Carious Lesions In Children Research Articles

Evaluation of near-infrared digital imaging transillumination compared with bitewing radiography for proximal caries detection in children.

Limitations in traditional caries detection tools have driven the development of alternatives methods, focused on the early lesion detection such as near-infrared digital imaging transillumination (NIDIT). The aim of this study was to evaluate the performance of NIDIT compared with bitewing radiography (BWR) in the detection of interproximal carious lesions in children. A retrospective audit of data from children who had NIDIT, BWR and intraoral photographs was conducted. Carious lesions were scored on a tooth surface level with BWR acting as the primary reference for comparison. Accuracy was determined using multi-class area under the curve (AUC), and correlation was determined using Fleiss' Kappa. Data from 499 tooth surfaces involving 44 children were included in this study. The average age across the participants was 86 months (~7 years) with an average dmft (decayed, missing and filled teeth in primary dentition) of 5.29. Multi-class AUC comparing NIDIT to BWR was 0.70. The correlation between NIDIT and BWR was moderate (0.43), whereas the correlation between photographic examination and BWR was 0.30, which is fair. When compared to BWR, NIDIT showed a high specificity but a low sensitivity for proximal caries detection in primary teeth.

Examining the Efficacy of 38% Silver Diamine Fluoride in Halting Active Dental Caries Lesions Among Children: A Descriptive Study.

Dental caries, a prevalent issue among children, often leads to discomfort and potential complications. Utilizing caries-arresting treatments to slow down its progression offers a practical alternative. Previous research indicates that topical fluorides can deactivate and remineralize enamel caries. This study aims to evaluate the efficacy of 38% silver diamine fluoride (SDF) in halting active dental caries lesions in children. This descriptive case series was conducted at the Operative Dentistry Department of the Nishtar Institute of Dentistry in Multan, Pakistan. We enrolled 753 patients aged three to nine years, of both genders, each with at least one cavitated lesion graded 3-6 according to the International Caries Detection and Assessment System (ICDAS). SDF was directly applied to dried and isolated teeth using a micro brush and left to absorb for up to two minutes (adjusted based on the child's cooperation), and parents were instructed to ensure the child refrained from eating or drinking for an hour post-application. Baseline examinations were performed by consultant restorative dentists, and reexaminations were conducted after two to three weeks by a consultant unaware of the study. The study included children aged three to nine years, with a mean age of 6.02±1.35 years. The majority of patients (61.75%) were aged between three and six years. Among the 753 patients, 619 (82.20%) were male, and 134 (17.80%) were female, with a male-to-female ratio of 4.6:1. The efficacy of 38% SDF in arresting active dental caries lesions in children was observed in 720 (95.62%) patients. This study demonstrates that 38% SDF is highly effective in halting active dental caries lesions in children.

Efficacy of a high concentration of nano silver fluoride in preventing caries: A randomized controlled trial.

To investigate the effectiveness of a novel agent containing Nano Silver Fluoride 1500 (NSF 1500) and chitosan to inactivate carious lesions in children. The study included eighty children. While both groups had fluoride dentifrice applied to their teeth, only the experimental group received treatment with the NSF 1500-ppm solution. The first and sixth-month interval examinations were conducted by two calibrated dentists (k = 0.85). The NSF 1500 group had 69.2% of their teeth with arrested decay, while the control group had 24.1%. The difference was statistically significant (p 0.001), with a preventive fraction of 59.4%. The number needed to treat (NNT) was approximately two. The NSF 1500 formulation was more effective than toothbrushing alone with fluoridated dentifrice in preventing dental caries. The effectiveness of NSF 1500 is determined by the size and depth of the dental cavity. Its ability to arrest caries lesions was comparable to previously tested products, NSF 400 and NSF 600. Key words:Preventive dentistry, dental caries, nanoparticles.

Association of masticatory efficiency with deep carious lesions in children.

Masticatory efficiency is defined as an individual ability to grind and pulverize food material, and can be influenced by many factors. This research aimed to investigate the association between masticatory efficiency and deep carious lesion. The research included 48 children (24 male, 24 female) aged from 3 to 14years. Participants were allocated to two groups; children with no or with only incipient carious lesions were included in the first group (ICDAS levels 0, 1, or 2), and children with bilateral deep carious lesions that are ICDAS levels 4, 5, and 6 were included in the second group. Information on dental parameters (dental status, ICDAS level of each carious lesion), and level of pain (Wong-Baker scale) were collected from each participant. Participants chewed Optosil® test food for 20 masticatory cycles, and chewed particles were analyzed by the optical scanning method. There is a significant difference in masticatory efficiency variables (number of chewed particles, minimal and maximal Feret diameter, Sauter mean diameter, a mean and total surface of particles) between groups. A positive significant correlation is observed between WBS level and time needed for masticatory performance in a group of children with deep carious lesions. Deep carious lesions in children are associated with a decrease in masticatory efficiency. Moreover, children with carious lesions that provoke a higher level of pain take more time for masticatory cycles.

Is Mutans Streptococci count a risk predictor of Early Childhood Caries? A systematic review and meta-analysis

BackgroundThe review aims to determine the risk predictability of mutans streptococci in the development of carious lesions in children with primary dentition.MethodsLongitudinal observational studies with at least 6 months follow-up and evaluating mutans streptococci presence in caries-free children under 6 years of age for the development of any cavitated or non-cavitated carious lesion. Six databases and grey literature were searched without any restrictions. Risk of bias was evaluated using the New Castle Ottawa scale for longitudinal studies, and the certainty of the evidence was evaluated by Grading of Recommendations Assessment, Development and Evaluation using GRADEpro software. Meta-analysis was performed using a random effect (DerSimonian and Laird, DL) model, and heterogeneity was evaluated using tau-squared, I2 statistics and prediction interval. Sensitivity analysis was performed to assess the relationship between the mutans streptococci presence at baseline and the caries development, according to the sample and methods used for the microbiological assessment and the length of follow-up of the studies. Publication bias was checked by funnel plot using a random effect (DerSimonian and Laird, DL) model.ResultsTwelve studies met the inclusion criteria and were included in the review. Four studies received a maximum of 9 stars, and among the remaining eight studies, six received 8 stars and the rest two studies were assigned 7 stars in the risk of bias scale. After pooling the results quantitatively, odds ratio (OR) was found to be 4.13 (95% CI: 3.33, 5.12), suggesting that children with mutans streptococci had 4 times higher odds of developing caries later (p < 0.001). Four studies were pooled to compare future caries experience among children with and without mutans streptococci at baseline, obtaining standardized mean difference (SMD) of 0.85 (95% CI: 0.33, 1.37), indicating a large effect (p < 0.001). Certainty of evidence was found to be moderate, and no publication bias was reported by the funnel plot criteria of symmetry.ConclusionsPresence of mutans streptococci in a preschool child is a risk predictor for future caries experience. Early identification of children with increased caries-risk may facilitate in implementation of appropriate preventive strategies.

Parents' acceptance of minimal intervention procedures for dental caries management in children: a scoping review.

In recent years, minimal intervention procedures (MIPs) for treating dental caries in children have stood out as an innovative method. Nevertheless, the treatment decision should be based on scientific evidence, professional expertise, and parents' preference/acceptance. Evaluating the acceptance of MIPs by parents is an essential factor, but little information is available on what guides this preference. This scoping review aims to synthesize the evidence on parents'/caregivers' acceptance of MIP for managing cavitated caries lesions in children. A search was performed in the PubMed, Cochrane Library, Lilacs and Google Scholar databases with no restriction on date or language. A total of 19 articles were selected (6 clinical trials, 1 longitudinal and 12 cross-sectional studies). The application of silver diamino fluoride (SDF) was the most commonly evaluated procedure (n = 17), followed by the atraumatic restorative technique (ART) and the Hall Technique (HT). The acceptance of MIPs ranged from 1.4% to 100%, and the application of SDF was better accepted in posterior teeth and in uncooperative children. ART had better aesthetic acceptance than HT. Application of SDF, Hall Technique and ART was well accepted by parents/caregivers. However, a gap remains in the literature regarding the acceptance of other procedures. Therefore, further studies in this area will contribute toward a better understanding of the opinion of parents/caregivers, and thus improve caries lesion management in children.

Dental Loupe’s Role in Detection of Caries of Molars in Children by Student and Dentists

Purpose: The objectives of this study were to examine the effectiveness of diagnosing occlusal caries in molar teeth in children under the use of loupes and, secondarily, to examine whether there is a difference in the diagnosis between permanent and primary teeth using dental loupes. In addition, to check whether the student’s diagnosis using loupes improves caries diagnosis compared to dentists’ diagnosis in both methods. Methods: The data were collected from 163 patients aged 6–14 who sought treatment in the Pedodontic Department of the Faculty of Dentistry at Tel-Aviv University during 2020–2021. The first and second permanent molars and second primary molars with deep groves were examined. A student and dentists made the diagnosis with and without loupes while using the ICDAS criteria. Results: The student’s examinations without the loupes detected no caries in 60% of the cases compared to 76.9% in the examinations with the loupes and found initial caries without cavitation (ICDAS1) in only 17.6% of teeth without loupes examination compared to 33% using loupes. The dentist correctly diagnosed no caries (ICDAS0) in 82.1% of cases without loupes and initial caries without cavitation (ICDAS1) in 62.5% of cases. The dentist correctly diagnosed distinct caries without cavitation (ICDAS2) in 90.8% of cases. No differences were observed in caries diagnosis between primary and permanent teeth when the examiner was a specialist/intern using loupes; however, there was a statistically significant difference (p = 0.047) when the diagnosis was made by a student using loupes. Clinical significance: The use of dental loupes is an effective method for the correct and early diagnosis of occlusal caries lesions in children’s molar teeth by both dentists and students, and this is in accordance with the principle of minimally invasive dentistry. There is a justification for the use of dental loupes for the diagnosis of initial occlusal caries in primary and permanent molars in children in a precise way. Using loupes especially improves the correct diagnosis of initial caries in primary teeth by students.

The Effect of Motivational Interviewing on Reduction of New Carious Lesions in Children with Early Childhood Caries: A Systematic Review and Meta-analysis.

Preventive therapies rely on effective behavior change. Motivational interviewing (MI), has been the most recent advancement in behavior therapies that have been successful in tobacco cessation. The effectiveness of MI needs to be evaluated in caries prevention. To evaluate the effectiveness of MI on the reduction of new carious lesions in children with early childhood caries (ECC). The two authors independently searched data from Cochrane Library, PubMed, Google Scholar, J gate, and Quintpub. Selection criteria-interventional studies written in the English language with MI as an intervention, a mean follow-up period of atleast 2 years, ECC with decayed, missing, and filled primary teeth/decayed, missing, and filled primary surfaces (dmft/dmfs) as the outcome measures, in the age group of 0-6 years. We excluded cross-sectional studies. Information regarding methods, participants, interventions, outcome measures, and results were extracted. A risk of bias assessment within and across studies was conducted. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria were applied to generate quality evidence. Six studies with a total of 2,663 participants were included in the review, and meta-analysis was conducted on 4; 3 studies had a high risk of bias. A mean reduction of 2.16 (-5.06, 0.75) was observed with MI as an intervention. A sensitivity analysis revealed a mean reduction of 3.64 (-5.77, -1.51) in favor of MI. There is some evidence with moderate certainty that MI is beneficial in the reduction of new carious lesions in children with ECC. Manek S, Jawdekar AM, Katre AN. The Effect of Motivational Interviewing on Reduction of New Carious Lesions in Children with Early Childhood Caries: A Systematic Review and Meta-analysis. Int J Clin Pediatr Dent 2023;16(1):112-123.

Serum levels of chemical elements and carious lesions in children after antitumor therapy

Aim. To study serum concentrations of trace and macro elements and their correlations in children and adolescents after antitumor therapy, depending on the presence or absence of caries.Materials and methods. The study included 98 patients aged 4 to 17 years who were in remission after an antitumor therapy performed for acute leukemia or lymphomas. Patients with carious tooth lesions were included in group 1 (n = 34) and without caries – in group 2 (n = 64). We used inductively coupled plasma mass spectrometry to calculate the content of essential, conditionally essential and toxic elements in blood serum. The median and interquartile range were calculated, the Mann-Whitney U-test was applied to compare groups, and the Kendall rank correlation coefficient (τ) was calculated for tandem elements.Results. In both groups, the concentrations of the studied elements were within the reference ranges. In group 1, compared with group 2, higher concentrations of potassium, arsenic, iodine and boron and lower concentrations of lithium and tungsten (p &lt; 0.05) were noted. There were no differences in the concentration of phosphorus, calcium, magnesium, manganese, gold, silver, platinum, aluminum, beryllium, bismuth, cadmium, cobalt, chromium, copper, iron, mercury, lithium, molybdenum, nickel, rubidium, antimony, tin, vanadium, zinc, zirconium and thallium between the groups. Significant correlation coefficients in both groups were obtained for the iron/manganese tandem (τ = 0.24, p &lt; 0.05). Different values of τ were got for nickel/ manganese, cobalt/iron, manganese/phosphorus, beryllium/lithium tandems: τ = 0.342 and τ = 0.14; τ = 0.363 and τ = 0.033; τ = –0.111 and τ = –0.326; τ = –0.365 and τ = 0.42, respectively, for groups 1 and 2.Conclusion. In patients in remission after antitumor therapy, an association of caries with an increase (within reference values) in the concentration of essential (potassium, iodine) and conditionally essential elements (arsenic, boron), a decrease in the concentration of lithium and tungsten; as well as a change in the ratio of nickel/manganese, cobalt/iron, manganese/ phosphorus and change the direction of the correlation in the beryllium/lithium tandem was revealed.

Chapter 8: Risk Assessment: Considerations for Coronal Caries.

Caries risk assessment (CRA) is essential to delivering personalized/precision care in caries management. Limited formal evaluation and validation of existing CRA tools affects the ability to accurately predict new lesions. However, this should not prevent clinicians from assessing modifiable risk factors to guide preventive measures and address individual needs to personalize care. Since caries is a multifactorial and dynamic disease process, CRA is complex and impacted by multiple variables throughout the life course, demanding periodic re-assessment. Many factors can influence caries risk at the individual, family, and community level; however, unfortunately, caries experience is still considered one of the greatest indicators of future risk for caries. CRA tools that are validated, inexpensive, and easy to use should be developed and prioritized to help support decision-making to implement evidence based, and minimally invasive caries management strategies for coronal caries lesions in children, adults, and older persons. Efforts into developing CRA tools should include evaluation and reporting of internal and external validation information. In the future, approaches using big data and artificial intelligence may drive risk predictions, and cost-effectiveness analyses may help derive the selection of appropriate risk thresholds for decision-making. Because of the importance of CRA in the treatment planning and decision-making process, challenges for implementation including how to communicate risk to drive behavior change, development of tools that are quick and easy to integrate seamlessly into the busy clinical flow, and reimbursement for the time needed to implement should be considered.

Management Thresholds for Molars With Occlusal Noncavitated Caries Lesions

AimThere is sparse research on the effect of factors related to the dentist and patient in the caries management decision-making process. This in vitro study explored the influence of factors related to dentists and patients on the management decision of occlusal noncavitated caries lesions in children. Materials and methodsFive investigators in the specialties of dental public health (DPH), paediatric, prosthetic, and operative dentistry and a general dentist (GDP) participated in this study. Initially, the investigators were asked to independently assess the occlusal surfaces of 175 noncavitated permanent molars and choose a management recommendation using 2 caries risk patients’ scenarios. After 1 month, investigators were trained and calibrated to use the International Caries Detection and Assessment System (ICDAS) scoring system. Then, they examined the same teeth, recorded the highest/worst ICDAS score, and chose a management recommendation. Two weeks later, the investigators repeated the teeth examination using magnification loupes and again chose a management recommendation. The teeth were sectioned to study the relationship between the presence of caries and the management recommendations. ResultsFor the low– and the high–caries risk scenarios, ICDAS training increased the operative intervention by 20% to 27% and 14% to 22%, respectively, for both the GDP and the paediatric dentist (P < .0001). For the low–caries risk scenario, using the magnifying loupes increased the operative recommendations for the DPH, GDP, and the operative dentist by 5% to 23% (P < .05). Compared to the low–caries risk scenario, teeth for patients with high caries risk received more surgical interventions (9%-30%) at all examination conditions for the GDP and the paediatric and operative dentists (P < .0001). ConclusionsFor occlusal noncavitated caries lesions, enhancing dentists’ caries detection skills had a significant impact on decisions of surgical intervention. This also influenced the appropriateness of the treatment recommended for the different caries risk groups.

Comparative real-time PCR quantification of cytomegalovirus in severe early childhood caries and caries-free children

The present study was undertaken to evaluate cytomegalovirus (CMV) load in carious lesions in children with severe early childhood caries (S-ECC) and compare it with caries-free (CF), healthy children, by quantitative real-time polymerase chain reaction (PCR). Dental plaque samples were collected from 57 subjects including S-ECC (n = 33) and CF (n = 24) patients. The two groups were matched in terms of age, gender, and socioeconomic status. After deoxyribonucleic acid (DNA) extraction, SYBR Green real-time PCR was used to quantify CMV DNA. The CMV DNA was detected in seven patients in theS-ECC group. The mean of decayed, missing, and filled tooth surfaces (dmfs) was 11.90 ± 5.95 in the S-ECC group. There was no significant difference in gender between the two groups. There was a significant relationship between CMV positivity in children and theS-ECC group (p = 0.043). Results of this study suggest a relationship between the presence of CMV in the oral cavity and S-ECC. We can design clinical trials to confirm these results and improve children's dental care.

Novel endodontic simulation trainer for dental pulpotomy and pulp capping

Pulp exposures are the common problems encountered during the management of deep carious lesions in children and adolescents. The clinical skill plays an important role to achieve cooperation, reduced chair side time, and total patient care. This article describes a novel endodontic simulation trainer for dental pulpotomy and pulp capping. The simulator described in the article provides advantages such as life size design, easy to use, and cheaper to fabricate with good functional fidelity. This invention has the advantage that the pellet is replaceable, and so the procedure can be done multiple times simply by replacing it with a new pellet.

Study protocol for a randomized clinical trial to evaluate the effect of the use of Xylitol gum in the prevention of caries lesions in children living in Ladakh\u2014the Caries Prevention Xylitol in Children (CaPreXCh) trial

BackgroundXylitol use is reported to be able to reduce dental plaque amount and cariogenic bacteria and, as a consequence, the caries increment. Only few data on the oral health of Ladakh’s population are available. The aim of the present protocol will be to record the caries prevalence of primary and permanent molars of schoolchildren living in Ladakh and to implement a school-based Xylitol programme, named the Caries Prevention Xylitol in Children (CaPreXCh) trial, using chewing gums.MethodsThe protocol is designed as a triple-blind randomized, controlled, parallel-group clinical trial in children aged 5–14 years. The study should have been carried out from August 2021 to August 2024 in Zanskar Valley (Ladakh), but the COVID-19 pandemic does not allow today to make predictions on the exact start. Participants will be randomly allocated into two groups: subjects who will receive a chewing gum with Xylitol (70% w/v) as only sweetener, and those who will receive a sugared chewing gum containing Maltitol (23% w/v). The subjects will be instructed to chew a total of 6 pellets for 5 min divided into 3 intakes a day (2 in the morning, 2 after the midday meal and 2 in the afternoon) for one school year. Clinical examination will comprise an oral examination in which caries index (ICDAS scores), bleeding on probing and plaque pH evaluation after sucrose challenge will be recorded at baseline (t0); the clinical examination will be repeated after 12 months since the beginning of the chewing gum administration period (t1), after another 12-month period (t2) and finally after further 12 months (t3) (24 months from the end of the chewing gum use). The primary outcome will be the caries increment measured both at enamel and dentinal levels on primary and permanent molars. Data analysis will be conducted through Kaplan-Meyer graphs to evaluate caries increment. A comparison of the methods will be carried out with Cox regression with shared frailty. The net caries increment for initial, moderate and severe caries levels, using ICDAS (Δ-initial, Δ-moderate and Δ-severe), will be calculated.DiscussionThis trial will be the first trial conducted in India assessing the efficacy of a school-based caries preventive programme through the use of chewing gum containing only Xylitol as a sweetener. The findings could help strengthen the evidence for the efficacy of Xylitol use in community-based caries prevention programmes in children.Trial registrationClinical trials.govNCT04420780. Registered on June 9, 2020

\u201cI guess it looks worse to me, it doesn\u2019t look like there\u2019s been a problem solved but obviously there is\u201d: a qualitative exploration of children\u2019s and their parents\u2019 views of silver diamine fluoride for the management of carious lesions in children

BackgroundDespite growing evidence to support the use of silver diamine fluoride (SDF) for managing carious lesions, and the increased interest in SDF worldwide, uptake in the UK remains limited. This study explored parents’ and children’s views and acceptability of SDF for the management of carious lesions in children.MethodsEleven semi-structured face-to-face interviews were conducted with 11 parent–child dyads recruited from patients attending Dundee Dental Hospital and School. Interviews were transcribed verbatim, coded and thematically analysed.ResultsPrevious dental experience varied across all child participants. Of the 11 children, five had undergone general anaesthesia (GA) for multiple primary tooth extractions. Two had received SDF treatment. Child participants expressed concerns about being picked on by their peers, if they had discoloured anterior teeth. Younger children appeared less concerned about the discolouration and child’s gender did not appear to influence parents’ decision-making, nor the child’s preferences regarding the use of SDF. Parents considered SDF to be particularly useful for anxious or uncooperative children but raised concerns about potential bullying at schools due to the unacceptable dental aesthetics when SDF is applied to anterior teeth. They believed they may be judged by others as neglecting their child’s oral health due to the black staining. Both parents and children were more accepting of the SDF when applied to less-visible posterior teeth. Parents accepted the use of SDF if such treatment avoided extractions under GA.ConclusionDespite the unfavourable aesthetics of SDF (black staining), parents appreciated SDF treatment, especially for uncooperative or younger children. However, both parents and children shared concerns about bullying at schools as a consequence of the black staining. Raising awareness about SDF was identified as one approach to encourage the uptake of SDF.

Best Treatments for Deep Caries Lesions in Children

Best Treatments for Deep Caries Lesions in Children

Design and evaluation of a booklet for the Oral Health Program in children from birth

There is no preventive control of oral health from birth in Spain. This situation entails a number of risks, such as increased caries lesions in children. The objective of this study was to design a pediatric dentistry booklet for the clinical assessment and follow-up of oral health in children, as well as its evaluation by health professionals and parents. Design of the booklet, in 2018, by pediatric dentists of the Murcia University Dental Clinic, based on a biblio-graphic review, to instruct in preventive (dietary and oral hygiene) and curative (planning of pediatric dental visits and treatments) habits. A convenience sampling of forty pediatric dentists, dentists, pediatricians and parents was carried out to evaluate the preliminary design, in 2019. They completed a questionnaire with their data, opinion on different aspects of the booklet and suggestions. The evaluation of the preliminary version of the booklet by health professionals and parents was positive. It was modified in line with their suggestions and the final version was made: a 16-page booklet, with data on the child's affilia-tion and parents, with a preventive and curative approach, making pediatric and pediatric dental check-ups coincide in time. The pediatric dentistry booklet was created and has been positively valued by professionals and parents, its use is recommended for early dental care, and can be extended to other health systems at the regional level in Spain.

Children Oral Health Following Treatment under General Anesthesia: A Retrospective Study

Introduction: Dental treatment for children can be provided and completed in dental chair using one or more behavior management methods applied in dentistry. When these methods did not work, special behavior management technique such as treatment under general anesthesia (GA) may be provided for optimal dental treatment. The purpose of this study was to evaluate long term oral health status such as oral hygiene (OH), recall rate, behavior changes and development of new or recurrent carious lesions in children who received dental treatment under GA. Methods: Data were collected retrospectively from dental records of 433 children who received dental treatment under GA between 2006 and 2010. Collected data looked at 1) Age, 2) Gender, 3) OH before treatment and at the recall visits, 4) Behavior changes, 5) New or recurrent caries experience, and 6) Treatment of these lesions. Results: Age of patients ranged between 2 and 13 yrs. Boys to girls were 223 (51%) to 210 (48%) respectively. OH post operatively was significantly improved in comparison to that before treatment (p-Value &lt; 0.0001). However, OH was almost the same among patients who attended recall visits (p-Value = 0.79). Number of patients who attended recall visits reduced significantly by time (p-Value &lt; 0.0001). There was significant improvement in patient cooperation post operatively in comparison to that pre-operatively (p-Value &lt; 0.0001). There was no significant difference in the incidence of new or recurrent carious lesions through recall visits (p-Value = 0.73). Conclusion: Dental treatment under GA did not seem to be effective in the improvement of OH or in reducing caries experience. However, children behavior showed some improvement in the follow up visits due to no active treatment required or simple dental procedures may be implemented.

Prefabricated Zirconia Crowns – A Solution to Treat Hypomineralized Permanent Molars: Report of a Case

The presence of carious lesions in children associated with developmental defects of enamel is frequently observed. Restoring these affected teeth can be a challenge for the clinician. Teeth with enamel defects may have poor or limited resin adhesion and some may require repeated restoration. Prefabricated zirconia permanent molar crowns were recently introduced as an option for restoring severely decayed and broken down young permanent molars. These new restorations offer an efficient, esthetic, and economic option to restore severely broken down carious permanent molars that may be associated with enamel defects in partially or fully erupted molars. A clinical case of a 13-year-old female patient is presented. She had a mandibular second permanent molar that demonstrated significant caries and loss of much of the clinical crown, which was treated with a vital pulpotomy and restored with a prefabricated zirconia crown.

Effectiveness of the use of xylitol chewing gum in prevention of dental caries: A systematic review.

This systematic review of the literature assessed the effectiveness of using chewing gum containing only xylitol compared to prevention strategies or placebo in reducing the incidence of carious lesions in children using data obtained from randomized controlled trials. Electronic search was carried out in PubMed MEDLINE, Latin American and Caribbean Literature on the Health Science, Web of Science, Scopus, Science Direct, and Scientific Electronic Library Online through the period between 2000 and 2020. Included clinical studies were done in children when the xylitol was dispensed in gum and the preventive effect of xylitol on tooth decay was compared to other preventive strategies or control groups. The studies were evaluated for their quality to obtain the level of evidence. The preventive fraction of each study was extracted. Two hundred studies were found. After analyzing the inclusion and removal of duplicates, only five studies were analyzed for the quality of evidence. With the analysis through the Grading of Recommendations Assessment, Development, and Evaluation system, it was possible to verify the very low level of scientific evidence on the effectiveness of gums containing only xylitol for the prevention of caries in children. The preventive fraction obtained varied between - 0.31 and 0.57 depending on the compared prevention strategy. The conflicting results, limitations, and inconsistencies of the studies allow us to establish that there is insufficient evidence to support the use of gums containing only xylitol for the prevention of caries in children. Other properly designed clinical trials need to be carried out.