Maxillary Primary Molars Research Articles

Progression of proximal caries in primary molars using the radiographic ICDAS: a retrospective cohort study.

To evaluate the proximal caries progression in primary molars using the radiographic International Caries Detection and Assessment System (ICDAS). A study was conducted on 196 children aged 3-9 years old who underwent the clinical examination and bitewing radiography during baseline and 6-month (and over) follow-up visits. The primary molars bitewing radiographs with initial enamel caries (RA1 and RA2) or outer dentine caries (RA3) of proximal surfaces were included. Caries advancement was scored using ICDAS criteria and statistical analyses with the chi-square test. Median survival time was evaluated using Kaplan-Meier survival curves and log-rank tests. A total of 439 surfaces of primary molars were included in this study and an averaged follow-up period of enamel and dentine caries group were 18.3 ± 9.6 months and 16.5 ± 9.5 months respectively. The progression of proximal enamel lesions significantly differed between primary maxillary and mandibular molars (p = 0.002) and among each patient's primary mandibular second molar and the others (p = 0.002). On the contrary, the outer dentine caries of each group of primary molars was not different. The median survival time of the initial enamel proximal caries (23.30 months) was non-significantly longer than that of the dentine (20.80 months). Progressions of the initial enamel proximal caries were significantly different among primary molars at the average 18.3-month follow-up. The median survival period of the enamel proximal caries was more extended than that of dentine but without statistical difference. These results provide essential information for dentists regarding an appropriate appointment for bitewing examinations.

CBCT ANALYSIS OF PULP CHAMBER THICKNESS AND MORPHOLOGY IN PRIMARY MOLARS: AN OBSERVATIONAL STUDY

Objective: To evaluate the thickness of pulp chamber and morphologic characteristics in order to plan the treatment ofdeciduous molars using cone beam computed tomography. Material and Methods: Cross-Sectional study is done with CBCT images of primary teeth of children. Evaluation of Pulp chamber thickness and morphology of each maxillary right primary second molar was done through CBCT. Data were analyzed and sent for statistical analysis. Results: Total 50 teeth i.e., right maxillary primary second molars of children age group 4-10 years were analyzed. Male shows the horizontal and vertical Mean (SD) values 4.5 (0.76) and 1.7(0.58) respectively greater than females. Mesial and Distal pulp horns were also greater in height for males with Mean (SD) 3.1(0.51) and 2.5(0.52) respectively. Conclusion:General variations might be involved however, when preparing a course of treatment for a childit is important to take note of gender differences in the mesiobuccal pulp horn. Even small restorations have a significant effect on pulp size. Probably it becomes exposed when the cavity is being prepared.

Is it possible to extract primary maxillary molars without palatal injection?: a controlled clinical trial

ObjectivesThe absolute necessity of a palatal injection for the extraction of primary maxillary molars has never been explored, despite the fact that it is widely known that children do not tolerate local anesthetic injections into the palatal tissue well. The aim of this study was to compare separately the perception of pain in the absence of palatal injection after anesthesia and maxillary primary molar tooth extraction using different anesthetic solutions and different post-anesthetic waiting times.Materials and methodsA single-blinded randomized controlled study was conducted in 78 participants (26 patients with palatal anesthesia (the control groups), and 26 patients with 5 min and 26 patients with 8 min post-anesthetic waiting time without palatal anesthesia (the study groups)). Subjective experiences of pain were evaluated separately after anesthesia and tooth extraction using the Visual Analog Scale (VAS) and the Wong-Baker Faces Pain Rating Scale (WBS).ResultsIn terms of VAS scores obtained following administration of anesthesia, there was a statistically significant difference between the groups (p<0.05). VAS pain scores were reported to be lower in the groups without palatal anesthesia than in the groups with palatal anesthesia. No statistically significant difference was observed in VAS and Wong-Baker scores after tooth extraction between the groups with and without palatal anesthesia (P>0.05).ConclusionsWhile the pain reported following administration of anesthesia was found to be higher in the groups receiving palatal anesthesia, no difference was found between the groups in the pain reported after tooth extraction.Clinical relevanceExtraction of maxillary primary molars is possible without palatal injection by injecting 4% articaine or 2% lidocaine into the buccal vestibule of the tooth with a waiting time of 5 or 8 min.

A Study of Root Canal Morphology of Human Deciduous Maxillary Molars using Cone Beam Computed Tomography (CBCT): An in Vivo Study

Aim: The purpose of this study was to investigate the root canal morphology of the primary maxillary right first and second molars using CBCT according to Vertucci &amp; New root canal classification system given by Ahmed HMA et al., Method: 60 Patients aged 3-9 years were taken in the study. The CBCT of maxillary right quadrants of study subjects were taken at imaging centre and evaluated on CBCT scans according to Vertucci &amp; Ahmed HMA et al.,’s classification both. Result: The most common canal configuration for right primary maxillary 1st and 2nd molar was Vertucci Type I except mesio-buccal canal in right maxillary second molar was Vertucci Type IV. Conclusion: As deciduous molar teeth exhibit thin torturous canals and ribbon like roots a thorough knowledge of the root canals can improve the outcome of pulp treatment in pediatric patients.

Evaluation of Familial Similarity of Carabelli’s Trait in South Kerala Population: A Pilot Study

Abstract Background: The distribution of Carabelli’s trait is variable in different individuals and also amongst children and their parents. Knowledge and distribution of Carabelli’s trait and evaluating their familial similarity can be very useful in forensic dentistry. The forensic implication also includes the identification of deceased individuals, racial identification and cases of disputed paternity. Aim and Objective: The aim of this study was to determine the familial similarity of Carabelli’s trait in South Kerala population and to determine the extent of expression of Carabelli’s pattern in both child and parent. Materials and Methods: Children and their parents from the department of pedodontics over 1 month were selected and examined for the expression of Carabelli’s trait in the maxillary primary second molar and permanent maxillary first molars. For this study, non-carious teeth with good anatomical landmarks are selected. Caries tooth, fractured tooth and supernumerary para molars are excluded from the study. Child age groups between 6 and 12 years were selected and parents of any age groups were selected for the study. Informed consent both verbal and written was taken before taking intraoral impressions and photographs. Maxillary impressions and intraoral photographs of both child and their parent were recorded, and further examination and scoring were done on cast and photographs on the basis of the classification developed by the Arizona State University Dental Anthropology system which specifies the eight grades of expression of Carabelli’s pattern. Result: In our study, we are able to identify a familial similarity in the expression of Carabelli’s trait in children and parents in the South Kerala population. Conclusion: Cusp of carabell’s trait in south Kerala population.

Effect of Photobiomodulation Therapy With an 810-nm Diode Laser on Pain Perception Associated With Dental Injections in Children: A Double-Blind Randomized Controlled Clinical Trial.

Introduction: This study investigated the photobiomodulation effect of an 810-nm diode laser in adjunction with topical anesthesia on pain perception during infiltration anesthesia of primary maxillary molars in children. Methods: This double-blind randomized controlled clinical trial was conducted on 64 children (aged 5-9 years) requiring extraction or stainless steel crown for their primary maxillary molars. The patients were randomly allocated into two groups (n=32) of laser and control. In the laser group, the injection site (buccal and palatal mucosa) was irradiated with an 810-nm laser (200 mW, 5.2 J/cm2) after 20% benzocaine topical anesthetic application, while the control group received a placebo laser following topical anesthesia. The pain intensity experienced by children during needle insertion into the buccal and palatal mucosa was determined using a visual analog scale (VAS) and modified behavioral pain scale (MBPS). Results: According to the results of the VAS and MBPS, no significant difference was detected in pain scores between the laser and control groups neither in the buccal nor in the palatal mucosa (P>0.05). Conclusion: Photobiomodulation therapy with an 810-nm laser with the current setting adjunct to topical anesthesia did not promote significant additional effects on the pain intensity.

A New Criteria to Assess Quality of Obturation in Primary Teeth: KEDOO Classification.

The success of the pulpectomy depends on adequate access, cleaning, shaping, and good-quality obturation. Evaluating the quality of obturation is the major tool that determines the success of the procedure. The present study aimed to assess the quality of obturation in all the canals of primary teeth and suggest a new classification. A total of 1,000 radiographs of the pulpectomy procedure performed in primary molars were evaluated. The quality of obturation was assessed for each canal using the criteria given by Coll and Sandrian. The prevalence of each obturation criterion in every canal was represented in the form of a percentage. It was observed that among the mandibular primary molars, most of the mesial canals were underfilled, and in the distal canal, most of the canals were overfilled. Among the maxillary primary molars, most of the mesial canals were overfilled, more distal canals were underfilled, and with respect to palatal canals, optimal obturation was seen. The pitfalls of the previous classification were revised, and a new classification for assessing the quality of obturation was proposed, which is arch, segment, and canal specific. The new classification will give a more precise assessment for the evaluation of various techniques and materials used for pulpectomy in primary teeth. Jeevanandan G, Govindaraju L, Kotian N, et al. A New Criteria to Assess Quality of Obturation in Primary Teeth: KEDOO Classification. Int J Clin Pediatr Dent 2023;16(2):376-379.

Full Mouth Rehabilitation of A Child with Early Childhood Caries: A Case Report

Early childhood caries is a multifactorial disease that severely degrades the primary maxillary incisors and molars in a child aged 71 months or younger. It can cause reduced masticatory efficiency, loss of vertical dimension, development of speech problems, esthetic-functional problems such as malocclusion and space loss, and psychological problems that can compromise the behavioral development of the child. The treatment of severely decayed primary teeth presents a special challenge to pediatric dentists. The present case report describes the oral rehabilitation of a 5-year-old male patient with type II ECC whose teeth were restored using various treatment modalities including preformed space maintainers, preformed zirconia crowns, fiber post, SSC, pulpectomies and composite restorations.&#x0D; Keywords: Early Childhood Caries, Stainless-steel crowns, Zirconia crowns, Fibre-post, Dental caries

Prevalence of Accessory Canals in Primary Maxillary Molars: A Radiographic Analysis

Prevalence of Accessory Canals in Primary Maxillary Molars: A Radiographic Analysis

Reliability of the electric pulp tester as an indicator of pulpal anesthesia in primary maxillary posterior teeth to assess the need for supplemental injections: An observational clinical study.

The primary maxillary molars occasionally remain sensitive during operative procedures even post the buccal supraperiosteal injection. This could be due to the widely flared palatal roots receiving accessory innervation from the palatal nerves. Identifying inadequate anesthesia upfront using the electric pulp test (EPT) would give vital information to the clinician on the need of a supplemental palatal injection. Aim: The aim of this study was to assess and evaluate the reliability of the EPT as an indicator of pulpal anesthesia in primary maxillary molars. Methodology: Fifty one primary maxillary molars were subjected to the EPT following a buccal supraperiosteal injection. During the operative procedure, the " Face Legs Activity Cry Consolability" (FLACC) scores were recorded. The outcome of the EPT was correlated with the results of the FLACC score using Pearson's Chi-square test.

Pain Control of Needle-less Jet Anesthesia Versus Conventional Infiltration Anesthesia for Pulpotomy of Maxillary Primary Molars in Children: A Randomized Controlled Trial

Pain Control of Needle-less Jet Anesthesia Versus Conventional Infiltration Anesthesia for Pulpotomy of Maxillary Primary Molars in Children: A Randomized Controlled Trial

The Effect of Education on the Ability of Dental Students to Detect External Root Resorption of Maxillary Primary Molars

The Effect of Education on the Ability of Dental Students to Detect External Root Resorption of Maxillary Primary Molars

Prevalence of class I caries in the second maxillary primary molar in 3-6-year-old children: A retrospective study.

Class I caries is located in the occlusal surface of molars and premolars. Dental care is an international public health challenge, mainly in young group children, as they are easily affected by caries with an increased addiction to sweets and chocolates. Caries begin early in life and progress rapidly and can affect a child in the long-term quality of life. The data were collected from the institutional patient records between June 2015 and February 2021. The details of 6831 pediatric patients were collected, of which 1500 patients fulfilled the inclusion criteria. The data were collected and analyzed using SPSS software (IBM Corp, IBM SPSS Statistics for Windows, Version 24.0. Armonk, NY). P = 0.005 was set as level of significance. Highest prevalence of caries was seen in male children with P = 0.008 (<0.05), denoting that there is a significant association between gender and number of teeth affected with caries. When age group was considered, the caries prevalence was highest at the age of 4 years and the P value was statistically significant. The prevalence of class I caries in the second maxillary primary right molars was more than the second maxillary primary left molars and within the age group of 4 years.

Children’s satisfaction and survival rate of fiber-reinforced space maintainer versus band and loop space maintainer in children with premature loss of maxillary primary first molar

Background: Band and loop space maintainer (BLSM) are well tolerated and long-lasting appliances, but it comes with several drawbacks, including longer lab times, more frequent cement loss dislodgements, longer visits, and the inability to avoid the rotation or tilting of neighboring teeth. These limitations motivate the search for alternative appliance such as fiber-reinforced space maintainers. Aim of the study: Evaluation of children’s satisfaction and survival rate of fiber-reinforced space maintainer versus band and loop space maintainer in children with premature loss of maxillary primary 1st molar. Materials and Methods: Thirty patients, randomly divided into two groups (n=15). BLSM group: which included (15) patients who receive band and loop space maintainer. FRSM group: which included (15) patients who were received fiber-reinforced space maintainer. The patients were evaluated for satisfaction based on Likert -type scale and survival rate. Results: The FRSM group showed a higher satisfaction score than BLSM group. For survival rate the fiber-reinforced space maintainers showed a greater success rate than band and loop space maintainers. Conclusions: The FRSM can be used as an alternative to BLSM regarding clinical performance and patient’s satisfaction in children with premature loss of maxillary 1st primary molars.

Effect of a needle-free system versus traditional anesthesia on pain perception during palatal injections in children.

Needle-free injection systems can contribute to the prevention of needle-related pain during palatal infiltration anesthesia (PIA) in children. Research on this topic in children is required. The purpose of this clinical study was to evaluate the effectiveness and patient preference of a needle-free system versus traditional anesthesia (TA) on pain perception during PIA in children. The study was designed as a randomized, controlled crossover clinical study with 48 children aged 6-12 years requiring dental treatment with PIA in bilateral maxillary primary molars. TA was applied on one side and the Comfort-in™ injection system (CIS) on the other side in two separate sessions. Then, patient preference was recorded. The pain perception during PIA was evaluated using the Wong-Baker FACES Pain Rating Scale (PRS) and the Face, Legs, Activity, Cry, Consolability (FLACC) Scale. The data were analyzed for statistical significance (p < .05). There were statistically significant differences between the TA and the CIS according to the PRS and FLACC Scale scores. On both scales, significantly higher pain ratings were observed in the TA group during PIA (p < .001). There was a statistically significant difference in terms of patient preference (p < .001). Although 77.1% (n=37) of the children preferred the CIS, 22.9% (n=11) preferred the TA. Moreover, patient preference for the CIS was significantly higher in older children (p < .01). The application of a needle-free system during PIA ensured a decrease in pain perception in children.

CBCT Analysis of Dento-Skeletal Changes after Rapid versus Slow Maxillary Expansion on Deciduous Teeth: A Randomized Clinical Trial.

The aim of the present study was to compare skeletal and dental changes after rapid maxillary expansion (RME) and slow maxillary expansion (SME) performed by a Leaf Expander (LE) with upper deciduous teeth as anchorage and using 3D CBCT (Cone Beam Computed Tomography) analysis. Mixed dentition patients were randomly divided in two groups, according to the different expansion used anchored on maxillary primary second molars: the RME group (n = 16) was treated with a Hyrax type expander, whereas the SME group (n = 16) was treated with an LE expander. CBCT scans were performed before (T1) and after treatment (T2) and analyzed with a custom landmarks system. A paired t-test was used for intragroup analysis between T1 and T2, and a Student t-test was used for intergroup analysis; statistical significance was set at 0.05. Both RME and SME groups showed a statistically significant increase in dental and skeletal diameters. Group comparisons between T1 and T2 showed a significant expansion rate in the RME group for upper permanent molars (p = 0.025) but not for deciduous molars (p = 0.790). Moreover, RME showed higher increases for skeletal expansion evaluated at nasal walls (p = 0.041), whereas at pterygoid plates did not show any significant differences compared with the SME group (p = 0.849). A significant transverse expansion could be achieved with the expander anchored on deciduous teeth. RME and SME produced effective both skeletal and dentoalveolar transverse expansion; RME produced more anterior expansion than SME but less control regarding the permanent molar decompensation. SME by LE therefore could be an efficient and helpful alternative in the treatment of transverse maxillary deficiency in growing patients.

Infraocclusion: Prevalence, Characteristics, and Associated Dental Anomalies in Arabian Children

Aim To analyze the distribution and characteristics of infraocclusion among Arabian children in primary dentition and its associated dental anomalies. Methods A radiographic analysis was performed retrospectively using digital panoramic radiographs of children attending the pediatric dental clinic of College of Dentistry, Majmaah University, Saudi Arabia, from January 2019 to May 2021. The panoramic radiographs were analyzed to assess the distribution and characteristics of infraocclusion and its associated dental anomalies. Descriptive statistics were used for comparisons using SPSS version 21.0 (IBM Corp., Armonk, N.Y., USA). The chi-square test was used to compare percentages. Results Among the study population (542), only 40 children reported infraocclusion of 65 primary molars. Infraocclusion was common in males (90%) and very frequent in the mandibular arch (n = 48 teeth). In the primary dentition, unilateral infraocclusion (62.5%) was very frequent than bilateral presence (37.5%). Single molars were involved in 50% of the patients, while two, three, and four molars were involved in 42.5%, 2.5%, and 5% of cases. The mandibular second primary molar was frequently affected with infraocclusion, while the maxillary first primary molar was less commonly affected. In the mandibular arch, the second primary molar (28, 58%) was more commonly affected with infraocclusion than the mandibular first primary molars and maxillary primary and secondary molars (p < 0.05). The majority of the infraoccluded molars were mild (75%), followed by moderate (23.5%) and severe (1.5%). Hypodontia (12.5%) is frequently associated with infraocclusion, followed by supernumerary teeth (5%) and radix entomolaris of the first permanent mandibular molars (5%). Infraocclusion was more in the second primary molar mandibular arch, while in the maxillary arch, the first primary molars were commonly affected (p > 0.05). Conclusion In Arabian children, infraocclusion was commonly observed in mandibular second primary molars. Unilateral infraocclusion is a mild type of infraocclusion frequent in Arabian children. Numerical anomalies such as hypodontia and supernumerary teeth are associated with infraocclusion.

Evaluation of requirement of extraction of a second maxillary primary molar in 3 to 5-year-old children

Background: The extraction of primary teeth is a major problem in developing countries. They are given little or no attention because they are thought to shed off on their own, resulting in significant difficulties such as crowding and malocclusion. Aim: The current aim of this study is to study the requirement of extraction of the second maxillary primary molar in 3 to 5-year-old children. Materials and Methods: A total of 136 children from the age group of 3-5 years who had undergone extraction of the second maxillary primary were collected from the DIAS record. The data were clubbed together and the results were analyzed using SPSS software the Pearson Chi-square test was done to find the sign where the p-value was kept &lt;0.05 as the significance level. Results: The results show that 48.62% requirement for extraction is due to caries, 15.42% due to trauma, 15.02% due to mobility, 7.15% due to root resorption, and 13.44% due to other reasons. Conclusion: The study concludes that despite the improvement in pediatric oral health, caries are found to be the main reason for extraction.

Postoperative pain after primary molar pulpectomy using rotary or reciprocating single files: A superior, parallel, randomized clinical trial.

To compare postoperative pain intensity between two single-file systems with different kinetics (the OneShape file with continuous rotation vs. the WaveOne Gold file with reciprocation movement) after primary molar pulpectomy. This superiority, parallel, randomized clinical trial included 164 healthy children aged 6 to 8years with asymptomatic, necrotic, maxillary primary second molars due to caries. An equal number of children were assigned to the two groups. The teeth of children in Group 1 were instrumented with the OneShape rotary system (Micro-Mega), whereas teeth of children in Group 2 were instrumented with the WaveOne Gold reciprocating system (Dentsply Maillefer). Postoperative pain intensity was assessed using a 4-point pain scale at 6, 12, 24, 48 and 72h and 1week after treatment. The parent of each participant received 6 flashcards that included four faces and a word describing each face. A chi-square test was used to compare postoperative pain intensity. The level of significance was set to 5%. Over the follow-up period, no significant difference in postoperative pain intensity was found between the two groups (p>.05). Although the absolute risk reduction maximum limit of 95% CI equal or exceeded the predetermined proportional difference of 0.15, pain intensity was inconclusive at 6, 24, and 48 hours denoting that the superiority of the OneShape single-file over the WaveOne Gold single-file could not be declared. Postoperative pain intensity associated with a rotary vs. reciprocating file system was nearly similar.

Identification and treatment of second mesiobuccal canal in primary maxillary molars during pulpectomy procedure in pediatric dental patients

Endodontics in primary teeth is a significant challenge in pediatric dental patients due to behavioural, anatomic and access related issues. The role, these primary teeth serve is important for space maintenance, mastication, speech and occlusion. The permanent molars have shown high prevalence of second mesiobucal canal as outlined by many studies which have been crucial for endodontic success. In case of primary teeth, a similar question can be raised by attempting to evaluate presence of MB2 canals in primary maxillary molars. This paper aims to sensitize the possibility of presence of MB2 canals in primary maxillary first and second molars with discussion about identifying, instrumenting and obturating such canals for the increased diagnostic and prognostic accuracy in primary molar endodontics.