Primary Teeth Research Articles

Development of New Chitosan-Based Complex with Bioactive Molecules for Regenerative Medicine

Background/Objectives: The development of new materials incorporating bioactive molecules for tissue regeneration is a growing area of interest. The objective of this study was to develop a new complex specifically designed for bone and skin tissue engineering, combining chitosan, ascorbic acid-2-magnesium phosphate (ASAP), and β-tricalcium phosphate (β-TCP). Methods: Chitosan and the complexes chitosan/ASAP and chitosan/ASAP/β-TCP were prepared in membrane form, macerated to a particulate format, and then subjected to characterization through Fourier transform infrared (FTIR) spectroscopy, optical and scanning electron microscopy (SEM), zeta potential, thermogravimetric analysis (TGA), and differential scanning calorimetry (DSC). Cell viability was evaluated through a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and with fluorescein diacetate (FDA) and propidium iodide (PI) staining in stem cells obtained from deciduous teeth. Statistical analyses were performed using analysis of variance (ANOVA), followed by Tukey’s test. Results: The FTIR results indicated the characteristic bands in the chitosan group and the complexation between chitosan, ASAP, and β-TCP. Microscopic characterization revealed a polydisperse distribution of micrometric particles. Zeta potential measurements demonstrated a reduction in surface charge upon the addition of ASAP and β-TCP to the chitosan matrix. TGA and DSC analyses further indicated complexation between the three components and the successful formation of a cross-linked structure in the chitosan matrix. Stem cells cultured with the particulate biomaterials demonstrated their biocompatibility. Statistical analysis revealed a significant increase in cell viability for the chitosan/ASAP and chitosan/ASAP/β-TCP groups compared to the chitosan control. Conclusions: Therefore, the chitosan/ASAP complex demonstrated potential for skin regeneration, while the chitosan/ASAP/β-TCP formulation showed promise as a biomaterial for bone regeneration due to the presence of β-tricalcium phosphate.

Morphology of Denisovan molars: problems of taxon identification in the context of genetic data

Attempts to analyse fragmentary specimens of Denisovan remains in conjunction with archaeological and ge-netic data may be a useful experience in the search for taxonomically valuable traits. The paper presents the results of a dental analysis of 3 permanent molars and 1 deciduous tooth of the upper and lower jaws of different individuals, representing different stages of the Denisovan (Homo altaensis or Homo s. denisovan) existence in the territory of modern Altai during the Pleistocene. The chronological age of the finds is marked by a wide interval from about 300–200 kyBP to 84–55 kyBP. The materials were obtained during excavations in Denisova Cave (Northwestern Altai). The presence of both exceptional megadontia and obvious hominin features in the odontoglyphics of Denisovans allows us to discuss this feature as the most characteristic. The crowns of the teeth show certain proportions, with a relative reduction of the hypocone, but the dimensions of this tubercle are consistently larger than in other hominins (with the exception of Homo heidelbergensis and Neanderthals, who often show the same variations, but with diffe-rent proportions and less crown size). Often, the chewing surface shows features characteristic of anatomically mo-dern humans and Neanderthals, but at the same time the teeth are marked by the presence of unique combinations characteristic of hominoids, not hominins. The tooth of a representative of a later wave of migration shows a greater number of unique combinations than the tooth of a representative of an early wave of migrants to Altai. It is possible that the later populations of Denisovans showed a founder effect during selection, crystallizing, among other things, rare phenotypes, for example, unique combinations of chewing surface relief.

Main genetic entities associated with tooth agenesis.

Tooth agenesis refers to the absence of one or more of the deciduous or permanent teeth. Tooth agenesis results from a series of disrupted reciprocal ectodermal mesenchymal interactions taking place during the early stages of tooth development. A narrative literature review was performed to describe the main genetic syndromes associated with tooth agenesis. The etiology of congenital tooth agenesis is multifactorial and include genetic, epigenetic, and environmental influences. Syndromes associated with chromosomal alterations, ectodermal dysplasia, Axenfeld-Rieger syndrome, oral-facial cleft syndromes, and syndromes with cancer predisposition are among the main entities presenting with tooth agenesis. Tooth agenesis disorders can affect the masticatory function and cause disfigurement leading to physiological and psychological complications. Early recognition of these entities is crucial to guide the management of the patient and to provide families with the appropriate genetic counseling.

Post-COVID-19 Trends in Dental Emergencies: A Two-Year Retrospective Study from Romania

Background/Objectives: Dental emergencies significantly impact public oral health, particularly in the post-COVID-19 context. This study aimed to analyze the patterns of dental emergencies presenting to the Emergency Dental Service in Bihor, Romania, during the years 2022 and 2023, focusing on demographic characteristics and the frequency of diagnoses. Methods: A retrospective analysis of medical records from the Emergency Dental Service at Oradea County Emergency Clinical Hospital was conducted. Inclusion criteria encompassed patients presenting with dental emergencies during the specified period. Data regarding demographics, diagnoses, and living environments were collected and statistically analyzed. Results: A total of 4769 patients were analyzed, with acute pulpitis (39.2%, n = 1869) and acute apical periodontitis (37.5%, n = 1788) identified as the most common diagnoses. The study population included 52.3% males and 47.7% females, with a larger proportion residing in urban areas (58.0%) compared with rural areas (42.0%). Significant age-related patterns were evident: pulpitis was more common among patients aged 10–39 years, trauma was associated with patients aged 0–9 years, and gingival infections were prevalent in the 70–79 age group. Diagnoses also varied by dentition type, with abscesses, caries, trauma, and rhizolysis occurring more frequently in deciduous teeth, while pulpitis and post-extraction alveolitis were predominant in permanent teeth. However, no statistically significant differences were found in diagnosis frequency between genders or between rural and urban patients, indicating equitable access to emergency services across environments. Conclusions: The findings underscore the need for targeted interventions in pediatric populations to address early childhood caries, which remains a significant burden. Enhanced public health strategies and preventive education are essential to mitigate the prevalence of dental emergencies, particularly in the aftermath of the COVID-19 pandemic.

Minimal intervention dentistry for treating primary teeth: a survey study among members of the Israeli Society of Paediatric Dentistry.

To assess the attitudes of dentists in Israel to minimal intervention on primary teeth. For this cross-sectional study, data were accessed from questionnaires that were completed anonymously by members of the Israeli Society of Paediatric Dentistry. For four clinical scenarios, the respondents were asked to describe the stage at which they would intervene, the type of preparation they would utilize, and the restorative materials they would use. The scenarios included proximal and occlusal caries in the primary molar and buccal and proximal caries in the primary maxillary incisor. Forty-six dentists completed the questionnaire. Forty-one (89%) cited that they would intervene in stages 3 and 4 (of 6) of proximal caries in the primary molar; 34 of these stated that the cavity preparation would be of the proximal box type. For occlusal caries, 37 (80%) stated they would intervene in stages 2 and 3 (of 5); 31 of these would only remove the carious lesion. Thirty-three (72%) of the respondents stated they would intervene in stage 3 (of 4) of buccal caries; 31 (67%) stated they would intervene in stage 2 (of 4) of proximal caries in the primary maxillary incisor. The study reveals that specialists and non-specialists dentists in Israel use minimally invasive dentistry to treat children, either by intervening at a later stage of tooth decay or by employing conservative techniques to restore teeth. This aligns with the philosophy of minimal intervention.

Whitening of a Primary Tooth with 16% Carbamide Peroxide: A Case Report

The clinical indications for dental whitening include discolorations caused by traumatic injuries, which may lead to the diagnosis of either dental pulp necrosis or calcification. This procedure is widely used in adult patients; however, it is uncommon in pediatric patients, possibly due to the limited publication of relevant studies or because primary teeth are expected to be replaced in the future. The purpose of this paper is to describe the treatment of a darkened primary tooth belonging to a five-year-old boy who attended the dental clinics at Universidad Santo Tomás in Bucaramanga, Colombia.

A Prospective Randomised Clinical Trial Evaluating Pulpotomy in Primary Molars With Three Bioceramic Calcium Silicate Cements: 24 Month Follow-Up.

In recent times, bioceramic calcium silicates have gained attention due to high success rates with pulpotomy in primary teeth. To evaluate and compare the clinical and radiographic outcomes of three different bioceramic calcium silicate cements in vital deciduous teeth treated with pulpotomies over a period of 24 months. Children aged 4-9 years, with deep dentinal caries (ICDAS 4-6) in primary molars, having no history of spontaneous pain or signs of non-vitality were included in the study. Following clinical and radiographic evaluation 117 primary molars diagnosed as having reversible pulpitis received pulpotomy treatment, after randomly being assigned into three groups based on the bioceramic calcium silicate medicament used: a pre-mixed syringe-loaded MTA putty (NeoPUTTY); a traditional powder-liquid hand mix MTA material (NeoMTA Plus), and a precapsulated, trituration mixed material (Biodentine). Clinical and radiographic evaluation was done at 6, 12, 18 and 24 months. The cumulative clinical and radiographic success for NeoPUTTY was 92%, NeoMTA Plus 97% and for Biodentine 95% and 89%, respectively, after 24 months follow-up. The clinical and radiographic success rates of all three bioceramic calcium silicate cements were found to be high, with no significant differences over a period of 24 months. Clinical trial registration number: CTRI/2021/03/031655.

Dental Anomalies in the Past: Fusion, Gemination, and Talon Cusp in Two Archeological Samples.

Disruption in odontogenesis can influence the normal development of both deciduous and permanent dentition resulting in anomalies in morphology, number, and position of teeth. Although dental anomalies are frequently reported in clinical practice, their occurrence in past populations from archeological contexts is rarely acknowledged. To describe two cases of dental anomalies on two non-adult individuals from Italian archeological sites. Individual sex diagnosis was performed by analyzing amelogenin peptides from the dental enamel through liquid chromatography mass spectrometry (LC-MS/MS). Age-at-death estimation was based on stages of dental formation and eruption. Dental twinning and talon cusp were morphologically evaluated and classified following standardized scoring systems proposed by clinical literature. The first individual, a 3-4-year-old female from the Imperial Roman necropolis of Isola Sacra, presents the fusion of the upper right deciduous central incisor with a supplementary tooth; the second individual, a 3-3.5-year-old male from a Late Antiquity catacomb, shows a case of bilateral gemination on the upper permanent central incisors with a co-occurrence of dental gemination and talon cusp on the right one. The cases reported here (the two anomalies in the individuals presented) are useful into understanding these dental conditions within past/archaeological populations.

Quercetin and Mesenchymal Stem Cell Metabolism: A Comparative Analysis of Young and Senescent States.

Quercetin is a natural flavonoid renowned for its potent antioxidant, anti-inflammatory, anti-diabetic, and antibacterial properties, making it a highly promising candidate for the treatment of various medical conditions. Our current study investigates the influence of quercetin on energy metabolism, fatty acid composition, oxidative stress gene expression, and sirtuin expression in early- and late-stage passages of stem cells derived from human exfoliated deciduous teeth (SHEDs). Mitochondrial respiration was analyzed by measuring oxygen consumption following a 24 h quercetin treatment, while fatty acid profiles were examined using gas chromatography-mass spectrometry (GC-MS). Additionally, quantitative PCR (qPCR) was used to assess the expression of oxidative stress genes and sirtuins. In younger SHEDs, quercetin enhances metabolic activity and mitochondrial respiration, although higher doses may decrease mitochondrial activity. Conversely, in older, senescent SHEDs, quercetin supports mitochondrial function at lower concentrations but appears to inhibit respiration at higher doses. These results suggest that quercetin may hold therapeutic potential for maintaining SHED viability and function, especially at lower doses in older cells. Further research is essential to fully elucidate a dose-dependent effect of quercetin and optimize its applications in regenerative medicine.

Case report of 2-year-old child with congenital torticollis and crossbite treated with functional orthopedics of the jaws

Satisfactory chewing is performed by an alternating bilateral pattern that depends on occlusal balance, the absence of occlusal interference or premature contacts, stability, good functioning of the temporomandibular joints (TMJs) and neuromuscular maturation. If mandibular functional imbalances occur, discrepancies in maxillomandibular development and future facial asymmetries may occur. The objective of this work was to remove dental interferences that cause anterior and posterior crossbite, as well as those that prevent the good execution of symmetrical lateroprotrusive movements (right side/left side), through occlusal adjustment and subsequent correction of maxillary asymmetry using the device; encapsulated. Clinical case report of a two-year-old female patient, with unilateral crossbite on the right side (anterior/posterior), diagnosed with congenital torticollis, difficulty breastfeeding and difficulty performing alternating lateral movements. with follow-up until the complete deciduous dentition. The treatment was divided into three stages. The first step was to correct the unilateral crossbite (anterior and posterior), on the right side, by making occlusal adjustment using a grid, and later with the addition of Planas Direct Tracks resin. The second stage used an encapsulated device to correct maxillary asymmetry. The third stage was completed after the eruption of the deciduous second molars with the functional analysis of lateral movements plus occlusal adjustments using a grid. Correction of unilateral crossbite (anterior and posterior) on the right side, symmetrization of the maxilla and better execution of lateroprotrusive movements. The results obtained in this case report suggest that the occlusal adjustment removed the dental interferences that caused the anterior/posterior crossbite on the right side; the maxilla was symmetrized with the distalization of sector 63-65, and the removal of dental interferences that prevented lateral movements made it possible to perform lateroprotrusive movements (right/left side) after the complete eruption of the primary teeth.

Efficacy of chemo-mechanical caries removal: a 24-month randomized trial.

Chemo-mechanical caries removal (CMCR) offers an alternative to conventional drilling for carious dentin removal, but limited evidence exists on its long-term effects on treating caries in primary teeth. The primary aims of this study were to compare CMCR to drilling in terms of restoration status and the presence of secondary caries after 24 months. A randomized, parallel-group, single-blinded, controlled trial was conducted in Thailand. Participants were children aged 7-8 years with occlusal caries in second primary molars, randomly assigned to CMCR with Papacarie® (n = 242) or drilling (n = 246). All cavities were restored using glass ionomer cement. Completeness of caries removal was evaluated clinically by two blinded dentists, and patients' discomfort was measured using a facial visual analogue scale. Restoration status and development of secondary caries were assessed every six months clinically and every 12 months radiographically over a 2-year period. Both groups achieved complete caries removal, but the CMCR took significantly longer than the drilling method (9 vs. 2.3 min, p < 0.001). Children in the CMCR group reported significantly lower discomfort during treatment (p < 0.001). At 24 months, ten (4.6%) restorations in the CMCR group failed, compared to three (1.2%) in the drilling group. Clinically, four restorations (CMCR = 2, control = 2) exhibited secondary caries at the margin, while nine restorations (CMCR = 8, control = 1) showed radiographic evidence of secondary caries beneath the restoration. However, neither clinical nor radiographic evaluations revealed statistically significant differences in treatment outcomes at the two-year mark. CMCR demonstrated comparable efficacy to conventional drilling for complete caries removal and restoration success at 24 months in primary teeth. Despite a longer chair time, it resulted in less discomfort during treatment. https://clinicaltrials.gov/study/NCT01641861, identifier: NCT01641861.

Cultivation and molecular characterization of viable Helicobacter pylori from the root canal of 170 deciduous teeth of children

BackgroundHelicobacter pylori is a persistent pathogen in the human stomach. However, the proposed transmission route via the oral cavity is not understood and under intense debate. While dozens of studies have shown by PCR that H. pylori DNA is frequently present in the oral cavity, data on the growth and characterization of viable H. pylori from this compartment are very scarce, and it is unclear whether the bacteria can survive in the oral cavity for longer time periods or even colonize it.MethodsSelective growth methods, scanning electron microscopy, urease assay, Western blotting, PCR, and gene sequencing were applied to identify and examine viable H. pylori in decayed milk teeth.ResultsHere, we studied viable H. pylori in the plaque and root canals of 170 endodontically infected deciduous teeth that were extracted from 54 children. While H. pylori DNA was detected in several plaque and many root canal samples by PCR, live bacteria could only be cultivated from 28 root canals, but not from plaque. These 28 isolates have been identified as H. pylori by PCR and sequencing of vacA, cagA and htrA genes, phylogenetic analyses, protein expression of major H. pylori virulence factors, and by signal transduction events during infection of human cell lines.ConclusionsThus, the microaerobic environment in the root canals of endodontically infected teeth may represent a protected and transient reservoir for live H. pylori, especially in individuals with poor dental hygiene, which could serve as a potential source for re-infection of the stomach after antibiotic therapy or for transmission to other individuals.

The histochemical distribution of Matrix Metalloproteinase-2 (MMP-2) in the coronal dentin of exfoliated human upper deciduous teeth

The histochemical distribution of Matrix Metalloproteinase-2 (MMP-2) in the coronal dentin of exfoliated human upper deciduous teeth

Anchorage In Primary Vs. Permanent Teeth For Rapid Maxillary Expansion In Children: Systematic Review And Meta-Analysis

Background: Rapid maxillary expansion (RME) is a widely used orthodontic technique to correct transverse maxillary deficiencies. Both primary and permanent teeth are commonly used as anchorage for this procedure. However, there is limited evidence regarding differences in skeletal and dental effects or buccal alveolar bone preservation between these anchorage types. Materials and Methods: A systematic review was conducted to compare the skeletal and dental effects of RME using primary or permanent teeth as anchorage. Searches were performed in the following databases: PubMed, Web of Science, Scopus, LILACS, and OpenGrey. The risk of bias was assessed using the Rob 2.0 and Robins I tools. The certainty of evidence was evaluated according to the GRADE system, and meta-analysis was performed with R software. Results: Eight studies were included in the qualitative analysis and five in the quantitative analysis. The risk of bias was low in two studies, moderate in five studies, and high in one study. The certainty of evidence was very low. It was not possible to perform a meta-analysis for the outcome "buccal alveolar bone thickness" due to the lack of available studies, which was limited to only one study. The intermolar width was greater when the anchorage used permanent teeth SMD= -1.24; 95% CI (-2.14; -0.33); p&lt;0.01]. However, this difference may not be clinically relevant. Conclusion: The evidence does not support a clear recommendation for the use of primary or permanent teeth as anchorage in RME, as no clinically relevant differences were observed in skeletal or dental effects. Primary teeth may be preferred when buccal alveolar bone preservation is a priority. Further studies are required to enhance evidence and support clinical decisions.

Post Traumatic Impaction of Maxillary Deciduous Central Incisor: A Case Report

Background and Objectives: Primary tooth impaction is a rare phenomenon when compared to permanent teeth impaction, particularly in upper front teeth. The problem could be either a physical blockage of the eruption or a malfunction of the eruption process. Methods: This case study describes a 4-year-old girl who experienced incomplete eruption of her upper right baby front tooth due to an injury. The unerupted tooth was surgically removed. Regular check-ups were recommended to monitor the development of her teeth and ensure sufficient space for her permanent front teeth. Results: This case study describes an unusual situation where a baby's upper front tooth failed to erupt. that associated with trauma. That caused delay in progression of the permanent successor compared to the contralateral permanent central incisor. And by extracting the impacted primary tooth a path of eruption opened for the permanent successor tooth so it will accelerate the progression of erupting the permanent successor and mostly may erupt in the same time of the contralateral tooth. Conclusions: It's crucial to closely watch the eruption of permanent and deciduous teeth to spot and address any issues with tooth eruption early on. Keywords: Primary incisors, Childhood trauma, Impacted tooth.

Characterisation of the very young child's palatal vault growth pattern: how do its size and shape evolve?

This study aimed to characterise the palatal vault evolution during the first years of life, both in terms of shape and size. The study sample was composed of 168 healthy children aged less than 4 years. Twenty-one measurements of distances and 6 angles were taken from 7 fixed landmarks set on the palatal vaults 3D surfaces reconstructed from CT-scans. To analyse only the shape evolution, the "sizefree" log-shape ratio of those measurements were computed and the global shape of the palatal vault and their transversal curve were plotted. Statistical analyses were performed to highlight the shape and size differences separately. The shape and size evolution of the palatal vault during the first years of life was not only correlated with deciduous dentition development. We assumed that the progressive orofacial muscles activation and tongue movements in the oral cavity may also explain these results as they induced strains on the palatal vault, warping it in various ways.

Atraumatic restorative treatment induces transient changes in salivary total protein and redox biomarkers in children with caries: a non-randomized clinical study.

This study aimed to evaluate if dental atraumatic restorative treatment (ART) impacts salivary total protein and redox biomarkers in children with caries. The study included 30 children (aged 4 to 6 years) with caries on posterior deciduous teeth, classified by ICCMS, attending a basic education school. Participants were divided into enamel (n=15) and dentin (n=15) lesion groups. Unstimulated saliva samples were collected before (B), immediately after (A), and seven days after (A7) ART. Analyses included total protein concentration, lipid peroxidation (TBARS), total antioxidant capacity (TAC), and uric acid (UA). The results obtained at different time points (B, A, A7) were compared between children with caries and between those with enamel or dentin lesions using a paired repeated-measures ANOVA, followed by Tukey's post-hoc test (p < 0.05). ART caused significant decreases in total protein concentration (p = 0.0146), which rebounded by the 7th day. TBARS levels increased (p = 0.0215) immediately after ART and remained unchanged until the 7th day. TAC (p = 0.0032) and UA (p = 0.0006) levels decreased in the saliva of children 7 days after ART. These changes were significant only in children with dentin lesions, not enamel lesions. ART temporarily alters salivary protein levels and redox biomarkers in children with caries, returning to baseline after 7 days. These findings highlight the importance of complementing restorative treatments with dietary advice and oral hygiene to ensure comprehensive caries management.

Polydeoxyribonucleotide enhances the bioactivities of stem cells from human exfoliated deciduous teeth through Akt activation

Although numerous approaches have emerged to address the challenges of critical limb ischemia (CLI), their clinical trials have proven elusive. Stem cell therapy has been utilized for CLI; however, its efficacy is limited, resulting in low survival rates in patients. Here, we investigated the impact of polydeoxyribonucleotide (PDRN) on the bioactivities of stem cells derived from human exfoliated deciduous teeth (SHED) against oxidative stress. PDRN treatment increased the proliferation, migration, antioxidant properties, and mitochondrial respiration of SHED. These beneficial effects were regulated by Akt activation. Through a murine hindlimb ischemia model, PDRN treatment demonstrated augmented the survival and proliferation of transplanted SHED at ischemic injury sites, whereas the inhibition of Akt suppressed these effects. Our findings revealed that PDRN promoted the therapeutic potential of SHED via Akt phosphorylation, suggesting PDRN-primed SHED as promising candidates for the development of novel stem cell therapeutics.

Deciduous Teeth Extraction Practice and Associated Factors Among Under Five-Years-Old Children in the Gambella Region, South West, Ethiopia: A Mixed Study.

Deciduous teeth extraction (DTE) is a harmful traditional practice often performed by traditional healers. This practice can lead to both acute and chronic complications that significantly impact children's health. Despite national strategies and initiatives, DTE remains prevalent in Ethiopia, especially in the Gambella region. However, there is limited information on its prevalence and determinants in this area. Both qualitative and quantitative studies were conducted. A community-based cross-sectional study involved 803 mothers with children under five in the Gambella region. Multistage simple random sampling was employed, and data were collected using a pretested structured questionnaire and in-depth interviews. Data entry was performed using Epi Data version 4.6, and the analysis was conducted in SPSS version 25. Both bivariable and multivariable binary logistic regression analyses were used to identify factors associated with deciduous tooth extraction (DTE). Odds ratios were calculated with a 95% confidence interval, and a p-value of less than 0.05 was used to determine statistical significance. The prevalence of Deciduous teeth extraction practice among < 5 years was 48.3% (95% CI: 0.44-0.51). Mothers lack of awareness (AOR = 2.08; 95 CI:1.21-3.58), mothers lack of information on scientific solutions of teething symptoms (AOR = 2.08; 95% CI: 1.21-3.60), mother's positive attitude towards milk tooth extraction (AOR = 10.06; 95%CI: 6.36-15.91), being ill during teething eruption (AOR = 8.70; 95% CI: 5.56-13.62) and Community DTE tradition (AOR = 2.06; 95% CI: 1.34-3.15) were significantly associated. The qualitative findings also found that culture, misconception about DTE, peer and social pressure as factors. Deciduous teeth extraction practice in the Gambella region poses a significant public health concern. Lack of awareness regarding the consequences and scientific solutions for teething symptoms, mothers' attitudes, illness perceptions during teething, and community traditions were identified factors. Hence, comprehensive awareness campaigns involving all stakeholders should be emphasized. Health care providers should play a crucial role to educate both mothers and traditional healers.

Teeth Structure Analysis of Primary Teeth in Children with Congenital Heart Disease (Ventricular Septal Defect) in Erbil City

Teeth Structure Analysis of Primary Teeth in Children with Congenital Heart Disease (Ventricular Septal Defect) in Erbil City