Mandibular Primary Teeth Research Articles

CLINICAL AND RADIOGRAPHIC EVALUATION OF NANOHYDROXYAPATITE AND PLATELETS-RICH FIBRIN AS PULPOTOMY MATERIALS FOR PRIMARY MOLARS

Objectives: Pulpotomy works to retain a healthy tooth in the mouth till exfoliation by protecting the radicular pulp. The coronal pulp must be removed, and the radicular pulp must be given medication, in order to maintain the tooths health and function. Subject and Methods: The children who took part in this clinical investigation were chosen aged 4 to 8 years old, following approval from the Ethical Committee and obtaining signed informed consent from their parents. Based on the type of pulpotomy material used, the NHAp group and the PRF group, and 40 mandibular primary teeth that needed pulpotomy treatment were split into two groups (n=20). The split-mouth prospective clinical trial design for this study was authorized. Three distinct follow-up intervals of 6 weeks, six, and twelve months were used to note and evaluate the clinical and radiological outcomes. Results: The teeth treated with PRF had improved clinical and radiographic outcomes at the three distinct follow-up intervals of 6 weeks, 6, and 12 months, but there was no statistically significant difference between them and the teeth treated with NHAp. Conclusion: The results of the pulpotomized primary molars clinical and radiographic outcomes could be improved by using PRF as a pulp dressing agent.

Plausible predicament in emergency endodontic rehabilitation of a child with Sturge-Weber syndrome: A case report

Sturge–Weber Syndrome (SWS) is a neuro-oculo-cutaneous vascular disorder that includes leptomeningeal hemangioma and port wine stains, usually ipsilaterally, with ocular manifestations and extended lesions over the oral cavity. It is an embryonic developmental disorder affecting both mesodermal and ectodermal germ layers, associated with somatic mutation of gene GNAQ. It has a sporadic occurrence of 1:50,000 and no gender predilection. This case report added to the knowledge and understanding of systematic rehabilitation of a child patient with SWS and its associated risk factors in an emergency scenario. A 3.5-year-old girl child with a known diagnosis of SWS presented abscess over the right lower mandibular deciduous teeth and distinct oral features of SWS, requiring emergency endodontic intervention, followed by full mouth rehabilitation. Thus, an in-depth knowledge of the clinical state that helps in the expert assessment of dental interventions, including emotional co-regulation in those children, is essential. Keywords: Angiomatosis; Endodontics; Port Wine Stain; Syndrome

Functional and esthetic rehabilitation of deciduous maxillary anteriors

Dental caries is the most common chronic childhood disease. Although the rate of dental caries has significantly decreased in recent years, it is still the most prevalent chronic disease of childhood. In Early Childhood Caries (ECC), there is early carious involvement of all maxillary and mandibular posterior teeth with gross destruction of maxillary anteriors. This case presents the clinical sequence of complete rehabilitation of decayed maxillary and mandibular primary teeth with placement of prefabricated metal post and strip crowns in maxillary central incisors.

Evaluation and Comparison of Formocresol and Sodium Hypochlorite as Pulpotomy Medicaments in Treatment of Mandibular Primary Molars - A Randomized Controlled Study

Background: the main idea behind the pulpotomy of a primary tooth is to remove the infected or inflamed coronal pulp tissues and cover the pulp with a suitable medicament or dressing which promotes healing and preserve the vitality of the teeth especially in young permanent teeth. A medicament should be biologically compatible, have healing capabilities, should be non cytotoxic, or mutagenic and with no carcinogenic potential. Aim: the main aim of the study was to compare and evaluate the efficacy of commonly used two medicaments i.e. formocresol and sodium hypochlorite in pulpotomy of mandibular primary teeth. Material and methodology: a randomized controlled single blinded clinical trial was done on 50 subjects of age ranging from 3 to 6 years with bilateral mandibular first or second molar requiring pulpotomy. The subjects were randomly divided into two groups with 25 subjects in each. Group I, consisted of subjects on which formocresol medicament was used after extirpation of coronal pulp while in Group II, 3% sodium hypochlorite was used. Clinical along with the radiographic signs and symptoms were blindly recorded at an interval of 1, 3, 6 and 12 months respectively. Results: Statistically significant results were obtained in group II, when patients treated with 3% sodium hypochlorite. There was no major difference between the two medicaments used, but to the various adverse effects of formocresol, its usage has been limited. Conclusion: within the limitation of the study, it was concluded that sodium hypochlorite medicament proved to have better prognosis and can be suggested as a pulpotomy agent for primary teeth. Although formocresol was found to have similar significant results can also be used as a medicament. Keywords: Formocresol, Pulpotomy, Primary Teeth, Sodium Hypochlorite

Comparative evaluation of efficacy of Physics Forceps versus conventional forceps in pediatric dental extractions: a prospective randomized study.

BackgroundThis study aimed to determine the efficacy of Physics Forceps in pediatric dental extractions.MethodsThis was a double-blind, randomized controlled trial with a parallel-arm design and identical allocation ratio (1:1). Children (n=104) were randomly divided into two groups for extraction of mandibular primary teeth (group I: Physics Forceps; group II: conventional forceps). The outcome variables assessed in the study were the time taken for extraction, pre- and postoperative anxiety (using RMS pictorial scale), incidence of fractured teeth, and postoperative pain on the first and third days (using the Wong-Baker faces pain scale).ResultsA significant reduction (P < 0.001) in intraoperative time, anxiety, and incidence of tooth fracture was confined to group I. The pain significantly reduced from the first to the third postoperative day in both groups, but the mean reduction in RMS scores in the physics forceps group was far better than that in the conventional forceps group.ConclusionPhysics Forceps aid in extraction of primary teeth with minimal trauma to supporting structures, as well as reducing anxiety in the pediatric population.

Unilateral Fusion of Two Primary Mandibular Teeth: Report of a Portuguese Archeological Case

This paper describes a unilateral fusionof two mandibular teeth in an infant skeleton recoveredfrom the late Roman cemetery of Miroiço (Sintra,Portugal). Morphological and radiographic data wereused for the analysis and interpretation of this dentalanomaly. A brief review of the literature of present dayprimary dental fusion is presented. This report showsthat primary dental fusion was present in Portuguesepast populations, representing a contribution to thehistory of dental anomalies.

Comparative evaluation of effectiveness of intraligamentary injection technique using articaine and lidocaine for extraction of primary mandibular posterior teeth

Introduction: Inferior alveolar nerve block (IANB) has been the traditional technique for achieving anesthesia of mandibular teeth. However, its failure rate and associated complications have resulted in need and quest for alternative local anesthetic techniques, of which intraligamentary injection technique is one. Aim: The aim of this study is to compare the effectiveness of articaine hydrochloride 4% with adrenaline 1:100,000 and lidocaine hydrochloride 2% with adrenaline 1:80000 for extraction of mandibular primary teeth using intraligamentary injection technique. Materials and Methods: The present study was conducted over a sample of 60 patients, aged between 6 and 10 years requiring extraction of primary mandibular posterior teeth. Patients were selected and divided randomly into two groups as follows: Group A received anesthesia through intraligamentary injection containing articaine hydrochloride 4% with adrenaline 1:100,000 and Group B containing lidocaine hydrochloride 2% with adrenaline 1:80,000. Sound eye motor scale was used to assess pain perception for each group. On failure of completion of extraction, IANB technique was employed. Results: The success rate of intraligamentary injection within articaine group was 80%, and lidocaine group was 30% with the mean SEM scores (± standard deviation) on administration of lidocaine group were higher than articaine group. Conclusion: Intraligamentary technique with articaine may be an alternate to IANB for extraction of primary mandibular molars.

Demystifying the Mysteries: Sexual Dimorphism in Primary Teeth.

One of the critical steps in the process of identification is the sex determination of an unknown individual. Many studies have shown that sex can be determined using the human skeleton, especially by examining the pelvis and skull. Odontometric analysis of the human sexual variation has been less investigated, especially of primary dentition. To verify the presence of sexual dimorphism in primary teeth of local population of Faridabad, Haryana, India. The research was performed on dental casts of 500 children (250 boys and 250 girls, age range 3-5 years). Mesiodistal and buccolingual crown dimensions of maxillary and mandibular primary teeth were measured with a digital Vernier's caliper and were analysed for sexual dimorphism. Mann-Whitney-U test was used to check the statistical significance of difference in tooth dimensions among boys and girls. Differences were found in the mean values of mesiodistal and buccolingual diameters of primary teeth, in which boys generally had larger crown diameters than girls. Primary teeth may be used as an additional tool for sex identification of juvenile skeletons where other dimorphic features are not much developed.

Bilateral fusion of mandibular primary teeth with partial anodontia of permanent teeth: A report of a rare case

Fusion is a developmental anomaly of shape of the tooth seen in developing primary or permanent teeth. Etiology is not exactly known, but the physical pressure or force generated during growth causes contact and fusion between adjacent tooth buds. The genetic foundation for the anomaly is possibly autosomal dominant with reduced penetrance. The bilateral type of fusion in the primary dentition is very rare and is usually 0.02%. Till now, only 18 cases have been previously reported in dental literature since 1940, and in the Indian population, only few cases have been reported. In bilateral fusion of primary lateral incisor and canine, 75% chance of lacking the succedaneous lateral incisors have been reported. The anomalies of the permanent dentition are strongly associated with anomalies in the primary dentition. The potential clinical problems associated with fusion require orthodontic, prosthetic, cosmetic, and periodontal intervention also. Thus, to establish a right treatment to this anomaly, the early proper examination and knowledge to recognize the anomalies associated between primary teeth and permanent teeth is a prerequisite.

Clinical evaluation of fiber-reinforced composite crowns in pulp-treated primary molars: 12-month results.

Objective:The aim of this study was to evaluate the clinical performance of tooth-colored fiber-reinforced composite (FRC) crowns in pulp-treated second primary mandibular teeth.Materials and Methods:This split-mouth randomized, clinical trial performed on 67 children between 3 and 6 years with two primary mandibular second molars requiring pulp treatment. After pulp therapy, the teeth were randomly assigned to stainless steel crown (SSC) or FRC crown groups. Modified United States Public Health Service criteria were used to evaluate marginal integrity, marginal discoloration, and secondary caries in FRC crowns at intervals of 3, 6, and 12 months. Retention rate and gingival health were also compared between the two groups. The data were analyzed using Friedman, Cochran, and McNemar's tests at a significance level of 0.05.Results:Intact marginal integrity in FRC crowns at 3, 6, and 12 months were 93.2%, 94.8%, and 94.2%, respectively. Marginal discoloration and secondary caries were not found at any of the FRC crowns. The retention rates of the FRC crowns were 100%, 98.3%, and 89.7% at 3, 6 and 12 months, respectively, whereas all the SSCs were found to be present and intact after 12 months (P = 0.016). There was no statistically significant difference between the two groups in gingival health.Conclusion:According to the results of this study, it seems that when esthetics is a concern, in cooperative patients with good oral hygiene, FRC crowns can be considered as a valuable procedure.

Eugenol Hypersensitivity in Pediatric Dental Patient: A Rare Case Report

ABSTRACT Eugenol is a phenolic compound commonly used in dentistry as an analgesic and anti-inflammatory drug. Zinc oxide eugenol is an important root canal filling material in primary teeth with excellent documented success. Its cytotoxic effect is documented in some cases due to production of zinc eugenolate which is highly unstable and induces type IV hypersensitivity reactions and even generalized anaphylactic symptoms. But, the case reports documenting immediate hypersensitivity reaction to eugenol are very rare. This was a case of type I immediate hypersensitivity reaction to eugenol in a 3 years old pediatric patient. During the full mouth rehabilitation under general anesthesia, hard indurated swelling of lower lip was observed at the time of obturation of mandibular primary teeth. The procedure was stopped immediately suspecting an allergic response which was later confirmed to be eugenol allergy by patch test. Hence, it is important to evaluate all local allergies even if the patient fails to report allergy history. How to cite this article Beniwal A, Chaturvedi S, Bhatt T, Sharma A, Nigam AG. Eugenol Hypersensitivity in Pediatric Dental Patient: A Rare Case Report. J Mahatma Gandhi Univ Med Sci Tech 2016;1(2):68-70.

Morphometric, densitometric and mechanical properties of mandibular deciduous teeth in 5-month-old Polish Merino sheep

BackgroundCaries, enamel hypoplasia, molar incisor hipomineralization, amylogenesis imperfecta, dentine dysplasia, hypophosphatasia and other dental disorders lead to tooth mineralization disturbances and structural abnormalities, decreasing masticatory organ functions. Dental disorders in sheep can lead to premature slaughter before they have attained final stage of their reproductive life and induce economic loss due to high flock replacement costs. Growth rate, health status and meat quality of sheep depends on tooth properties and quality determining in large extent efficiency of the masticatory apparatus and initial food break up. Considering lack of basic anatomical and physiological data on teeth properties in sheep, the aim of the study was to evaluate morphometric, densitometric and mechanical traits of deciduous mandibular incisor, canine and the second premolar obtained at the slaughter age of 5 months of life.ResultsThe obtained results have shown the highest values of weight, total tooth volume, enamel volume and dentine volume in second premolar. Morphometric and mechanical parameters of incisors reached the highest values in first incisor and decreased gradually in second and third incisor, and in canine. Densitometric measurements have not revealed significant differences of the volumetric tooth mineral density in hard dental tissues between the investigated teeth.ConclusionsIn conclusion, proposed methodological approach is noninvasive since the deciduous teeth undergo physiological replacement with permanent teeth. Deciduous teeth can be easy collected for analyses from large animal population and may reflect mineral status and metabolism resulting from postnatal growth and development of the whole flock. In individual cases, evaluation of properties of deciduous teeth may serve for breeding selection and further reproduction of sheep possessing favorable traits of teeth and better masticatory system functions.

Bilateral fusion in primary mandibular teeth

Fusion has been described as a developmental anomaly characterized by the union of two adjacent teeth. Few cases of this rare anomaly in primary dentition have been reported in Indian population. A rare case of bilateral fusion between primary mandibular lateral incisors and canines is presented in this report.

Bilateral fusion in primary mandibular teeth: A report of two cases

The rare anomaly of fusion in primary dentition has very little documentation in Indian population. Two rare cases of bilateral fusion between primary mandibular lateral incisors and canines and primary mandibular central incisors and lateral incisors have been presented in this report. A minimal intervention approach, preventive procedures, and a long-term follow-up have been discussed.

Bilateral fusion of mandibular primary teeth

The aim of the report was to highlight the rarity of occurrence of bilaterally fused mandibular primary lateral incisors and canines by virtue of the number of such cases reported in literature; to identify congenital absence of successor teeth;and to evaluate their pulpal morphologies to understand the type of fusion. Clinical observation along with an orthopantomograph and periapical radiographs were used to arrive at a diagnosis. The pulpal morphologies varied in each of the fused teeth although both were fusions of the Complete type. There was congenital absence of the permanent mandibular lateral incisors, bilaterally. It was a case of bilateral fusion of mandibular primary lateral incisors and canines of the Complete type with congenitally absent mandibular permanent lateral incisors. Only 13 such cases have been previously reported in literature.

Prevalence of erosive tooth wear and associated risk factors in 2–7‐year‐old German kindergarten children

The aims of this study were to (1) investigate prevalence and severity of erosive tooth wear among kindergarten children and (2) determine the relationship between dental erosion and dietary intake, oral hygiene behaviour, systemic diseases and salivary concentration of calcium and phosphate. A sample of 463 children (2-7 years old) from 21 kindergartens were examined under standardized conditions by a calibrated examiner. Dental erosion of primary and permanent teeth was recorded using a scoring system based on O'Sullivan Index [Eur J Paediatr Dent 2 (2000) 69]. Data on the rate and frequency of dietary intake, systemic diseases and oral hygiene behaviour were obtained from a questionnaire completed by the parents. Unstimulated saliva samples of 355 children were analysed for calcium and phosphate concentration by colorimetric assessment. Descriptive statistics and multiple regression analysis were applied to the data. Prevalence of erosion amounted to 32% and increased with increasing age of the children. Dentine erosion affecting at least one tooth could be observed in 13.2% of the children. The most affected teeth were the primary maxillary first and second incisors (15.5-25%) followed by the canines (10.5-12%) and molars (1-5%). Erosions on primary mandibular teeth were as follows: incisors: 1.5-3%, canines: 5.5-6% and molars: 3.5-5%. Erosions of the primary first and second molars were mostly seen on the occlusal surfaces (75.9%) involving enamel or enamel-dentine but not the pulp. In primary first and second incisors and canines, erosive lesions were often located incisally (51.2%) or affected multiple surfaces (28.9%). None of the permanent incisors (n = 93) or first molars (n=139) showed signs of erosion. Dietary factors, oral hygiene behaviour, systemic diseases and salivary calcium and phosphate concentration were not associated with the presence of erosion. Erosive tooth wear of primary teeth was frequently seen in primary dentition. As several children showed progressive erosion into dentine or exhibited severe erosion affecting many teeth, preventive and therapeutic measures are recommended.

Genetic analysis of deciduous tooth size in Australian twins

Investigations of permanent dental crown size in twins and family groups indicate a high degree of transmissible control, but little is known about the relative contributions of genetic and environmental factors to variation in size of the deciduous (primary) teeth. Here, maximum mesiodistal and buccolingual crown dimensions of maxillary and mandibular primary teeth were measured from dental models of 602 individuals, including 99 monozygous (MZ) twin pairs, 81 dizygous (DZ) same-sex pairs, 41 DZ opposite-sex pairs, and 160 singletons. Data were subjected to univariate genetic analysis with the structural-equation-modelling package, Mx using the normal assumptions of the twin model. A model incorporating additive genetic (A) and unique environmental (E) variation was found to be the most parsimonious for all tooth-size variables. Estimates of heritability for deciduous crown size ranged from 0.62 to 0.91. This study shows that variation in deciduous crown size has a strong genetic component, similar to that observed in the permanent dentition. Further studies are required to determine whether the underlying genetic mechanisms are the same for both deciduous and permanent teeth.

Glucose retention on the surfaces of primary teeth in 3- and 4-yr-old children

Glucose retention was determined in 38 kindergarten children aged 3–4 yr. The children rinsed their mouths with 10 ml of a 0.5 mol/l glucose solution for 15 s and then spat out. Three minutes after they put the solution in their mouths, a small paper-point was used to collect samples of saliva from the labial and buccal surfaces of the maxillary and mandibular primary teeth. The concentration of glucose in the small amount of saliva collected was measured with an immobilized enzyme system. Glucose retention was highest on the maxillary central primary incisor, second highest on the maxillary first primary molar and third highest on the maxillary lateral primary incisor. An intermediate value was seen on the maxillary and mandibular second primary molars, the mandibular first primary molar and the maxillary primary canine. A lower value was observed on the mandibular primary canine and the lowest on the mandibular incisors. It was concluded that there were site differences in glucose retention on primary teeth of 3- and 4-yr-old children.

One year follow-up study of stature, weight, emergence of dentition, and sexual maturation of well-nourished indian girls from birth to 20 years.

Stature, weight, and emergence of deciduous and permanent teeth of 1,330 well-nourished girls from birth to 20 years belonging to well-off families residing in Delhi are reported. All subjects were measured on two occasions 1 year apart. In addition, each subject was examined for gingival emergence of deciduous or permanent teeth on both occasions. Data on age at menarche were also collected. Single-year velocities of stature and weight are highest during the first year. The peak of adolescent spurts in stature and weight velocities are observed at 11.0 and 12.0 years, respectively. The first deciduous tooth to emerge is the mandibular I1 , of girls at 7.6 months. The sequence of emergence based on ascending median ages is I1, I2, M1, C, and M2 for both maxillary as well as mandibular deciduous teeth. The permanent dentition starts with the emergence of mandibular M1 at 5.75 years. The sequence of emergence of permanent teeth is M1 , I1 , I2 , PM1 , C, PM2 , and M2 in the maxilla, and M1 , I1 , I2, C, PM1 , PM2 , and M2 in the mandible. Annual increase in number of permanent teeth erupted shows a spurt between 9 and 10 years of age. Median age at menarche is 12.37 ± 0.03 with a standard deviation of 0.8 years; it is about one and one-half years later than the estimated age at peak height velocity. Single-year velocities of stature and weight decline after the onset of menarche. An association of emergence of deciduous teeth with birth weight is observed. Newborns with higher birth weight tend to have more teeth emerged at one year of age compared to those having lower birth weight. In all age groups, girls who had experienced menarche are taller and heavier and have more erupted permanent teeth compared to those who have not yet attained menarche. Girls with earlier menarche apparently have short adult stature compared to those with later menarche. © 1994 Wiley-Liss, Inc.

Physical growth and age at eruption of deciduous and permanent teeth in well-nourished Indian girls from birth to 20 years.

The results of a cross-sectional anthropometric survey of 1,643 well-nourished girls, from birth to 20 years, from the city of Delhi (India) are reported. The standardized measurements of body weight, height/crown-heel length, sitting height/crown-rump length, biacromial and bicristal diameters, head circumference, chest girth, upper arm girth, calf girth and skinfolds at biceps, triceps, and subscapular regions were taken for each subject. Medians fall between the 10th and 25th percentiles of National Center for Health Statistics (NCHS) reference data for height and the 10th and 50th percentiles for weight. The mean height and weight of the present girls are above the national reference values given by Indian Council of Medical Research (ICMR). Means and standard deviations of the weight/height ratio and body mass index (BMI) are also presented. The height/weight ratio increases continuously with age to 18 years. The mean values of the BMI, however, decrease to 6 years, rising afterward to adulthood. Median ages of eruption of deciduous and permanent teeth are presented. The first deciduous tooth to emerge in present girls is mandibular I1 at 7.6 months. The sequence of emergence based on ascending median ages is I1 , I2 , M1 , C, and M2 for both maxillary as well as mandibular deciduous teeth. The permanent set of dentition starts with the emergence of mandibular M1 at 5.75 years. Despite the rapid physical growth of American and British girls, the present girls are ahead in dental emergence and show earlier emergence of maxillary and mandibular permanent premolars, suggesting a genetic basis for the emergence of deciduous and permanent teeth. Partial correlation coefficients with age constant between height and the number of erupted deciduous and permanent teeth are positive and significant, reflecting an association, to some degree, with height and weight. © 1992 Wiley-Liss, Inc.