Primary Central Incisors Research Articles

The Effect of Mandibular Symphysis Fracture on the Position of the Permanent Incisor Tooth Germ

Background: Among facial bones in children, mandible bone has the highest fracture rate, 8.4% of which is related to Symphysis fractures. Case Presentation: A 3.5-year-old girl with complaints about the mobility of the mandibular left primary central incisor without a history of recent dental trauma and caries referred to the Department of Pediatric Dentistry of Hamadan University. After radiographic evaluation, occlusal displacement of lower left permanent central incisor tooth germ and root resorption of lower left primary central incisor were seen. Conclusions: This case report implies that because of the close proximity of the root of the primary tooth to its developing permanent successor, jaw fracture and especially mandibular fracture combined with dental injuries (e.g., intrusion, avulsion, and extrusive luxation) can cause damages and significant displacement in permanent successor tooth germs.

Dental trauma on primary teeth at different root resorption stages-A dynamic finite element impact analysis of the effect on the permanent tooth germ.

Dental trauma is a common emergency in children with primary teeth. The aim of this study was to determine stress propagation to the permanent tooth germ and surrounding bone and soft tissues during dental trauma to primary central incisors with three levels of physiological root resorption. Stresses were determined using finite element analysis (FEA). Cross-sectional models were created using cone-beam computed tomography images of 3.5, 5, and 6years olds, representing three different physiological root resorption stages of a maxillary primary central incisor. The models included periodontal ligament, bone, and soft tissues. An impact with an asphalt block moving at 1m/s,was simulated for two impact two directions, frontal on the labial tooth surface, and on the incisal edge. Stresses and strains were recorded during impact. The impact caused stress concentrations in the surrounding bone and soft tissues and permanent tooth germ, regardless of the direction of impact and the primary tooth resorption stage. Impact stresses in dental follicles and surrounding bone increased in models with more physiological root resorption of the primary tooth. Incisal impact generated higher stress concentrations in surrounding bone and soft tissues and permanent tooth germ regardless of physiological root resorption stage. The primary incisor with no physiological root resorption showed high stress concentrations at its root apex. During impact to a primary incisor, stresses most significant for potential damage to the formation of permanent enamel and dentin were at the dental follicle and surrounding bone tissue with the three levels of physiological root resorption.

Management of impacted primary maxillary central incisor: A report

Impaction of primary tooth is a rare and unusual finding, particularly in the maxillary anterior segment. A variety of reasons are listed in literature for such condition. Here is a case report of impacted primary maxillary left central incisor in a 4-year-old child. The condition was diagnosed with the help of clinical examination, intraoral periapical radiograph, and cone-beam computed tomography. The tooth was surgically removed, and the patient was asked for periodic check-up.

In Vivo Evaluation of Customized Pulse Oximeter and Sensitivity Pulp Tests for Assessment Of Pulp Vitality.

The purpose of this study was to test a customized pulse oximeter (CPO) for evaluation of pulp vitality in primary and permanent teeth against clinical diagnosis (vital and untreated non-vital) in order to expand its clinical use for pulp preservation. CPO was evaluated on intact primary and permanent central or lateral incisor (CI, LI) teeth-vital (group 1, 20n each); untreated non-vital (group 2, 10n each) and; root filled non-vital (group 3, 10n each) of children 4-12 years according to inclusion/ exclusion criteria. For each patient CPO was first applied on finger followed by vitality tests in following sequence-electrical, pulse oximetry and thermal tests. Mean oxygen saturation (%SpO2) in permanent and primary-vital teeth was 88.78% & 87.77% respectively; non-vital teeth was 74.67% & 75.00% respectively; and in all root filled teeth was 0%. Tooth and finger oxygen saturation values showed strong positive relationship in vital primary or permanent teeth and; no correlation in untreated non-vital primary or permanent teeth. The accuracy rate of thermal pulp test and pulse oximetry was 100% and for electrical pulp test it was 90% for permanent and 86.67% for primary teeth. The CPO tested in this study proved to be a valuable adjunct for diagnosing pulp vitality by objective means.

A Child With an Unusual Retained Oral Foreign Body

BackgroundPediatric foreign-body ingestions are common. Oral foreign bodies are rare but can be life-threatening. Management of their extraction requires knowledge and careful consideration of removal techniques, pharmacology, and potential complications. Case ReportA 5-year-old boy presented to the emergency department with a wooden block retained in his mouth after a fall. The block was lodged behind the patient's primary central incisors without causing apparent oral or dental trauma. Initial manipulation was unsuccessful given patient apprehension and muscle spasm. The patient was given i.v. diazepam for anxiolysis and muscle relaxation, and a tenaculum was used to extract the object. He was observed for a period of time and had no complications. Why Should an Emergency Physician Be Aware of This?Retained oral foreign bodies in children require a careful approach and understanding of pharmacologic anxiolysis, as patients may not be candidates for moderate sedation. Emergency physicians must be aware of potential complications of oral foreign bodies, including palatal injury, temporomandibular joint dislocation, epiglottitis, and retained foreign bodies.

Reciprocating instrumentation in a maxillary primary central incisor: A protocol tested in a 3D printed prototype.

Efficient endodontic instrumentation of primary teeth is a challenge for paediatric dentists. To evaluate biomechanical outcomes of endodontic instrumentation with a reciprocating system in a polymer-prototyped primary maxillary central incisor. The specimen was systematically instrumented and micro-CT scanned before and after each file. The amount of debris, percentage of non-instrumented areas, removed dentin volume, and lower dentin thickness at specific points along the root canal were analyzed. A 10% increase in removed dentin volume was observed when R40 was compared to R25 (14.5% vs 4.2%). When comparing R50 with R40, this increase was only 3.4% (17.9% vs 14.5%). In the root cervical third, there was substantial reduction in dentin thickness with R50 (48.8%), followed by R40 (39.5%) and R25 (18.6%). There was no difference between R25 and R40 in the removal of dentin at the apical third (15.8%), while R50 resulted in 39.8% reduction in dentin thickness. Percentage of non-instrumented areas were the same for all files. Accumulated debris with R40 and R50 was the same (0.19mm³) while for R25 was 0.11mm³. The Reciproc® system was effective for instrumentation of a prototyped primary maxillary central incisor. The most suitable file for apical preparation was R40.

Case Report: Patent Mandibular Symphysis with Congenital Absence and Ankyloglossia

The mandible develops prenatally as left and right halves (hemimandibles) that meet at a suture in the anterior midline. This suture normally is obliterated in the first year of life. We describe a 4-year-old girl in whom (A) this suture (symphysis menti) is only partially fused, (B) the primary lower left central incisor is congenitally absent (and also its permanent successor), and (C) there is pronounced ankyloglossia. These midline problems share a common etiology, namely incomplete fusion of the halves of the first branchial arch. No cause is suggested, but the embryological problem seems to stem from inadequate streaming together of the mesodermal cores of the first branchial arches. Similar cases with the dental and bony aspects of this condition should be identifiable in skeletal remains.

Korean National Oral Health Survey Data on the Symmetry of Primary Dentition Surface Caries.

This study evaluated the intraoral symmetry of dental caries in primary teeth as part of a study of caries patterns in primary dentition. The data for 4,800 5-year-old and 4,379 8-year-old children in this study were from the 2012 Korean national oral health survey. Pearson correlation coefficients of the decayed and filled surface (dfs) values ranged from 0.436 (lower primary canines) to 0.835 (upper primary central incisors) for the right and left primary teeth and from 0.084 (right primary central incisor) to 0.457 (left primary second molar) for the upper and lower primary dentition (P< 0.01). The upper and lower dfs values differed significantly (P< 0.05) when the right and left primary second molars were excluded. The left or right primary data without caries ranged from 56.4% (lower of first and second primary molars) to 99.7% (lower primary central incisors). The bilateral caries among cases with one or more in the right or left primary teeth ranged from 25.0% (lower lateral primary incisor) to 72.7% (upper primary central incisors). These results suggested that dental caries in primary teeth show bilateral symmetry and differences in the degree of symmetry according to the teeth set or surface set of the homologous teeth.

Perbandingan Waktu Erupsi Gigi Susu Incisivus Pertama Pada Bayi Usia Yang Diberi Susu Asi Dan Yang Diberi Susu Fomula

Background: Exclusive breastfeeding coverage in East Nusa Tenggara was 42,8% according to Riskesdas 2013. Most mothers gave formula feeding or partial to their babies accounting for 57,2%. Nutrition is one of the factors that correlate with tooth eruption. A baby gains nutrition through breastfeeding or formula. Formula feeding has low nutrition compared with breastfeeding. Aims: Knowing the eruption comparison of primary central incisors of babies with breastfeeding compared with formula. Method: Observational research was applied to gain the information needs. The samples were divided into two groups: the first group had breastfeeding while the second group with formula. Each group accounted for 30 babies. The research locations were Posyandu of Pasir Panjang and Oebobo’s public health center. Data were analyzed by using Man Whitney test. Results: Average tooth eruptions of babies with breastfeeding and formula accounting for 7 months and 9 months, consecutively. Babies with breastfeeding had primary central incisors eruption two months earlier compared with babies with formula. Man Whitney statistic analyzed indicated there is no significant difference in tooth eruption between babies with breastfeeding and formula. Conclusion: Eruption of Primary central incisors in babies with breastfeeding compare with formula is the same.

Methodological Proposal to Assess Gingival Thickness in Children.

Inadequate gingival thickness (GT) may lead to gingival recession. Thus, early identification of patients/teeth at risk would be advantageous. In adults, the probe's visibility through the marginal gingiva (reference test) has been considered a reliable criterion to describe a thin gingiva. This study aimed to evaluate in children two more convenient methods: the whitening of the attached gingiva with coronal labial traction (GW test) and the visibility of the gingival blood supply (BS test). In 69 children, the GT of primary and/or permanent central and lateral incisors, first primary molars and/or first premolars was assessed with the three tests. The sensitivity and specificity of the GW and BS tests and their odds ratio with probing were calculated. According to probing, 39% of children in the studied population had thin gingiva. The GW and BS tests reported different percentages of GT compared to probing, except for primary teeth, maxillary permanent incisors and mandibular first premolars, where the GW test exhibited a comparable percentage. The sensitivity of GW and BS tests was 37% and 19%, respectively, when compared to probing, while the specificity was 84% and 96%, respectively. The GW and BS tests could be used for first-line diagnosis of thin gingiva; if the results are negative, probing should be implemented.

Aesthetic Rehabilitation of Maxillary Primary Anterior Teeth with Early Child Hood Caries – Report of Three Different Cases

It is a great challenge for Pediatric Dentists to restore and to aesthetically rehabilitate a pre-schooler, who has lost their anterior teeth subsequent to early childhood caries or extensive dental trauma. This paper discusses case reports of anterior aesthetic rehabilitation of upper primary incisors in three different methods taking into account the different aspects of the treatment modalities. The different methods employed were post and core restoration with direct resin composite build up, restoration with strip crowns and rehabilitation with fixed functional space maintainers replacing the crowns of upper primary central and lateral incisors.

Nature and pattern of primary teeth extractions in a tertiary care hospital setting in South India.

Many studies have been carried out on the prevalence of dental diseases in children although not much information is available regarding its outcome among Indian children. The aim of the present study was to analyze the type of primary tooth extracted and the reasons for the extraction among children attending a tertiary care hospital in the Southern part of India. The dental records of pediatric patients who had visited the dental clinic of a tertiary care hospital located in Tamil Nadu, South India from December 2013 to November 2016 were reviewed. Patients who underwent extraction of at least one primary tooth under local or general anesthesia were included in the study. A total of 943 primary teeth were extracted from 447 patients over 3 years. The most commonly extracted tooth type was the first primary molar followed by the primary central incisor. Grouping by age, the most frequently extracted tooth type between 2 and 5 years was the primary central incisor, the first primary molar among the 6-9-year-old and the second primary molar among 10-15-year-old. The majority of primary teeth extractions were performed in the age group of 6-9 years. No significant gender differences were noted. The most common reason for extraction of primary teeth in children was dental caries. This study demonstrates a high prevalence of untimely primary teeth extractions in young children and dental caries continues to be the leading cause. It clearly reflects on the lack of infant oral health care, the inadequacy of awareness and underutilization of oral health services among children in India.

Three year follow-up and management of a severely dislocated tooth after primary trauma.

Objective: This case report describes the management and a 3-year follow-up of an unerupted and ectopic positioned anterior tooth. Case Report: The patient, a girl (9 years old) was referred due to the lack of a permanent maxillary left central incisor. When she was 2 years old suffered a complete intrusion of her primary maxillary left central incisor, and the tooth re-erupted after 4 weeks. Radiographic examination revealed the impaction and severe dislocation of the permanent maxillary left central incisor. The impacted tooth was surgically exposed and placed in orthodontic traction for alignment over a period of 12 months. Results: After this period the central incisor presented satisfactory periapical and periodontal health, adequate occlusion and a good esthetic outcome. After three years of follow-up, apically rounded and no extensive damage to tooth or tissues structures were observed Conclusion: The orthodontic management had been successfully performed with excellent functional and esthetic results. Treatment of an impacted incisor is a challenge, which should be carefully planned. A clinical and radiographic follow-up by a multi-professional group is of outmost importance.

Occurrence of traumatic dental injuries among preschool children with Autism Spectrum Disorder.

Objective:To determine the occurrence of traumatic dental injuries (TDIs) among Saudi preschool children with autism spectrum disorder (ASD) and compare it with Saudi preschool children without ASD.Methods:This study was conducted on a randomly selected sample of three to five year old Saudi preschool children in Riyadh, Saudi Arabia. The sample consisted of two groups; a study group (SG) of 257 ASD children, and a control group (CG) of age- and gender-matched 257 children without ASD. Clinical examinations were performed at selected ASD centers and kindergartens to determine the occurrence of TDIs based on modified World Health Organization (WHO) classification system.Results:Out of 514 children examined, 108 (21.0%) had suffered TDIs. The prevalence of TDIs was significantly higher in the SG (25.7%) children than the CG (16.3%) [p=0.012]. The primary maxillary central incisors were the most commonly affected teeth in both the groups; significantly more in CG (72.9%) than SG (50.1%) [p=0.017]. Enamel fracture was the most frequent type of TDI in both the groups; significantly more in CG (29.2%) than SG (21.1%) [p=0.032]. Luxation injuries and tooth avulsions were significantly higher in the SG than the CG (p=0.028).Conclusions:The occurrence of TDIs was higher in Saudi preschool children with ASD than in non-ASD children.

A case of dental fusion in primary dentition from late bronze age Greece

Background/Aim: Dental fusion is a developmental abnormality that can occur in primary and/or permanent dentition. Case report: A case of double primary teeth from a Late Bronze Age cemetery in Greece is presented. Age estimation of the skeleton was based on dental eruption and development as well as on fusion of primary ossification centres of the cranial and post-cranial skeleton. Analysis of double teeth used morphology, anatomy, location, tooth count and radiological examination. Results showed a 18 month infant. Primary lower right central and lateral incisors were joined by the dentin, and they had distinct crowns and separated pulp chambers; each tooth maintained its own root canal and resembled a normal primary central and lateral incisor shape respectively. Diagnosis showed that double teeth were the result of partial fusion rather than gemination. No other dental abnormalities or lesions were recorded and subsequent teeth were not affected. Conclusions: This is the first example of double teeth in primary dentition reported in the literature from archaeological assemblages in Greece. Being one of the rare examples of dental fusion in the bioarchaeological record, this report adds further to the mapping of dental anomalies in past populations.

Management of Natal Teeth: Paediatric Dentist Role

The occurrence of teeth at the time of birth is called natal teeth. The incidence of this anomaly has been approximately 1:1400 to 1:3500 live births. Most commonly seen in mandibular primary central incisor region and usually occur in pairs. The present case scenario describes about the management of natal teeth in a seven day old new born baby and also the role of paediatric dentist in its management as well as guidance for medical practitioners and parents.

Additional Maxillary Primary Central Incisor Root Causing Disturbance of Permanent Tooth Eruption

Additional Maxillary Primary Central Incisor Root Causing Disturbance of Permanent Tooth Eruption

Concomitant hypohyperdontia: Mesiodens and agenesis of a maxillary central incisor in the primary dentition

Simultaneous occurrence of supernumerary and agenesis of the teeth is called concomitant hypohyperdontia (CHH). The condition is rare with unknown etiology. CHH may occur in both the jaws and is more common in the permanent and mixed dentition. In this article, we describe a case of nonsyndromic CHH in the primary dentition. A 5-year-old boy showed a conical mesiodens and missing left primary central incisor. Radiographic examination of the patient did not reveal any anomalous succedaneous permanent teeth.

Histological and chemical analyses of mesiodens development and mineralization

ObjectiveThis study aimed to compare the developmental timing and mineralization quality of mesiodentes, i.e., supernumerary teeth located mainly in the midline of the maxilla between the central incisors, with the developmental timing and mineralization quality of permanent and primary central incisors. DesignSixteen mesiodentes, nine permanent and seven primary central incisors were collected. The location of the neonatal line was determined using a light microscope at 10× or 20× enlargements. Chemical composition of the enamel at two locations was analyzed using energy dispersive X-ray spectrometer. ResultsNeonatal lines were observed in eight out of 16 mesiodentes, in all primary central incisors and in none of the permanent central incisors. Chemical analyses showed that mesiodentes mineralization was impaired, resulting in higher amount of organic ions and reduced inorganic ions. Discriminant analysis showed minimal overlap of mesiodentes with either primary or permanent centrals. ConclusionsMesiodentes development begins before birth in 50% of the cases but later than the primary centrals. Mineralization of mesiodens is impaired with less mineral content and higher organic content. The results showed that mesiodentes are a special group of teeth with defective morpho-differentiation and mineralization, with little similarity to primary or permanent central incisors.

Evaluation of the effect of different post materials and adhesive systems on the bonding strength of short-post technique for primary teeth.

The most important process in treating grossly decayed teeth, including decay in the pulp, is the ability to hold a retainer in for a short time. The aim of this study was to investigate the bond strengths of different adhesive systems and post materials on primary teeth. One hundred and twenty extracted maxillar primary central incisor teeth were randomly divided into two main groups (total-etch and self-etch adhesive systems) and five subgroups (1: control-nanohybrid composite resin, 2: pre-impregnated glass fiber, 3: unsaturated glass fiber, 4: polyethylene fiber, 5: short-fiber reinforced composite resin). The push-out test was performed using a universal testing machine with a crosshead speed of 0.5mm/min. No statistically significant difference was detected between the two different adhesive systems and five different materials in terms of the maximum values measured for fractures in the specimens when both the adhesive materials and the short-post materials were evaluated separately (P>0.05). However, as a result of multiple comparisons made, it was found that statistical differences between the groups applying the total-etch adhesive system occurred in Groups 3 and 5. The highest push-out test values were measured in Group 5 and Group 1, and the lowest value in Group 3. Although the fracture type distribution in the total-etch adhesive system groups was not statistically different based on the material used (χ2 =11,865; P=0.309), the self-etch adhesive systems did show differences (χ2 =28,463; P<0.001). Both the total-etch and the self-etch adhesive system groups showed mostly adhesive failures. The fiber-reinforced and nanohybrid composite resin had higher values in the short-post technique, and there was no significant difference between the different fiber posts.