Primary Dentition Research Articles

Grade C Molar-Incisor Pattern Periodontitis in Young Adults: What Have We Learned So Far?

Grade C molar-incisor pattern periodontitis (C-MIP) is a disease that affects specific teeth with an early onset and aggressive progression. It occurs in systemically healthy patients, mostly African descendants, at an early age, with familial involvement, minimal biofilm accumulation, and minor inflammation. Severe and rapidly progressive bone loss is observed around the first molars and incisors. This clinical condition has been usually diagnosed in children and young adults with permanent dentition under 30 years of age. However, this disease can also affect the primary dentition, which is not as frequently discussed in the literature. Radiographic records have shown that most patients diagnosed in the permanent dentition already presented disease signs in the primary dentition. A hyperresponsive immunological profile is observed in local (gingival crevicular fluid-GCF) and systemic environments. Siblings have also displayed a heightened inflammatory profile even without clinical signs of disease. A. actinomycetemcomitans has been classified as a key pathogen in C-MIP in both dentitions. Scaling and root planning associated with systemic antibiotics is the current gold standard to treat C-MIP, leading to GCF biomarker reduction, some systemic inflammatory response modulation and microbiome profile changes to a healthy-site profile. Further studies should focus on other possible disease-contributing risk factors.

Characteristics Of Occlusion In Primary Dentition And Its Relationship With Caries In Preschool Children In Aydın

Objective: The purpose of this study was to determine the clinical characteristics of occlusion in primary dentition and examine its relationship to caries experience in preschoolers in Aydın, TÜRKİYE. Materials and methods: The study was conducted among 962 children aged 3–5 years from preschoolers in a cross-sectional design. The clinical features were evaluated according to Björk et al and the caries examination was carried out with dft index. Results: The most common type of terminal plane relationship was flush type (46.7%) and primary canine relationship was Class I (69.6%). The most common type of irregularity was the prevalence of deep overbite (55.7%) followed by midline deviation (15.8%). Approximately half of the children (51.2%) had at least one carious tooth but caries experience was not related with any of the occlusal irregularities. Conclusion: Occlusal characteristics of the preschool children were defined and no relationship was found between these features and gender or caries experience.

Prevalence of Malocclusion Traits in Primary Dentition, 2010-2024: A Systematic Review.

The present review was aimed to describe the prevalence and the regional distribution of malocclusion among preschool children worldwide. Two independent reviewers performed a systematic literature search to identify English publications from January 2010 to May 2024 using PubMed, ISI Web of Science and Embase. Search MeSH key words were "malocclusion", "primary dentition" and "child, preschool". The reporting quality was assessed by the modified Newcastle-Ottawa Quality Assessment Scale. We identified 2599 publications and recruited 47 articles. Fourteen of the included studies were conducted in Asia, four in Europe, twenty-eight in South America and one in Africa. The prevalence of malocclusion ranged from 28.4% to 83.9%, and half of the reported prevalences were higher than 50%. The highest percentage was in Asia (61.81%), followed by Europe (61.50%), South America (52.69%) and Africa (32.50%). Statistically significant differences existed in deep overbite, anterior open bite, posterior crossbite, edge-to-edge incisor relationship and distal step between continents (p < 0.05). Europe showed the highest prevalence (33.08%) of deep overbite. Africa showed the highest prevalence (18.60%) of anterior open bite. Europe showed the highest prevalence (15.38%) of posterior crossbite. The most common malocclusion traits were increased overjet and deep overbite. To conclude, malocclusion remained prevalent in the primary dentition and varied between countries.

Evaluation of Volumetric Changes between Pediatric Rotary Files and Manual Files during Canal Preparation of Primary Mandibular Canine: A Nano-CT Analysis

Abstract Objective Pediatric endodontics has become popular due to advancements in cleaning, shaping, and irrigation systems, resulting in faster and effective removal of infected pulp, saving time, and creating a pathogen-free environment. The patented rotary file system, Kedo S, designed for primary teeth, introduced a single file generation for efficient pulp therapy. However, there are currently no studies assessing canal preparation in primary mandibular canine using nano-computed tomography (nano-CT). This study aims to evaluate the efficacy of rotary file systems (Kedo S plus, Kedo SG blue) against traditional hand files in root canal preparation of primary mandibular canines using nano-CT. Materials and Methods This in vitro study was performed in extracted primary mandibular canine based on certain inclusion and exclusion criteria. Samples were prepared and working length was determined before the preoperative scan using a high-resolution nano-CT device (SkyScan 2214, Bruker, Kontich, Belgium). A single well-experienced pediatric dentist prepared the canals using three file systems: Kedo S plus, Kedo SG blue, and hand K-files. A postoperative scan was performed similar to preoperative scan. Image reconstruction was performed with NRecon software for three-dimensional volumetric visualization and analysis of the root canals. Results Kedo S plus displayed significant alterations in volumetric, surface area, and instrumented areas postpreparation compared with Kedo SG blue and hand files. Statistical analysis revealed significant differences in volumetric and surface changes between Kedo S plus and hand files. Conclusion Rotary file systems, especially Kedo S plus, resulted in increased canal volume and surface area with minimal uninstrumented areas, showing promise for primary dentition root canal preparations. Further clinical assessments are warranted to validate these findings.

Traditional Versus Advanced Pulp Capping Materials in Primary Teeth.

In situations where pulp degeneration and carious lesions may coexist, pulp therapy is a regularly employed method. Mineral trioxide aggregate, a material that is now utilized for indirect pulp treatment (IPT), is nontoxic and nonmutagenic. There is proof that the restoration margin can be sealed to manage the caries lesion. In terms of the clinical and radiological outcome, it has been demonstrated that IPT is more effective and secure than direct pulp capping and pulpotomy. The pulp capping treatment's goal is to protect the pulp from microorganisms as well as from thermal, electrical, chemical, and physical stimulation. There is evidence that suggests targeted caries clearance and composite restoration may stop caries lesions more effectively than full dentin removal. Various pulp capping materials that are available in the market were highlighted in this review, and the discussion of each material was expanded to demonstrate its clinical efficacy. Articles were specifically selected and discussed for the materials used for the IPT in the primary teeth as very few studies have been done so far in relation to this subject. A literature search in various libraries, including PubMed, Cochrane, ResearchGate, Scopus, ScienceDirect, and other libraries, was done for several available materials that have been used for the IPT procedure in primary dentition in the last 20 years.

A Review on Dental Age Estimation in Children and Adolescents

Abstract Children are seen as beings who exist from birth through puberty, while teenagers are regarded as existing from puberty until around the age of 20 years. For a number of legal processes, including child labor, employment, the age of majority, rape, adoption, marriage eligibility, and situations where the birth certificate is unavailable, age estimation in children and adolescents is crucial. Despite the wide range of methods available, dental age estimation techniques that take into account tooth maturation are thought to be the most reliable predictors of chronological age in subadults. This is because genetic factors predominate and environmental factors, particularly between birth and age ten, tend to have little impact on tooth maturation. The eruption of teeth holds greater significance in the deciduous dentition, where genetic factors predominantly govern the process, compared to the permanent dentition. Conversely, tooth calcification serves as a viable indicator for estimating dental age in both primary and permanent dentitions. Current dental age estimation methods are based on age-related changes in teeth, such as tooth growth and development, changes that occur after teeth form, and biochemical changes. Therefore, in this review article, we will explore the several methodologies used for dental age assessment in children and adolescents.

Influence of Maternal Risk Factors for Occurrence of Early Childhood Caries in Children – A Literature Review

Children with early childhood caries (ECC) may develop caries in their developing permanent teeth also. The etiology of ECC is multifactorial. Amongst the common risk factors, maternal risk factors have been studied a lot and are considered as the risk of developing ECC in primary dentition till 71 months of age. There are various maternal factors that can influence the occurrence of ECC in children, such as the educational level of the mother, socioeconomic status, occupation, mother’s inappropriate feeding practices, frequency of maternal sugar consumption, her oral hygiene practices, and her dental treatment-related experiences. Mothers whether working or homemaker, number of siblings at home, type of family also influence the dental care toward her child suffering with ECC. Factors with economic problems in the family leads to familial stress resulting in maternal psychological distress, which is accompanied by throwing temperaments on her child and can lead to dysfunctional parenting behaviors, which is responsible for having ECC in her child.

Oral health status, behavior, and practices among hearing impaired children attending a specialized school in Jordan.

To assess the oral health status and related factors among hearing impaired schoolchildren. A cross-sectional study among 115 hearing impaired schoolchildren enrolled at the School of the Deaf in Jordan. The World Health Organization (WHO) methodology and criteria were applied to collect data on caries, gingival bleeding. The WHO classification modified by Andreasen etal. was used to record traumatic dental injuries (TDIs). Sociodemographic data, oral health practices, and oral health related quality of life information were collected using a structured questionnaire. The prevalence of caries among the study sample was 84.3%, the dominating component was untreated dental caries. Mean decayed, missing, filled primary teeth (dmft) was 8 in the primary dentition and 3.62 in the mixed dentition, mean Decayed, Missing, Filled permanent Teeth (DMFT) was 1.38 in the mixed dentition and 2.87 in the permanent. The overall mean of gingival bleeding percentage among the whole study sample was 70.38%. the prevalence of TDIs was of 11.3% and mostly caused by falls. The prevalence of dental caries and caries experience, rate of gingival bleeding and dental trauma in children with hearing impaired individuals are high compared to figures observed in studies conducted among Jordanian schoolchildren with normal hearing. Dental diseases impact the quality of life of these individuals.

Nonfamilial cherubism in a 6-month-old infant: a case report

BackgroundCherubism is known as a very rare autosomal dominant familial disorder of childhood caused by a mutation in the SH3BP2 gene on 4p16.3. It has not yet been observed at birth and is usually diagnosed in children aged 2–7. Here, we present a non-hereditary case of cherubism at a very early age.Case presentationA 6-month-old girl presented with bilateral progressive jaw enlargement. On physical examination, bilateral asymmetrical jaw enlargement, predominantly on the left side, and some enlarged, non-tender, mobile submandibular lymph nodes were detected. No other abnormality was observed. Further investigations with radiology suggested cherubism and Burkitt’s lymphoma as differential diagnoses. Later on, histopathologic evaluations were suggestive of cherubism. No surgical interventions were indicated, and the child is on regular follow-ups.ConclusionNon-hereditary Cherubism, despite scarcity, can present in children below two years of age, even as early as the beginning of primary dentition. Accurate and swift diagnosis is essential to avert physical and psychological complications. Our case report shows the importance of keeping cherubism in mind as a differential diagnosis of bone disease, even in children under a year old, and the value of interdisciplinary collaboration in dealing with rare genetic disorders.

The Use of Different Dental Notation Systems among Dental Practitioners in Benghazi

Dental notation systems (DNSs) play a crucial role in dentistry, facilitating accurate communication and efficient record-keeping. In this study, we explore the use of different dental notation systems among dental professionals in Benghazi. Background: As the Dental notation systems utilize symbols and abbreviations to represent specific teeth, these systems enable effective communication between dental professionals, laboratory technicians, and dental assistants. Aim: To assess the knowledge, awareness and practice of DNSs by the dentists in Benghazi dental clinics and to know the most common types of DNSs used in Benghazi dental clinics Materials &amp; method: A cross-sectional survey. a self-completed structured questionnaire containing yes or no questions was randomly distributed to Benghazi dentists during the summer 2023. The survey comprised of the gender, and experience. The remaining part focused on the questions related to most commonly used and understandable Tooth numbering system. Results 69 responses on the randomly distributed questionnaire to dentists were received. 91.3 % 0f participants were females and only 8.7% were males. The results revealed that the participants used Palmer system very common 63.8% and 72.5% for primary dentition and permanent dentition respectively Conclusion: The most common type is Palmer system for both primary and permanent teeth but there is shift toward electronic communication which favors the FDI system. Clarity, consistency, and ease of use remain critical considerations for effective dental notation. Keywords: Notation, Tooth numbering system (TNS), FDI, Palmer, Universal system

A Deep Learning Approach to Automatic Tooth Caries Segmentation in Panoramic Radiographs of Children in Primary Dentition, Mixed Dentition, and Permanent Dentition.

The purpose of this study was to evaluate the effectiveness of dental caries segmentation on the panoramic radiographs taken from children in primary dentition, mixed dentition, and permanent dentition with Artificial Intelligence (AI) models developed using the deep learning method. This study used 6075 panoramic radiographs taken from children aged between 4 and 14 to develop the AI model. The radiographs included in the study were divided into three groups: primary dentition (n: 1857), mixed dentition (n: 1406), and permanent dentition (n: 2812). The U-Net model implemented with PyTorch library was used for the segmentation of caries lesions. A confusion matrix was used to evaluate model performance. In the primary dentition group, the sensitivity, precision, and F1 scores calculated using the confusion matrix were found to be 0.8525, 0.9128, and 0.8816, respectively. In the mixed dentition group, the sensitivity, precision, and F1 scores calculated using the confusion matrix were found to be 0.7377, 0.9192, and 0.8185, respectively. In the permanent dentition group, the sensitivity, precision, and F1 scores calculated using the confusion matrix were found to be 0.8271, 0.9125, and 0.8677, respectively. In the total group including primary, mixed, and permanent dentition, the sensitivity, precision, and F1 scores calculated using the confusion matrix were 0.8269, 0.9123, and 0.8675, respectively. Deep learning-based AI models are promising tools for the detection and diagnosis of caries in panoramic radiographs taken from children with different dentition.

Orthopaeddontics in Cleft Treatment

Orthopaeddontics offers a comprehensive treatment paradigm tailored to paediatric patients aged 5 to 11 years with cleft anomalies, focussing on early correction of dento-alveolar and orthognathial deformities alongside structured psychological support. The intensive pre- surgical preparational treatment phase, conducted during this very active growth period, lays the foundation for subsequent surgical interventions, particularly secondary osteofusion, in children with the CLA and CLAP deformities. The primary objective is to achieve optimal gothic arch formation, ideal maxillary-mandibular occlusal relationship and attain balanced facial aesthetics while mitigating orthognathial deformities. Following surgery, orthopeaddontic maintenance continues into the pre-adolescent years, typically until the age of 12 years, ensuring sustained treatment efficacy before transitioning to standard orthodontic care. Central to this approach is a non-extraction treatment philosophy targeting both primary and permanent dentition, aimed at aligning teeth to achieve the most ideal arch or horse-shoe- shaped alveolus arch for all of the two (uCLA/uCLAP) or three arch segments (bCLA/bCLAP) within a balanced maxillary-mandibular occlusal relationship with an ideal facial balance. Various orthopaeddontic techniques are employed to address abnormal dimensional appearances, complimented by a psychologically sensitive approach to support paediatric patients and their families. During the orthopaeddontic treatment the treating expert needs to liaise with the parents to support the cleft child with a gentle, psychologically meaningful approach to warrant essential ultimate outcome with lifelong positive aesthetic appearance and functionality and to secure an easier acceptance of their odyssey as a person with a cleft deformity. A result of the utilization of this growth phase, related to the midfacial development and function, needs to be comparable with the expected development of a non-cleft child at a similar age. Ultimately, successful orthopeaddontic intervention during the critical growth phase should yield marked improvements in speech, facial aesthetic and a functional occlusion, potentially reducing the need for future orthodontic treatments and minimizing treatment duration.

Care of genetic structural anomalies in the primary dentition: 3 case reports

Care of genetic structural anomalies in the primary dentition: 3 case reports

Analysis of Pediatric Pulpotomy, Pulpectomy, and Extractions in Primary Teeth Revealed No Significant Association with Subsequent Root Canal Therapy and Extractions in Permanent Teeth: A Retrospective Study.

Recent evidence suggests that an ever-growing number of pediatric patients require invasive treatments such as root canal therapy (RCT) in their permanent dentition, albeit with little information about risk factors such as prior invasive treatments of pulpotomy or pulpectomy in their primary dentition. Therefore, the primary objectives of this study were to determine the number of pediatric patients who have had any type of invasive treatment in their primary teeth, to assess their association with any subsequent invasive treatment (root canal therapy, extractions) in their permanent dentition, and to assess these trends over time. This retrospective study utilized summary data from a clinical pediatric patient pool (ages 0-17) over the period of 2013-2022. This analysis revealed that pediatric patients requiring pulpotomies and pulpectomies in primary dentition declined between 2013 (n = 417, n = 156) and 2022 (n = 250, n = 12), while root canal therapy (RCT) in permanent dentition increased six-fold from n = 54 to n = 330. In addition, few (7.8%) patients with RCT had a previous history of pulpotomy or pulpectomy, which suggests that invasive treatments performed in primary dentition have no direct association with the subsequent need for invasive treatments in permanent dentition, although more research is needed to determine the explanations for these observations.

Revised evaluation objectives of the Korean Dentist Clinical Skill Test: a survey study and focus group interviews

This study aimed to propose a revision of the evaluation objectives of the Korean Dentist Clinical Skill Test by analyzing the opinions of those involved in the examination after a review of those objectives. The clinical skill test objectives were reviewed based on the national-level dental practitioner competencies, dental school educational competencies, and the third dental practitioner job analysis. Current and former examinees were surveyed about their perceptions of the evaluation objectives. The validity of 22 evaluation objectives and overlapping perceptions based on area of specialty were surveyed on a 5-point Likert scale by professors who participated in the clinical skill test and dental school faculty members. Additionally, focus group interviews were conducted with experts on the examination. It was necessary to consider including competency assessments for “emergency rescue skills” and “planning and performing prosthetic treatment.” There were no significant differences between current and former examinees in their perceptions of the clinical skill test’s objectives. The professors who participated in the examination and dental school faculty members recognized that most of the objectives were valid. However, some responses stated that “oromaxillofacial cranial nerve examination,” “temporomandibular disorder palpation test,” and “space management for primary and mixed dentition” were unfeasible evaluation objectives and overlapped with dental specialty areas. When revising the Korean Dentist Clinical Skill Test’s objectives, it is advisable to consider incorporating competency assessments related to “emergency rescue skills” and “planning and performing prosthetic treatment.”

Prevalence of Developmental Dental Anomalies in Pediatric Patients and an Assessment of Students’ Knowledge in Two Mexican Dental Schools: A Cross-Sectional Study

Dental anomalies (DAs) in children refer to conditions affecting the structure, number, shape, and size of teeth. This study aimed to assess the prevalence of these anomalies in both primary and permanent dentitions among two Mexican pediatric populations aged 2-14 years. Additionally, the level of knowledge about DAs among students pursuing a degree in dentistry in both universities was determined. A cross‑sectional study was conducted on children making their first visit to the Pediatric Dental Clinics of the Universities of Nuevo León and San Luis Potosí in México between March and May 2017. The prevalence of DAs was estimated. In addition, a questionnaire comprising 20 closed items regarding DAs was administered to 100 undergraduate students to evaluate their level of knowledge. Ninety-four children (54 boys and 42 girls; mean age 9.73±2.1 years) were included. Twenty-two patients (23.4%) exhibited at least one DA in their primary or permanent teeth. The most common DAs were in size (macrodontia) and structure (enamel hypoplasia). Agenesis occurred three times, and there were two cases of mesiodens. Regarding gender, 10 patients were girls (45.4%), and 12 were boys (54.6%). The prevalence of DAs in permanent teeth (57.5%) was higher than that in primary teeth (42.5%, p=0.031). Only two patients presented DAs in both primary and permanent teeth. No tooth-shaped anomalies were detected. Regarding the level of knowledge among the university students, the percentage of correct answers was 61.6%. Our findings emphasize the importance of encouraging parents to initiate pediatric dental visits early. Additionally, the study highlights the significance of conducting a thorough evaluation of the patients.

Solitary median maxillary central incisor syndrome: cone beam computed tomography illustrated review

The solitary median maxillary central incisor syndrome (SMMCI) is a rare autosomal dominant genetic syndrome characterized by the presence of a single central incisor positioned along the midline in both primary and permanent dentition. It is often associated with the holoprosencephaly spectrum, a group of brain and facial malformations. The etiopathogenesis of SMMCI is believed to involve embryonic developmental defects occurring between the 35th and 38th day of gestation, primarily affecting midline facial structures. Several genetic factors, including mutations in the Sonic Hedgehog gene on chromosome 7 and other genetic variants, have been implicated in SMMCI development. Diagnosis is typically made through clinical examination, prenatal ultrasound, and postnatal dental evaluation. Management of SMMCI requires a multidisciplinary approach involving pediatricians, otolaryngologists, neuro-pediatricians, and genetic counselors. Dental interventions may include extraction and space maintenance, orthodontic treatment, prosthodontic options, or esthetic considerations. Further research is needed to understand better the underlying mechanisms and genetic factors associated with SMCI, which will contribute to improved diagnosis and management of this syndrome.

Comparison of traditional regression modeling vs. AI modeling for the prediction of dental caries: a secondary data analysis

IntroductionThere are substantial gaps in our understanding of dental caries in primary and permanent dentition and various predictors using newer modeling methods such as Machine Learning (ML) algorithms and Artificial Intelligence (AI). The objective of this study is to compare the accuracy, precision, and differences between the caries predictive capability of AI vs. traditional multivariable regression techniques.MethodsThe study was conducted using secondary data stored in the Temple University Kornberg School of Dentistry electronic health records system (axiUm) of pediatric patients aged 6–16 years who were patients on record at the Pediatric Dentistry Clinic. The outcome variables considered in the study were the decayed–missing–filled teeth (DMFT) and the decayed–extracted–filled teeth (deft) scores. The predictors included age, sex, insurance, fluoride exposure, having a dental home, consumption of sugary meals, family caries experience, having special needs, visible plaque, medications reducing salivary flow, and overall assessment questions.ResultsThe average DMFT score was 0.85 ± 2.15, while the average deft scores were 0.81 ± 2.15. For childhood dental caries, XGBoost was the best performing ML algorithm with accuracy, sensitivity. and Kappa as 81%, 84%, and 61%, respectively, followed by Support Vector Machine and Lasso Regression algorithms, both with 84% specificity. The most important variables for prediction found were age and visible plaque.ConclusionsThe machine learning model outperformed the traditional statistical model in the prediction of childhood dental caries. Data from a more diverse population will help improve the quality of caries prediction for permanent dentition where the traditional statistical method outperformed the machine learning model.

The Midline Supernumerary Tooth – Mesiodens: A Case Series

Supernumerary teeth have been proposed to be one of the most significant dental defects affecting the primary and early mixed dentition. These teeth can cause poor facial and dental aesthetics, as well as many pathological problems for the development of permanent dentition. Mesiodens are the extra teeth that have erupted or not yet erupted in the maxilla between the central incisors. Early identification and treatment are necessary to mitigate the negative effects of the mesiodens dentoalveolar structures. This case series discusses three different cases for the presence of supernumerary teeth leading to discomfort and aesthetic concerns. Extraction of the supernumerary teeth was performed to reduce future complications and was further suggested for orthodontic correction. Key Words: Children, Mesiodens, Supernumerary tooth

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.