Primary Dentition Period Research Articles

Predictors of dental arch abnormalities in children with primary dentition (part two)

Relevance. Assessing the influence of risk factors during the primary dentition period on the development of dental arch abnormalities is essential for planning preventive and therapeutic interventions, as well as encouraging compliance with these measures. The first part of this article focused on identifying predictors of malocclusion, while this second part aims to determine the predictors of dental arch abnormalities.Purpose. To identify prognostic factors (predictors) of dental arch abnormalities in children during the primary dentition period.Materials and methods. This study presents the results of a retrospective analysis of the oral health status of 123 children (55 boys and 68 girls). The initial examination took place when the children were between 4.0 and 5.5 years old (mean age 5.1 ± 0.6 years), with follow-up examinations conducted between the ages of 6.0 and 10.5 years (mean age 8.7 ± 1.3 years). The relationship between risk factors in primary dentition and the development of dental arch abnormalities in early mixed dentition was evaluated using Pearson's chi-squared test (χ2) and Welch's t-test (V). For each pair of "primary dentition risk factor – dental arch abnormality in early mixed dentition," the odds ratio with a 95% confidence interval was calculated.Results. Differentiating predisposing factors and analyzing the effects of their various combinations allowed the identification of predictor clusters in primary dentition, where the probability of developing dental arch abnormalities in mixed dentition exceeds 95%. For upper arch abnormalities, the cluster includes infantile swallowing and early extraction of deciduous molars in the lower jaw (χ2 =19.67, V=0.50); for lower arch abnormalities, the cluster consists of infantile swallowing, "lazy" chewing, sucking habits, and a deep bite in the anterior region (χ2 =16.58, V=0.67); For lower incisor crowding, the cluster includes "lazy" chewing, infantile swallowing, and a deep bite in the anterior region (χ2 =17.54, V=0.63); for diastema in the upper arch, the cluster includes an abnormal labial frenum and interdental tongue position (χ2 =19.16, V=0.49); for maxillary anterior spacing, early extraction of deciduous canines in the upper jaw is the primary factor (χ2 =16.23, V=0.46).Conclusion. Identifying and addressing predictors of dental arch abnormalities in children during the primary dentition period can significantly reduce the risk of developing pathological conditions during the mixed dentition period.

The Evaluation of Occlusion Characteristic and Deleterious Oral Habits in 3- to 5-year-old Children

Aim: Malocclusion is a prevalent public health concern, impacting craniofacial growth and development, and significantly affecting the quality of life of children in terms of oral health. This study investigated the prevalence of malocclusion in children aged 3 to 5 years, aiming to understand its occlusal characteristics, deleterious oral habits, correlations, and their parents’ attitudes toward malocclusion. Materials and Method: This cross-sectional study included 275 children aged 3-5 and their parents. The occlusion characteristics of the children participating in the study, including the relationship of the primary molar and canine teeth, overjet, crossbite, deep bite and anterior open bite, were evaluated and recorded by a researcher. A 7-item questionnaire was administered to the parents to collect sociodemographic data and oral health habits of the children's parents. The chi-square test was used for statistical assessment of results. Results: The results revealed that 40.7% of the children had malocclusion during their primary dentition period. It was found that the most common malocclusion was deep bite (15.7%) and harmful oral habits, especially bruxism (16.3%), were commonly observed among children in the researched age group. Conclusion: The results of this study will play an important role in shaping future oral health planning, especially regarding malocclusions seen in the primary dentition. It is thought that the findings from the study will guide strategies to improve oral health and preventive measures.

The Effect of Cleft Width on Maxillary Morphology in Newborn with Unilateral Cleft Lip and Palate

Objective: This study aims to investigate the impact of cleft width on maxillary morphology in newborns with unilateral cleft lip and palate (UCLP). Materials and Methods: Plaster models from 35 newborns with unilateral cleft lip and palate (UCLP) (17 boys, 18 girls) and 35 newborns with isolated soft palate cleft (CP) (16 boys, 19 girls) were examined. The measured parameters included C-C' , T-T', arch circumference, arch length, G-L, a-a', and b-b'. Statistical analyses were conducted using an independent samples t-test and Mann–Whitney U test for normally and non-normally distributed data, respectively. Pearson Correlation assessed the correlation between G-L and other measurements. The analysis was performed at a significance level of 0.05 using R software, version 4.0.5. Results: Statistically significant differences were found in C-C' (p < 0.001) and T-T' (p < 0.05) between the two groups. UCLP newborns showed a significant increase in arch length (28.4 ± 2.9 mm) compared to CP (25.0 ± 2.6 mm, p < 0.001). Both (a-a') and (b-b') demonstrated a significant increase in UCLP (p < 0.001). A significant correlation was observed between (G-L) and (C-C') and (a-a') (p < 0.01), and between (T-T') and (a-a') and (b-b') (p < 0.01). The correlation between arch circumference and (b-b') was significant at the 0.05 level. Conclusion: In UCLP newborns with increased anterior cleft width, the anterior alveolar arch width increases, affecting maxillary morphology. While early orthopedic and surgical interventions prove effective in managing severe clefts, the initial severity of the cleft width significantly influences dental arch relationships and treatment outcomes. Consequently, initiating maxillary expansion and protraction interventions during the early primary dentition period becomes crucial.

Positioning Errors in Panoramic Images Based on the Dentition Type of Patients Referring to the Oral and Maxillofacial Radiology Department of Tabriz Dental School During 2017-2018

Background: Panoramic imaging is a technique to create images of facial structures. Various factors affect the preparation of a high quality and proper panoramic image, such as the patient’s proper position. The aim of this study was to investigate positional errors in panoramic images based on the dentition type of patients referring to oral and maxillofacial radiology department of Tabriz Dental School Methods: This cross-sectional study was conducted in Radiology Department of Tabriz Dental School in 2017-18. Dentition of patients (primary, mixed, permanent, complete edentulous) was determined by radiography. 410 radiography per group (1640 samples) were selected from the archives of Radiology Department by simple random sampling method. one radiologist evaluated all the images in the same condition and in a semi-dark room, in a 21-inch DELL monitor, regarding the presence of each of the positioning errors. Radiographs that were repeated due to positioning errors and poor diagnostic quality were classified as unacceptable radiographic images. Results: In primary, mixed, permanent and edentulous dentitions, not attaching the tongue to the palate were the most errors in the radiographies, with 50.4%, 65.6%, 64.3% and 64.8%, respectively. The presence of 2 errors (563 radiographies, 34.3%) had the highest frequency. 123 radiographies (7.5%) were free of errors. Primary dentition with 95 radiographies (23.2%) had the highest unacceptable radiographies, and edentulous dentition with 29 radiographies (7.1%) had the lowest unacceptable radiographies. Chi-square test indicated that this finding was statistically significant (P <0.001). Conclusions: Positioning error has high prevalence in radiographic images, the most common of which is not attaching the tongue to the palate during radiography. In the primary dentition period, the number of acceptable radiographs was lower than the other periods.

Comparison of Maxillofacial Morphology Between Modified Furlow's and Modified two-Flap Palatoplasty in Orofacial Clefts During the Primary Dentition Period.

To assess the effect of two palatoplasty procedures, modified Furlow's palatoplasty (F procedure) and modified two-flap palatoplasty (T procedure), on the maxillofacial morphology of unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP) during the primary dentition period. Retrospective cohort study. Department of Orthodontics, School of Dentistry, Showa University. We enrolled 106 pediatric patients (63 boys, 43 girls; aged 4.43 ± 0.34 years) with non-syndromic orofacial clefts who underwent cheiloplasty and palatoplasty. Patients were divided into four groups according to cleft type (BCLP or UCLP) and palatoplasty procedure type (F or T procedure). Maxillofacial morphology was assessed by examining parameters on lateral cephalograms. Multiple comparisons revealed significant differences among N-A, N-ANS, and ANS-PNS distances and SNA and ANB angles among the groups. There were significant differences in N-A, N-ANS, ANS-PNS, SNA, and SNB among the UCLP and BCLP groups. The calculated effect sizes were all within 0.3-0.5. The statistical power was as follows: N-A, 86.41%; N-ANS, 79.77%; ANS-PNS, 97.49%; SNA, 96.88%; and ANB, 99.25%. Although UCLP and BCLP both exhibited differences in craniofacial distances and angles, the procedure type (either F or T procedure) had no significant effect on the maxillofacial morphology (as determined by lateral cephalograms). However, to rule out additional bias, patient-specific factors should be considered that may be affected by maxillofacial development when deciding surgical approaches.

Surgical Repositioning of the Premaxilla: Incidence, Indications and Growth Study About a 189 Bilateral Cleft Lip ± Palate Population.

We aimed to evaluate the rate of patient requiring Surgical Repositioning of the Premaxilla in a population carrying BCL ± P, retrieve age and operative indication. Our secondary objective was to present further facial growth characteristics. This was a retrospective, single-center cohort study conducted in Nantes University Hospital, Oral and Maxillofacial Surgery department, tertiary cleft center. Patients with BCL ± P born between 1980 and 2019 treated at Nantes University Hospital were included. Our primary outcome measure was the rate of patient requiring SRP. Over the whole period, 189 patients with BCL ± P were identified. Three patients (1,58%) underwent SRP. Patients who underwent SRP all had BCLP. SRP was performed during their primary dentition period. The indication for surgical repositioning was always premaxilla vertical overgrowth with an overbite over 10 mm. Facial growth features in the three patients were mostly comparable with a population carrying BCLP who had no premaxillary surgery. Our results showed a low incidence of SRP. No SRP was necessary during early infancy (ie, before lip repair) or during adulthood. Surgical repositioning of the premaxilla is beneficial for patient with orthodontically uncorrectable vertical premaxillary excess, even more since facial development compared with other patients with BCLP appears comparable.

Dentigerous Cyst Mimicking Radicular Cyst during Primary Dentition Period – A Diagnostic Dilemma

Dentigerous Cyst Mimicking Radicular Cyst during Primary Dentition Period – A Diagnostic Dilemma

Prevalence of maxillary and mandibular physiological space in the primary dentition

Introduction: Physiological space is the space between maxillary and mandibular primary central incisors as well as maxillary and mandibular primary lateral incisors that occur during primary dentition period. The absence of physiological space will lead the crowded of permanent dentition due to discrepancy of the size of tooth and jaw. The objective of this study was to evaluate and analyse the prevalence of physiological space of maxillary and mandibular during primary dentition period. Methods: The type of research was a descriptive survey technique. The study was conducted at the Early Childhood Education (PAUD) in Bandung City throughout January-March 2017. The study population was children aged 3-5 years. Multistage cluster sampling used to choose subjects based on the division of the area from the city area to obtain the desired population. The data used were primary data obtained by examining the existence of a gap with a gap width indicator that is used as a benchmark of at least 0.5 mm with the help of WHO probe tool. Data were collected, processed and analysed using the SPSS (Statistical Package for Social Sciences) version 20. Results: A total of 65 out of 97 subjects had physiological space in their first dentition period. From 97 study subjects (100%) examined, 44 children (45.36%) had maxillary physiological space, and 53 children (54.64%) did not have maxillary physiological space. In 97 research subjects (100%) there were also 48 children (49.48%) having physiological space in the lower jaw, and 49 children (50.52%) did not have physiological space in the lower jaw. Conclusion: Prevalence of the maxillary and mandibular physiological space in the primary dentition period of children in the city of Bandung are 67.01%.

Retrospective Study of Pediatric Oral Lesions in Rural Areas in District Etawah, Uttar Pradesh.

Aim and objectivesThe aim of the study was retrospective comparative evaluation of past 3 years’ pediatric oral lesions diagnosed from the Department of Dentistry, UPUMS, Saifai, Etawah, and classification and identification of pediatric oral lesions on the basis of demographic features and histopathological features.Materials and methodsThe present retrospective comparative evaluation was done with the help of the last 3 years’ histopathological reports obtained from the Department of Dentistry, U.P. University of Medical Sciences, Saifai, Etawah. Pediatric patients of age 0–17 years divided in three groups included in the study.ResultsIn our department, out of total 450 histopathological reports, 56 reports were of pediatric cases in which males were 38 and females were 18. Pediatric patients were further divided into three categories: primary dentition period (0–5 years), mixed dentition period (6–12 years), and permanent dentition period (13–17 years).ConclusionThis retrospective study is an effort for classifying and identifying pediatric oral lesions on the basis of demographic features and histopathological features. The majority of the oral lesions detected were benign in nature.How to cite this articleMishra R, Singh AK. Retrospective Study of Pediatric Oral Lesions in Rural Areas in District Etawah, Uttar Pradesh. Int J Clin Pediatr Dent 2020;13(5):468–470.

Interim use of a maxillary lip bumper during interdisciplinary management of ectopically erupted incisor teeth.

Ectopic eruption, manifesting as an aberration in the normal path of eruption of a tooth, can adversely impact facial aesthetics, phonetics and psychosocial development. This case series describes the orthodontic management of two adolescent patients with different clinical presentations of ectopically erupted maxillary central incisors secondary to trauma during the primary dentition period. The therapy primarily included periodontal soft-tissue surgery accompanied by orthodontic traction to align the ectopic incisors. Frenectomy was performed in one patient and surgical excision of a hypertrophied pseudo-pouch in the second patient. A modified maxillary lip bumper was used concomitantly for management of associated soft-tissue trauma, thus facilitating healing and aiding orthodontic traction. Appropriately planned interdisciplinary management involving the interim use of a modified lip bumper allowed proper alignment of the ectopically positioned incisors with a stable outcome at three-year follow-up. Fixed orthodontic therapy with concurrent use of modified maxillary lip bumper is an effective approach to treat incisors erupted ectopically in relation to the upper lip and frenum.

Condition of permanent teeth after chemotherapy during the primary dentition period in oncology patients

Condition of permanent teeth after chemotherapy during the primary dentition period in oncology patients

Longitudinal Evaluation of Salivary Iga-S in Children with Early Childhood Caries Before and After Restorative Treatment.

Background: Our aim was to compare salivary levels of secretory immunoglobulin A (s-IgA) in children with early childhood caries (ECCG) and those who are caries-free (CFG) and verify these levels in a follow-up period after restorative treatment. Materials and methods: We selected 46 systemically healthy children in the complete primary dentition period, who were allocated into two groups: CFG (n = 23) and ECCG (dmf-s > 0; n = 23). Unstimulated whole saliva was obtained at baseline from both groups and during the follow-up period (7 days, 1, 2 and 3 months) in the ECCG group. The s-IgA was measured using an ELISA assay, and total protein was assessed using the Bradford method. We also evaluated the flow rate (mL/min), Streptococcus mutans and Lactobacillus spp. counting using selective media plaques. The data were submitted to statistical analysis using the software SPSS 20.0 (SPSS Inc, IL, USA) with a confidence interval set at 95%. Results: Salivary s-IgA levels were higher in baseline of ECCG than in CFG (p<0.05). No statistically significant differences were observed between s-IgA salivary levels at baseline and the evaluations after dental treatment in ECCG (p>0.05). However, we observed two different changes in s-IgA levels among participants: one group presented s-IgA reduction, and the other group demonstrated its maintenance. It was shown that patients from the ECCG group who presented a reduction in s-IgA levels during follow-up also showed a decrease in Streptococcus mutans and Lactobacillus spp. count (p<0.05), in contrast to patients who did not present this reduction. The flow rate and total protein were similar between groups (p>0.05). Conclusions: The present data support the idea that children with early childhood caries present higher levels of s-IgA in saliva than caries-free children. The restorative dental treatment does not have a significant influence on salivary levels of this immunoglobulin during the follow-up period.

Alveolar Growth in Japanese Infants : A Comparison between Now and 40 Years ago.

To investigate differences in alveolar growth during the primary dentition period among different age groups, dental arch width, length, and height were measured in 93 dental arch plaster models obtained from 4-year-olds born between 1968 and 1974, 88 from 5-year-olds born between 1968 and 1974 (70s group), 61 from 4-year-olds born between 2007 and 2009, and 56 from 5-year-olds born between 2006 and 2008 (2000s group). A comparison was also performed to determine whether there was any difference in change between 4 and 5 years of age. The results showed age- and sex-dependent differences in growth patterns in primary dental arch width, length, and height. The amount of change was greater in the 2000s group than in the 70s group, suggesting that yearly growth between 4 and 5 years of age has increased over the last 40 years.

Repousser les limites de la dimension transversale. Asymétrie faciale, volume du palais et posture linguale chez les enfants ayant une occlusion croisée unilatérale postérieure : évaluation tridimensionnelle d’un traitement précoce

Unilateral posterior crossbites have been reported to be one of the most prevalent malocclusions of the primary dentition in Caucasian children. Facial asymmetry due to lateral mandibular displacement in unilateral posterior crossbite, if not treated in the primary dentition period, may lead to an undesirable growth modification which results in facial asymmetry of skeletal origin. Irregular tongue function and posture have also been diagnosed as important etiological factors. Early orthodontic treatment seems to be profitable and desirable to create conditions for normal dental, functional and skeletal development of the orofacial region. Treatment success after correction of unilateral posterior crossbite in the primary dentition is highly questionable, as it is very difficult to objectively assess correction of facial asymmetry and irregular tongue function and posture in small, growing children. Although facial photography is an important diagnostic tool in orthodontics, its main disadvantage is that it represents a three dimensional subject in two dimensions. Tongue posture and function during clinical examination are difficult to assess and is therefore unreliable. Contemporary 3D diagnostics in unilateral posterior crossbite enables uninvasive, valid and objective assessment of facial morphology, palatal volume, tongue function and posture. It can, therefore, become in the future an important part of morphological and functional diagnostics in orthodontics and dentofacial orthopedics before, during and after orthodontic treatment.

Odontogenic lesions in pediatric patients.

The purpose was to evaluate our 20-year experience of pediatric odontogenic lesions. Pediatric patients with a diagnosis of odontogenic lesion were identified. Three hundred ten patients were odontogenic; dentigerous cyst was seen in 62.0% of the cases. Most (70.2%) of them occurred in mixed dentition period, and it had a male preponderance. Odontogenic keratocystic tumor occurred in the permanent dentition period. It had an equal site distribution. Odontoma was seen in 20.0% of the cases. Its site of predilection was the mandible. Ameloblastoma was the most common odontogenic tumor. Most of the cases occurred in the permanent dentition period. It affected the male and female equally. Calcifying epithelioma odontogenic tumor was seen in 11.8% of the cases. All the lesions occurred in the primary dentition period. It had no sex or site preponderance. Myxoma was seen in 3.6% of the cases. It was most common in the permanent dentition period, and it was more frequent in the male. Iliac crest bone graft was successfully performed in 28 patients, postoperative infection occurred in 2 patients, and no donor-site dysfunctions were reported. The observed differences in lesion type and distribution in this study compared with previous researches may be attributable to genetic and geographic variation in the populations studied. Iliac crest bone graft was suggested for pediatric mandible reconstruction.

구강 내 장치와 III급 고무줄을 이용한 유치열기 전치부 반대 교합 치료

III급 부정 교합과 전치부 반대 교합은 동양인에게서 더 빈번히 관찰되며 이 문제는 치과 의사뿐 아니라 부모도 쉽게 인지할 수 있다. 유치열기 반대 교합의 경우, 피개량이 깊어질수록 하악의 기능성 전방 변위가 현저해지는데 이를 방치하면 골격성 반대 교합으로 이행될 우려가 있다. 따라서 치료가 필요한 유치열기 반대 교합의 경우 조기에 정확히 진단하는 것이 중요하고 조기교정 치료를 통해 개입할 필요가 있다. 본 증례에서는 유치열기에 전치부 반대 교합을 주소로 내원하여 기능성 반대 교합으로 진단된 만 4세 어린이들에게 구강내 장치를 이용한 치료를 시행하여 정상적 상하악 치열 관계로 개선시켰다. 또한 본과에서 유치열기 반대 교합 치료를 받은 7명의 어린이들의 치료 기간과 사용된 장치를 고찰하고, 측방 두부 규격 방사선 사진 분석을 통해 치료 전후의 상하악의 위치적 관계의 변화, 악골 크기의 변화량 등을 분석하였다. 그 결과 구내 장치와 III급 고무줄을 이용한 치료에서 대부분의 어린이들은 1년 이내에 반대 교합의 개선을 보였고, 그 치료 결과는 전하안면 고경의 수직적 성장을 통한 하악의 후하방 회전에 의한 것으로 나타났다. Class III malocclusion or anterior crossbite is commonly seen in Asian. This problem is easily recognized by dentists and parents. During the primary dentition period, anterior crossbite with functional shift and deep overbite could develop to skeletal protrusive mandible. So, early and proper diagnosis of anterior crossbite which needs prompt treatment is important. These cases showed the early management of crossbite with functional shift in primary dentition using intraoral removable appliance resulting in improvement of intermaxillary relationship. And I analyzed the positional change and the dimensional change during treatment with lateral cephalometric x-ray analysis. Our patients showed vertical dimensional change of lower anterior facial height and clockwise rotation which results crossbite correction in 1 year of treatment period.

Three-dimensional evaluation of early crossbite correction: a longitudinal study

The aim of this longitudinal study was to assess whether correction of unilateral posterior crossbite in the primary dentition results in improvement of facial symmetry and increase of palatal surface area and palatal volume. A group of 60 Caucasian children in the primary dentition, aged 5.3 ± 0.7 years, were collected at baseline. The group consisted of 30 children with a unilateral posterior crossbite with midline deviation of at least 2 mm (CB) and 30 without malocclusion (NCB). The CB group was treated using an acrylic plate expander. The children's faces and dental casts were scanned using a three-dimensional laser scanning device. Non-parametric tests were used for data analysis to assess differences over the 30 months period of follow-up. The CB children had statistically significantly greater facial asymmetry in the lower part of the face (P < 0.05) and a significantly smaller palatal volume (P < 0.05) than the NCB children at baseline. There were no statistically significant differences between the two groups at 6, 12, 18, and 30 months follow-ups. Treatment of unilateral posterior crossbite in the primary dentition period resulted in an improvement of facial symmetry in the lower part of the face (P < 0.05) and increase of the palatal surface area and palatal volume (P < 0.001). At 30 months, relapse was observed in eight children (26.7 per cent). Treatment of unilateral posterior crossbite in the primary dentition improves facial symmetry and increases the palatal surface area and the palatal volume, though it creates normal conditions for normal occlusal development and skeletal growth.

抑制矯正で顎矯正手術を避けることが出来なかった下顎非対称を伴う骨格性下顎前突症例

Interceptive orthodontic treatment is important to prevent malocclusion. This treatment is performed to minimize maxillo-facial deformation and malocclusion by removing their causes from primary dentition in an early stage of the mixed dentition period.This case was mandibular protrusion in the growth period with left deviation of the mandibular bone. Although interceptive orthodontic treatment was performed, facial asymmetry became marked with adolescent growth. As a result, surgical orthodontic treatment was performed upon reaching adulthood.The orthognathic surgery consisted of intraoral vertical ramus osteotomy (IVRO) on the deviated side and sagittal splitting ramus osteotomy (SSRO) on the non-deviated side. Although good results were obtained, we evaluated the effects of interceptive orthodontic treatment during the growth period.This case suggests: 1) To prevent mandibular asymmetry, early treatment from the primary dentition period should be regarded as an option; 2) a chin cap should be used in consideration of the possibility of adverse effects; and 3) evaluation of muscle functions is important to facilitate the normal growth and development of the mandible.

Bacteriological evaluation of mutans streptococci using modified mitis-salivarius-bacitracin (MSB) agar medium in primary dentition period

Mutans streptococci considered causative agents of dental caries are indigenous to the oral cavity. Modified mitis-salivarius-bacitracin (MSB) agar medium was supplied by BML. This media has characters to grow mutans streptococci very well and to inhibit of non-mutans streptococci. However, little is known about studies using this medium. In this study, we assessed the utility of modified MSB medium and discuss the relation between mutans streptococci and dental caries in primary dentition period. Modified MSB medium was found to be a suitable medium to isolate and quantify mutans streptococci since it could permit selective growth of mutans streptococci. Moreover, this medium inhibited to non-mutans streptococci ( S. anginosus and S. intermedius ), completely. The detection rate of Streptococcus mutans and Streptococcus sobrinus increased in proportion to the severity of dental caries in the nursery children. From these results, modified MSB agar medium is useful in the judgment to detect the mutans streptococci.

Evaluation of the Indications for Functional Orthodontic Appliances in Anterior Cross Bite Cases in the Primary Dentition Period

Evaluation of the Indications for Functional Orthodontic Appliances in Anterior Cross Bite Cases in the Primary Dentition Period