First Permanent Molars In Children Research Articles

Ectopic eruption of maxillary first permanent molars: Risk factors and association with alveolar and maxillary characteristics on children

Background/purposeThe etiology of the ectopic eruption (EE) of the maxillary first permanent molars (FPM) remains unclear and controversial. This study was designed to explore the dental and skeletal factors for EE of the FPM in children. Materials and methodsChildren aged 6–10 years were recruited to this study. Subjects were assigned to the ectopic eruption group (EEG) and the normal eruption group (NEG). Lateral cephalometric radiographs and panoramic radiographs were measured by angular and linear indices. ResultsThe prevalence of EE of maxillary FPM was higher in males and at younger ages. Subjects with skeletal class III malocclusion were more likely to be diagnosed with EE of maxillary FPM. The SNA, ANB, FMIA, Wits, Ptm-A, ANS-PNS, overbite, and overjet were significantly different between the EEG and the NEG. The length of the posterior region of the maxillary alveolar bone, U6-OP, and eruptive angulation of the maxillary FPM were statistically different between the two groups. ConclusionMale sex, skeletal class III malocclusion, mesial inclination of the maxillary FPM, hypoplasia of the maxilla, and insufficient length of the posterior region of the maxillary alveolar bone were related to EE of the maxillary FPM.

Outcomes of coronal pulpotomy on permanent first molars in children: a retrospective cohort study.

To investigate the survival probability of permanent first molars (PFMs) after coronal pulpotomy (CP) using two outcome definitions: success-focused and functional survival-focused, and to identify factors influencing tooth survival. A retrospective cohort study reviewing records of children undergoing CP with calcium silicate-based cements (CSCs) on PFMs. Each CP-treated PFM was classified as success, uncertain, failure, or censored. Survival probability was analyzed using Kaplan-Meier estimators. Success-focused definition considered failures and uncertain outcomes as events, while functional survival-focused definition considered only failures as events. Prognostic factors were analyzed using Cox regression analysis. Seventy-seven CP-treated PFMs with a follow-up period of 6-111months. Using the success-focused definition (two failures and 12 uncertain outcomes as events), survival probabilities were 93.1% (95% CI 84.3-97.1%) at 12months, 78.7% (95% CI 65.6-87.3%) at 36months, and 74.9% (95% CI 59.5-89.0%) at 60-111months. However, with the functional survival-focused definition, survival probabilities were 100% at 12months and 96.6% (95% CI 86.9-99.1%) at 24-111months. In multivariable analysis, proximal lesions increased failure risk compared to occlusal lesions (HR 17.17, 95% CI 2.18-135.31, p < 0.01), and resin composite restorations had higher failure risk than stainless steel crowns (HR 13.97, 95% CI 1.49-130.69, p < 0.05). CP using CSCs shows long-term survival potential as an alternative treatment for cariously exposed PFMs in children. Proximal lesions and resin composite restoration could contribute to the lower survival, indicating the need for careful consideration of restoration options and lesion location during treatment planning.

Dynamics of Morphological Changes in Oral Fluid in the Prevention of Fissure Caries in Children

The purpose of the study was to investigate the morphological properties of oral fluid in dynamics in the application of the developed set of measures for the prevention of fissure caries of the first permanent molars in children. Materials and methods. 62 children aged 6 years with fissure caries of the first permanent molars (main group) and 31 children without signs of carious lesions (control group) were examined. The study of the crystal formation of oral fluid was carried out according to the method of Leus P. A. (1977). The mineralizing potential of oral fluid was expressed as an average score depending on the types of crystals detected. Results and discussion. The analysis of the results of the study showed that 6 months after the start of preventive measures in the oral fluid of the children of the main group, a slight increase in type I crystals was noted in comparison with the initial data (40.18 ± 4.65% of cases, p&gt;0.5), at the same time, the number of children, in whom type III crystals were observed, decreased in the main group (16.45 ± 2.32%, p&gt;0.5), and increased in the control group (19.32 ± 2.47% of cases, p&gt;0.5) in comparison with the initial data. After two years of observation, in the children of the main group, type I crystals were most often detected in the oral fluid (48.41 ± 4.23% of cases), in the children of the control group, on the contrary, the number of children with this type of crystals decreased and was almost one and a half times less than among children of the main group (p&lt;0.05). On the other hand, the number of children in the control group, in whom type III crystals were detected, was two times higher than among children in the main group (22.34 ± 2.87% and 11.51 ± 2.56% of cases, respectively, p&lt;0.05). Conclusion. It was established that in children who received a complex of preventive measures, 6 months after the implementation of preventive measures, the mineralizing potential of oral fluid was, on average, 2.73 ± 0.07 points, which is slightly higher compared to the fissure detected at the beginning of caries prevention (2.57 ± 0.12 points respectively, p&gt;0.05). In the children of the control group, the mineralizing potential of oral fluid changed less noticeably (from 2.64 ± 0.11 points at the beginning of observation to 2.66 ± 0.11 points, p&gt;0.5). After two years of observation, it was found that in the main group the mineralizing potential of oral fluid continued to increase, while in the children of the control group it decreased and reached almost the initial level (2.65 ± 0.07 points in the second year of observation and 2.64 ± 0.08 points at the beginning, p&gt;0.05). Thus, it can be concluded that the proposed measures are quite effective

Assessment of Permanent First Molars in Children Aged 7 to 10 Years Old.

Background: Dental caries is a chronic, infectious and preventable disease that is very common around the world. It has been observed that dental caries affect not only the majority of adults but also 60% to 90% of children. Permanent first molars (PFM) are the most commonly decayed teeth observed in children. Aim: The aim of this study is to evaluate the decayed, missing filled teeth (DMFT) scores of PFMs in the early post-eruptive stage, within the scope of the United Nations Agenda for 2030 Sustainable Development Goals, thereby raising awareness for the prevention and treatment of permanent tooth decay. Methods: This descriptive cross-sectional epidemiological study was conducted in Erzurum between the years 2015−2016 by collecting data from children aged 7−10 years (17,208). In addition to the decayed, filled and missing data of the students’ 6-year-molars, their ages, genders, frequencies of both tooth brushing and dental office visits were evaluated. The relationship between the variables was analyzed with chi-square. Result: The present study analyzed the data of a total of 11,457 children, 5704 girls and 5753 boys with a mean age of 8.74 ± 1.18. There was a statistically significant difference between the PFMs 16, 26, 36 and 46 regarding the number of healthy, decayed, missing and restored teeth (p < 0.001). Conclusion: In this study, the prevalence of caries in the PFMs of children aged 7−10 years was 15.9% and the mean DMFT was 0.79 ± 1.39. This result showed that PFMs might develop carious lesions and even be lost within three years in the early post-eruptive stage.

STUDYING OF CHARACTERISTICS OF THE EMERGENCE OF CARIES IN THE FIRST PERMANENT MOLARS IN CHILDREN IN THE FIRST YEARS AFTER THEIR ERUPTION

The highest percentage of lesions among permanent teeth in childhood occurs on the first permanent molars.&#x0D; Objective of our research was to study the peculiarities of caries development in the first permanent molars in childhood, taking into account their odontoglyphics in the first years after eruption.&#x0D; Materials and methods. The type of pattern of the chewing surface of the teeth was determined according to the schemes of odontoglyphic variants of molars of the upper and lower jaws, proposed by A.P. Hasyuk and Skrypnikov P.M. (2001) of 540 first permanent molars in 155 children aged 6 without pathology.&#x0D; To study the frequency of caries lesions of the first permanent molars, depending on their odontoglyphics, 268 teeth were selected from the examined teeth, which had the most common types of chewing surfaces. The dynamics of the occurrence of fissures caries and the localization of carious foci were studied in these teeth during the 3-year study.&#x0D; Results and discussion. During the 1st year of observation, the increase in caries of the chewing surfaces of the lower molars was 8,36% of the surfaces, of the upper molars – 5,05% of the surfaces. A year later, caries in the blind pits of the vestibular surfaces were diagnosed in the lower molars, and the caries prevalence of these surfaces was 0,58 +- 0,41%. After three years of observation, the prevalence of caries of the chewing surfaces of the upper and lower molars, as well as the vestibular surfaces of the lower molars, increased significantly and amounted to 14,93 +- 2,18%, 23,58 +- 2,71%, and 8,54 +- 1,78%.&#x0D; It was found that shortly after the eruption of the first permanent molars, caries appeared in the pits of their chewing surfaces. With time (after 12-36 months), along with the pits, the furrows of the chewing surface were also affected by caries. But during the full observation period, the number of carious pits was probably higher than the number of affected furrows.&#x0D; Conclusions. The obtained data encourage childrens’ dentists not only to carry out preventive measures in the first permanent molars of children in the early period after their eruption, but also to carry out sanitary and educational work among parents about the need for regular preventive examinations of children with the aim of early diagnosis of caries in the first permanent molars.

Ectopic Eruption of First Permanent Molars in Children from North-Western Romania.

Ectopic eruption of first permanent molars can lead to complications if left untreated. The aim of this study was to determine the prevalence of the ectopic eruption of first permanent molars in a sample of children from North-Western Romania, and to identify the characteristic of this anomaly in the studied population. We included patients aged between 5 and 9 years, and patients who needed a radiological examination for the diagnosis and treatment of dental or dento-maxillary diseases. The following exclusion criteria were applied: unclear or poor-quality radiographs; radiographs that belonged to patients who benefited from an orthodontic treatment before the panoramic radiograph was taken; patients who were undergoing orthodontic treatment when the radiograph was taken; and patients with local or general diseases that could influence dento-facial growth and development. Three degrees of severity were selected (moderate, severe, and very severe). The sample consisted of 438 patients, and 61 patients were diagnosed with ectopic eruption of first permanent molars (13.92%). Out of the 1752 analyzed molars, 103 were affected (5.87%). Patients with a moderate degree of ectopy were more frequently boys (56%, n = 14), while patients with a severe degree of ectopy were more frequently girls (52.8%, n = 19). Patients with a moderate degree of ectopy had significantly more frequently a unilateral position (57.1%, n = 16), while patients with a very severe degree of ectopy had significantly more frequently a bilateral position (36.4%, n = 12). The ectopic eruption was diagnosed at the level of the upper-right first permanent molar in a percentage of 18.4% (n = 19), at the level of the upper-left first permanent molar in a percentage of 17.5% (n = 18), at the level of the lower-right first permanent molar in a percentage of 32% (n = 33), and at the level of the lower-left first permanent molar in a percentage of 32% (n = 33). Although not very frequent, the ectopic eruption of first permanent molars is an important anomaly that should be early diagnosed, monitored and treated.

Is zirconium or stainless steel the most suitable crown material for less dentin stress in endodontically treated teeth?

Stainless steel crowns (SSCs), which have been used frequently in the treatment of first permanent molars in children until now, has become less applicable due to its poor aesthetic appearance. Zirconia crowns (ZCs) have become more popular due to their aesthetic advantage. However, stress transmission of ZCs to dental tissues under occlusal forces in endodontically treated teeth has not been described. The aim of this study was to compare the stress distribution of different crown materials (ZCS, SSCs) and adhesive materials on dentin in endodontically treated permanent teeth and to specify the crown-adhesive model with lower stress. Finite element analysis (FEA) was used to apply a force of 300 N from the inner part of the buccal tubercles (vertical loading) and a lingo-buccal at an angle of 30 degrees (oblique loading) of the first permanent molars (FPM) with different crown (ZCS, SSCs) and adhesive (Glass ionomer cement, Resin modified glass ionomer cement, Resin cement) materials in twelve separate models. The von Mises values obtained from the models were compared and the optimal stress values were determined by FEA. The lowest stress values of dentin were found in zirconia crown model with glass ionomer cement (GIC) adhesive under vertical loading (26,793 Mpa). In the zircon crown and GIC adhesive model, less von Mises stress occurred on the dentin under all conditions. ZCs and GIC adhesive may be recommended for teeth with a high probability of dentin fracture.

Managing compromised first permanent molars in children: minimally invasive treatment protocols for practitioners

Employing minimally invasive operative techniques to manage compromised first permanent molars is discussed as a treatment regimen to achieve a favourable medium-to long-term prognosis in modern paediatric dental management. It is known that patient cooperation, stage of dental development and eruption state, as well as chronological age and severity of tissue breakdown of the compromised tooth have an influence on the prognosis of treatment.CPD/Clinical Relevance: Understanding the various prognostic factors involving compromised first permanent molar teeth is essential if optimum treatment is to be provided.

Effectiveness of Silver Diamine Fluoride in Arresting Caries in Primary and Early Mixed Dentition: A Systematic Review.

Dental caries is a painful condition that could lead to nutritional problems which affects the overall health of the child, as well it is expensive to treat. The effectiveness of silver diamine fluoride (SDF) in primary and early mixed dentition is systematically reviewed in this study. This systematic review utilized the Preferred Reporting Items for Systematic reviews and Meta- Analysis statement (PRISMA, 2020). A literature search conducted using the common electronic databases (from 2010–2021). Based on the inclusion and exclusion criteria, ten randomized clinical trials (RCT) have met the inclusion criteria and were considered for the qualitative assessment. Critical appraisal of these studies was done. This systematic review found that using SDF is a successful and effective method in arresting dentin carious process in the primary teeth and first permanent molars in children. Additionally, when compared to the commonly used topical fluoride products and materials, SDF showed to have better cariostatic effect. However, these findings must be cautiously viewed since more research is required to support them.

PARENTS' KNOWLEDGE WITH PERMANENT FIRST MOLLAR CARRIES IN STUDENTS

The first permanent molars are the first teeth to erupt at the age of 6-7 years. The first permanent molars function to chew, pound and grind food because they have a wide chewing surface with many protrusions and indentations, making them the teeth most at risk for caries. The incidence of caries in the first molar, especially in the mandible, is a tooth that has a high prevalence of extraction and most of it is caused by caries, and the discipline of children in maintaining their teeth is still lacking. good food retention. Most parents do not know that these teeth are porous, and assume that there will be more replacement teeth, even though these teeth are permanent teeth and will not be replaced again. The purpose of this study was to determine the relationship between parental knowledge and caries of the first permanent molars in children. The research method used descriptive non-experimental with a cross sectional design. The population of grade 3 school children at SDN Barutunggul IV, Rancabali District, Bandung Regency with a total sample of 52 people. The data were analyzed using the SPSS Version 21 application with the Chi-Square statistical test method. The results showed that most of the respondents had a level of knowledge about caries in the first permanent molars which were included in the sufficient and less categories (85%). Most of the respondents had experience of caries in the first permanent molars with moderate and poor criteria (94%). The results of the analysis showed that there was a relationship between parental knowledge and caries of the first permanent molars with a p-value of 0.001 indicating a significant correlation.

ASSESSMENT OF FIRST PERMANENT MOLAR HEALTH STATUS IN 6-15 YEARS OLD CHILDREN VISITING KHYBER COLLEGE OF DENTISTRY, PESHAWAR: A CROSS-SECTIONAL STUDY

Objective:&#x0D; To assess the health status of the first permanent molar (decayed, missing, filled teeth, hypoplasia, and hypocalcification) in 6-15 yrs old children.&#x0D; Materials and Methods:&#x0D; A total of 147 children ranging from the age of 6-15yrs with a mean of 9.36± 2.63yrs were considered in the study. A self-prepared performa was use to collect data regarding decayed, missing, filled, hypoplastic, hypocalcified first permanent molars in children attending the paediatric department, Khyber College of Dentistry, Peshawar. Demographic data like age, gender, and parental occupation (for socioeconomic status) were also recorded in the same performa. Children were examined on the dental chair by using a probe, mouth mirror, and tweezer. The collected data were analyzed using SPSS version 16.0. Frequencies and percentages of the variables were tabulated. The Chi-square test was applied for comparison among different socioeconomic levels. P-value ≤0.005 was considered significant statistically.&#x0D; Results:&#x0D; Out of a total of 147 children, ninety-seven were males (64.7%) and 53 were females (35.3%), with a male to female ratio of 2:1. The health status of the first permanent molar is poor in young children of low socioeconomic status.&#x0D; Conclusion:&#x0D; It is concluded from the study that the health status of the first permanent molar is poor in young boys whose parents were having low socioeconomic status.

Ectopic Eruption of First Permanent Molars for Pediatric Patients Attended King Saud University, Riyadh, Saudi Arabia: A Radiographic Study.

BackgroundEarly diagnosis and intervention of ectopically erupting first permanent molars (FPMs) are vital to avoiding later complex surgical or/and orthodontic treatment. Selection of proper type of intervention and simple treatment is considered as more convenient to use with children.PurposeThe aim of this retrospective radiographic cross-sectional study was to assess the prevalence and severity of ectopically erupting FPMs in children attending the Dental University Teaching Hospital (DUTH) at King Saud University, Riyadh, Saudi Arabia.MethodsThis retrospective study was conducted using panoramic radiographs (OPGs) of 2014 patients (973 females and 1041 males) aged from 5 to 8 years old who attended DUTH at King Saud University, Riyadh, Saudi Arabia. We assessed and recorded the age and gender of the subjects, the tooth number, arch, and location of the ectopic erupted FPMs, and the severity of resorption of the roots of the primary molars.ResultsOf 2014 reviewed OPGs, 45 (2.2%) cases were diagnosed with an ectopic eruption of the permanent first molar. The distribution of ectopic eruption based on gender showed that there was a higher prevalence in males 28 (2.9%) than in females 17 (1.6%). Of the 45 ectopic FPMs cases, 47 (78.33%) were detected in the maxilla, while 13 (21.66%) were seen in the mandible. Severe and moderate degrees of the ectopic eruption were found to be more common in the maxilla than in the mandible (p < 0.001).ConclusionClinicians should be aware of such conditions, as early diagnosis is essential for providing optimum dental care. To our knowledge, this study is the first to assess the prevalence of ectopically erupting FPMs in a Saudi population.

Visual Examination, Fluorescence-Aided Caries Excavation (FACE) Technology, Bitewing X-Ray Radiography in the Detection of Occlusal Caries in First Permanent Molars in Children.

To compare the effectiveness of visual examination, radiographic examination and fluorescence-aided caries excavation (FACE) in detecting occlusal caries in first permanent molars in 150 children aged 6-14 years with intact occlusal surface with caries lesions without cavitation, or with darkened or deep fissures that had no clear diagnosis. Two dentists independently performed a visual oral examination, FACE and bitewing radiography. The inter-rater reliability of each detection method was determined and their specificity and sensitivity. All caries detection methods showed high inter-rater reliability with absolute agreement between raters above 90%. Most caries lesions were detected by visual (75.8%) and FACE (79.1%), while only 28.8% of lesions were detected by radiography. Detection by visual examination was strongly correlated with detection by FACE (X2=37.9, Phi=0.498, p<0.001). A lower, yet statistically significant, correlation was found between visual examination and X-ray radiography (X2=5.53, Phi=0.190, p<0.001). FACE had higher sensitivity (87%) and specificity (65%) for detecting occlusal caries in comparison with radiography (60% specificity and 55% sensitivity). Although visual examination remains the best method to detect occlusal caries in young permanent molars in children, FACE is an effective and accurate diagnostic tool that may aid in detection and treatment decisions.

Extraction of first permanent molars severely affected by molar incisor hypomineralisation: a retrospective audit

AimThe aim of this study was to evaluate possible spontaneous space closure after extraction of first permanent molars in children and their eventual need for orthodontic treatment.MethodsTwenty-seven children with at least one first permanent molar planned for extraction were enrolled in the study. The children were referred to the Department of Paediatric Dentistry, University of Oslo, between 2009 and 2017. All extracted teeth were severely affected by Molar Incisor Hypomineralisation and/or caries. The children and their parents had consented to extraction and follow-up. Data were analysed with SPSS 26.ResultsThe age of the children was between 5.5 and 12.1 years (mean 8.7) at extraction. The mean follow-up time was 3.2 years (range 1.1–6.3). Sixteen children (59.3%) had all four molars extracted, five (18.5%) had three, five had two and one had one molar extracted. In the maxilla, the second permanent molar had erupted in the place of the first molar in all the children, and none of them needed orthodontic space closure. In the mandible, eight children (29.6%) needed orthodontic treatment to close the spaces after extraction. In three children, the second molar was not yet erupted and treatment need was not settled.ConclusionExtraction of severely affected first permanent molars before the eruption of the second molar is a treatment option causing little additional treatment in the majority of cases.

Minimal Intervention for First Permanent Molars in Children

Minimal Intervention for First Permanent Molars in Children

The Influence of Age on the Development of Dental Caries in Children. A Radiographic Study.

Dental caries is a chronic disease that can be influenced by a multitude of factors. Poor oral hygiene and unhealthy eating habits are the most incriminating factors in the onset of dental caries, but age has been proven to impact the disease. The aim of this study was to find correlations between age and the evolution of dental caries in the first permanent molars in children. The retrospective study was conducted based on 400 panoramic radiographs, belonging to Romanian children between the ages of 6 and 14 years. All first permanent molars were investigated, and the carious lesions were classified according to their depth. The chronological age was calculated by subtracting the patient’s date of birth from the date when the radiograph was performed, while for the assessment of dental age, the Demirjian method was used. The gender of the patients did not significantly influence the number of superficial, medium, and deep carious lesions. Most of the identified carious lesions were superficial. Regarding correlations between age and dental caries, there was an association between the decrease in the chronological age and the increase in the number of superficial carious lesions on the first permanent molars and also an association between the increase in the chronological age or dental age and the increase in the number of medium and deep carious lesions on the first permanent molars. Age can impact the development of dental caries in first permanent molars.

Dental Visits and Predictors of Regular Attendance Among Female Schoolchildren in Dammam, Saudi Arabia.

PurposeRegular dental visits are important for the maintenance of optimal oral health and improved quality of life. The purpose of the study was to evaluate patterns of dental visits and factors associated with routine dental attendance among female schoolchildren in Dammam, Saudi Arabia.Patients and MethodsThis cross-sectional study was performed on 449 female primary schoolchildren (6–11 years old) in Dammam, Saudi Arabia. The study included clinical examination for decay in the first permanent molars in children and questionnaire administration among their parents. The World Health Organization’s oral health questionnaire was used to collect data about children’s dental visits, oral hygiene behaviors, dental problems, and dietary practices. Bivariate and multivariate analyses were performed to evaluate factors associated with routine dental visits.ResultsMost children (64.1%) visited the dentist during the past one year, 22.1% performed no dental visit during the past one year, and 8.3% never visited the dentist. Among children who visited the dentist, the pain was the most common reason for dental visits (39.10%, N=170), followed by routine dental check-ups (18.60%, N=81). In bivariate analysis, education of parents, family income, daily tooth brushing, no decay in the first permanent molar, no toothache, no consumption of soft drinks, biscuits, cakes, and cream were significantly associated with routine dental attendance (P <0.05). However, the final logistic regression model showed that university education of mothers (OR 2.52, P = 0.005), not having toothache or discomfort (OR 2.88, P = 0.001), tooth brushing once or twice daily (OR 2.43, P= 0.034), and not consuming soft drinks (OR 1.96, P= 0.027) were significant predictors of routine dental visits.ConclusionThe study found that higher education of mothers, daily tooth brushing, not having dental pain, and not consuming soft drinks were significantly associated with routine dental visits in this sample of female schoolchildren. Routine dental attendance may be used to improve oral hygiene and reduce dental pain and consumption of soft drinks in children.

Silver Diamine Fluoride Versus Atraumatic Restorative Treatment in Pediatric Dental Caries Management: A Systematic Review and Meta-analysis.

ABSTRACTIntroduction:The objective was to compare the clinical efficacy of silver diamine fluoride (SDF) and atraumatic restorative treatment (ART) in arresting active caries in primary teeth and first permanent molars in children.Materials and Methods:The study protocol was registered in PROSPERO (CRD42020205675). A systematic search was performed in PubMed, Scopus, Embase, Cochrane Library, and gray literature for randomized controlled trials (RCTs) published in English language with a minimum follow-up of 6 months, comparing the caries arrest potential of SDF with ART in primary teeth and first permanent molars in children. The risk of bias and quality assessment of the studies was done using the Cochrane Collaboration Tool and Joanna Briggs Institute Critical Appraisal Tool. Data analysis was performed using RevMan software; the outcomes were summarized in meta-analysis (MA) using the random-effects model, and the odds ratio (OR) at 95% confidence interval (CI) was computed.Results:A total of 1059 studies were identified, out of which 562 remained after removal of duplicates. Eight studies were considered for full-text eligibility, and four studies were included in the qualitative review. Three out of four studies were conducted on primary dentition, whereas one study was done on erupting first permanent molars in children. MA of the two studies compared 30% SDF with ART in primary molars at 12 months and revealed the OR to be 2.02 (95% CI: 0.86–4.71; I2 = 62%; P = 0.10).Conclusion:The current review points to the lack of solid evidence comparing SDF with ART for arresting active caries in primary teeth, especially in the first permanent molars. No statistically significant difference between 30% SDF and ART in primary molars at 12 months was found in the present review. Well-designed RCTs are required to determine a minimum concentration of SDF which is effective and safe for caries arrest in children.

Minimally invasive judgement calls: managing compromised first permanent molars in children.

This paper aims to update the reader on how minimally invasive (MI) techniques may be used to improve the longevity of carious or defective/compromised first permanent molars (cFPMs) in young children. Clinical and radiographic diagnosis and the prognostic factors will be discussed in view of recent studies showing that these teeth can be kept in function and have an improved prognosis as the child gets older. Clinical protocols for their care, based on the latest evidence and techniques for MI restorations, together with longevity information of possible restorative options, are described. This paper also explores the rationale behind enforced extractions and related morbidity, in order to help oral healthcare practitioners to determine the optimal management of these key elements in the dentition for the benefit of the patients.

Application of Contemporary Magnifying Methods in the Diagnostics of Occlusal Carious Lesions on First Permanent Molars in Children.

Dental operating microscopes (DOM) enable dentists to examine, with the aid of magnification and photodocumentation in clinical conditions, the occlusal anatomy of newly erupted permanent molars and to detect any early carious lesions more precisely. To determine the advantages of magnifying technology in detecting early occlusal carious lesions in newly erupted permanent first molars. We examined 176 first molars of 44 children divided into two age groups: 7-8 and 9-10 years. The surfaces of each of the teeth were examined after they were cleaned with a brush without paste. The diagnoses were first made using only illumination and a clinical examination. These were followed by a visual examination of the occlusal surface using a DOM at ×8 magnification. A photo of the occlusal surface was then taken with a camera at the respective magnification for the purposes of photodocumentation. This study demonstrated that dental operating microscopes increased by 7% the rate of successful detection of early caries lesions on the occlusal surfaces. There was also a significant increase of the number of diagnosed cavitated caries in the dentine in comparison with those detected with naked eye. Using DOMs in pediatric dentistry facilitates the more detailed and precise diagnosing of early stage carious lesions and/or cavitations in the fissures. The use of a DOM facilitates differential diagnosing between deep fissures and early carious lesions, which is a key point in the assessment of occlusal surfaces of newly erupted permanent molars, necessary for their preventative sealing and micro-invasive treatment.