2.0). A significant difference was the proportion of untreated carious lesions in the cardiac group (52%) compared to the control group (32%; P < 0.001). Standard oral microbiological techniques were used to isolate S. mutans, Lactobacillus sp., Candida sp., and conventional methods for estimating salivary IgA. There was no difference between the cardiac and the control group. Children with severe congenital cardiac disease have moderately high levels of dental caries with a significantly greater amount of untreated disease. The high bacterial loading associated with high levels of bacterial dental plaque and gingivitis may put cardiac patients at unnecessary risk of developing bacterial endocarditis.

Adolescent↗
PubMed2026

Effectiveness of different anaesthetic techniques, agents and adjunctive interventions in handling pain during dental treatment of MIH-affected teeth: a systematic review.

BACKGROUND: Molar incisor hypomineralisation (MIH) is frequently associated with hypersensitivity, dental anxiety and reduced efficacy of local anaesthesia, complicating pain control during dental treatment in children. AIM: To evaluate, based exclusively on randomised controlled trials (RCTs), the effectiveness of different local anaesthetic techniques, agents and adjunctive interventions in reducing pain during dental treatment of MIH-affected teeth in children. METHODS: A systematic review was conducted following PRISMA 2020 guidelines and registered in PROSPERO (CRD420251150485). MEDLINE, Cochrane Central, ScienceDirect, SCOPUS, EBSCO, and LILACS were searched up to September 2025. Eligible studies were RCTs involving children and adolescents (6 - 18&#xa0;years-of-age) with MIH, assessing pain outcomes during dental procedures. Risk of bias was assessed using the Cochrane RoB 2 tool, and certainty of evidence was evaluated using the GRADE approach. RESULTS: Eight RCTs were included. Low-certainty evidence suggested that intraosseous anaesthesia and 4% articaine may reduce intra-operative pain compared with conventional techniques or 2% lidocaine. Adjunctive cryotherapy and pre-emptive ibuprofen showed potential benefits, but evidence was of very low certainty and limited to single trials. Findings for photobiomodulation were inconsistent across studies. Most trials were judged to be at high risk of bias, primarily due to lack of blinding and reliance on subjective pain outcomes. CONCLUSION: Current evidence supporting specific pain management strategies for MIH-affected teeth is limited and of low certainty. Whilst 4% articaine and intraosseous anaesthesia appear promising, well-designed, adequately powered RCTs with standardised pain outcomes are required to inform robust clinical recommendations.

Local anaesthesia↗