Introduction Pit and Fissure Sealants are effective in preventing occlusal dental caries by preventing the penetration of microorganism and food debris into susceptible pit and fissures. Aim To compare the marginal discoloration, marginal integrity and anatomic form of self adhesive flowable composite (Fusion Flo) and pit-and-fissure sealant (PF Seal) used with a bonding agent in permanent first molars of children aged 7-10 years. Study design A randomized controlled clinical trial was conducted among 25 healthy children, including 50 permanent first molars (2 teeth per subject). Materials and method ology: The teeth were isolated using cotton rolls prior to sealant placement. The first permanent molars were randomly allocated into two groups based on the material used: GROUP A (n = 25) - Self adhesive flowable Composite (Fusion Flo) used with a self adhesive bonding agent (Medicept); GROUP B (n = 25) - Pit and fissure sealant (PF Seal) placed with a bonding agent (Fusion 5). Evaluation of anatomic form, marginal integrity and marginal discoloration was performed according to Feigal's criteria. The collected data were tabulated and statistically analyzed using the Chi-square test with SPSS version 17. Results No statistically significant differences were observed between Fusion Flo and PF seal with respect to marginal integrity, marginal discoloration and anatomic form at 1, 3 and 6 month follow ups. Conclusion Fusion Flo self adhesive composite can be considered a suitable alternative to conventional PF Seal sealants, particularly advantageous in newly erupted teeth and uncooperative children where maintaining isolation is challenging.
Objective To evaluate the potential of a calcium salt–containing resin coating material as a proximal caries-preventive agent in children by comparing its adhesion, mechanical properties, flowability, wear resistance, and proximal coverage with conventional resin sealants. Materials and methods A 4-META–based, filler-free coating resin containing calcium salt–type functional monomers (BioCoat Ca®, BCC) was compared with two light-curing resin sealants (Teethmate F-12.0®, TM; BeautiSealant®, BS). Shear bond strength to enamel was measured after 24-h and 1-year water storage. Nanoindentation hardness and elastic modulus were determined on polished discs. Flowability was assessed using an ISO-based spread test. Toothbrush wear resistance was evaluated by surface roughness before and after simulated brushing. Proximal coverage on paired extracted molars was quantified using rhodamine-labeled materials and image analysis. Results BCC showed the highest initial shear bond strength and maintained its bond strength after 1-year storage, whereas TM and BS significantly decreased. BCC and BS exhibited higher hardness than TM, and BS had the highest elastic modulus. BCC showed the greatest flowability. A significant increase in surface roughness occurred only for TM. BCC achieved markedly greater proximal coverage than both sealants. Conclusion BCC provided durable enamel adhesion, favorable nano-mechanical properties, superior flowability, good wear resistance, and extensive proximal coverage compared with conventional sealants. These findings indicate that BCC shows good suitability as a proximal coating material under in vitro conditions and may be a promising candidate for proximal caries prevention in children.
Background: Fused teeth may cause esthetic and functional problems due to abnormalities in tooth morphology and size. Hemisection is a conservative treatment option for correction of fused teeth. Case presentation: The patient was an 8-year-4-month-old boy with severe crowding in the mandibular anterior region. Clinical and radiographic examinations showed fusion of the mandibular left central incisor with a supernumerary tooth, whereas the roots and pulp cavities were completely separated. The fused tooth complex was successfully treated by hemisection and crown restoration without endodontic treatment. Conclusion: Hemisection may be an effective treatment option for fused teeth with separate roots and independent pulp cavities, allowing for morphological correction while preserving pulp vitality without endodontic treatment.
Background: Adenomatoid odontogenic tumor (AOT) is a benign odontogenic tumor typically arising intraosseously in adolescents and often associated with impacted teeth. Case presentation: A 14-year-old girl presented with painless swelling in the anterior maxillary gingiva. Radiographs showed a well-defined radiolucency between the maxillary right central incisor and canine with localized cortical bone loss. The lesion was excised under general anesthesia, and histopathology confirmed AOT. Conclusion: This atypical presentation expands the clinical spectrum of AOT and underscores the importance of careful radiographic evaluation of gingival swellings in adolescents. In patients with developmental disorders, individualized behavioral assessment and treatment planning may be required to ensure safe diagnosis and management.
Delayed eruption of primary teeth is uncommon in clinical practice. Reported here are two cases of delayed eruption of mandibular primary anterior teeth managed using different treatment approaches. A 1-year-8-month-old child presented with delayed eruption of the mandibular primary lateral incisors. No pathological findings were identified, thus periodic follow-up examinations were performed, resulting in spontaneous eruption during the observation period. The second case involved a 2-year-8-month-old child with delayed eruption of the mandibular left primary central incisor associated with horizontal impaction. No eruptive improvement was observed, thus surgical window opening was performed, resulting in favorable eruption. These findings suggest that conservative management may allow for spontaneous eruption in young patients without severe positional abnormalities, whereas surgical intervention can facilitate eruption in those with persistent impaction.
Background: Crohn's disease is a chronic inflammatory bowel disease characterized by granulomatous inflammation of the gastrointestinal tract with an etiology that remains unclear. Although oral manifestations, including aphthous-like ulcers, lip swelling, gingival swelling and gingival enlargement, have been reported, cases with oral findings preceding gastrointestinal symptoms are relatively uncommon. Case report: A 13-year-old boy was referred for evaluation of persistent swelling of the lower lip. The patient initially experienced pain in the mandibular anterior gingiva during toothbrushing, followed by gradual worsening of lower lip swelling. Lower gastrointestinal endoscopy revealed numerous aphthae in the small intestine, longitudinal ulcers, erosion, and redness, leading to a diagnosis of Crohn's disease. Conclusions: Dentists should recognize that oral manifestations of Crohn's disease may precede gastrointestinal symptoms and collaborate closely with physicians to facilitate early diagnosis and appropriate management.
Aim: To investigate factors involved in the acquisition of feeding and swallowing functions during the treatment of feeding and swallowing disorders in children with these disabilities. Methods: We conducted a retrospective cohort study of patients who received treatment for 500 days at 11 medical institutions. The stages of feeding and swallowing functions at the last visit were compared with those at the initial visit, and changes in feeding and swallowing functions (improved, unchanged, or deteriorated) were determined. Results: At the final evaluation, 123 (76.9%) patients showed improvement, 37 (23.1%) showed no change, and 0 (0%) showed deterioration. Statistical analysis showed a significant improvement in the achievement stages at the final evaluation compared with those at the initial evaluation (P = 0.001). Factors significantly related to the acquisition of feeding and swallowing functions were "age group" and "steady head control (gross motor function)" (age group; P = 0.011, steady head control; P = 0.040).
Background: The present study aimed to assess prevalence of dental caries and associated factors among school going children residing in mountainous regions of Swat, Pakistan. Methods: This cross-sectional study involved 350 school going children (both public and private) aged 12-16, residing in district Swat, Pakistan. An interviewer-administered structured questionnaire was used for data collection from the participants followed by clinical oral examination to assess presence of dental caries using Decayed-Missing-Filled Tooth (DMFT) Index. Negative binomial regression was used to analyse DMFT as a count outcome, while modified Poisson regression with robust variance was used to assess factors associated with dental caries prevalence. Results: The overall prevalence of dental caries in the study population was 72.5% with a mean DMFT score of 2.33 +/- 2.31. In adjusted negative binomial regression, daily consumption of salty bakery products was associated with lower DMFT (RR = 0.48, 95% CI: 0.31-0.73, p = 0.001). In modified Poisson regression, daily consumption was also associated with lower prevalence of dental caries (PR = 0.61, 95% CI: 0.39-0.94, p = 0.001). School type showed a non-significant trend towards lower caries among private school students, while no significant associations were observed for age, sex, or fluoride toothpaste use. Conclusions: Dental caries is common among adolescents from rural, mountainous communities of Swat, Pakistan. Daily consumption of salty bakery products was associated with lower DMFT and lower prevalence of dental caries among adolescents. These findings should be interpreted cautiously due to the cross-sectional design and potential residual confounding.
Topic This comprehensive narrative review summarizes the available evidence regarding neonates with congenital epulis, the epidemiologic profile, prenatal imaging findings, histopathologic features, management strategies (surgical excision versus observation), and clinical outcomes. Clinical relevance Congenital epulis is a rare benign gingival tumor of the newborn that can impair feeding and, occasionally, breathing. Because evidence is scattered across isolated case reports, clinicians lack clear guidance for counselling and perinatal management. Methods A comprehensive literature search of MEDLINE, Embase, Scopus, and Web of Science was conducted from database inception to the final search date. Published case reports and case series involving neonates with congenital epulis were reviewed. Data regarding epidemiology, prenatal imaging, histopathology, management strategies, and outcomes were extracted and synthesized descriptively. Results One hundred twenty-four publications reporting 147 neonates were included. Most infants were female and had a solitary mass arising from the anterior maxillary alveolar ridge. Prenatal detection occurred in a minority of pregnancies. Early neonatal surgical excision was the predominant management, under general or local anesthesia, with minimal perioperative morbidity. No recurrences or malignant transformations were documented. Spontaneous regression was described only in a few small, conservatively managed lesions. Conclusion Evidence, restricted to retrospective case reports, consistently indicates an excellent prognosis for congenital epulis. Simple early excision appears safe and curative for most lesions, whereas careful observation may be reasonable for selected small tumors. Further prospective, standardized reporting is needed to refine prenatal counselling and postnatal management.
Appropriate timing of mesiodens extraction may reduce the risk of eruption disturbance of the maxillary central incisor. We encountered a case in which severe displacement of the maxillary central incisor tooth germ was associated with the presence of two mesiodens. After extraction of the mesiodens, the axis of the central incisor improved spontaneously, and the tooth subsequently erupted without orthodontic traction. We hypothesized that this spontaneous eruption was related to the developmental stage of the tooth germ, during which improvement of the abnormal axis could occur prior to eruption. To further investigate this hypothesis, we retrospectively assessed 49 maxillary central incisors with positional abnormalities associated with mesiodens. Among children diagnosed with mesiodens at 5-6 years of age, approximately 70% showed positional abnormalities of the maxillary central incisor tooth germ, whereas all incisors diagnosed at 7 years of age exhibited positional abnormalities. In the present investigation, mesiodens were extracted before the maxillary central incisors reached one-quarter root formation. The rate of positional improvement of the central incisor tooth germ affected by mesiodens tended to decrease as the developmental stage of the incisor advanced after mesiodens extraction. However, overall, more than 85% of the maxillary central incisors erupted spontaneously. This study underscores the importance of evaluating the stage of root development of the permanent maxillary central incisor when determining the timing of mesiodens extraction and predicting eruption outcomes.
Background Idiopathic internal resorption of primary teeth is uncommon and may lead to premature exfoliation and occlusal disturbances. Its management is particularly challenging in children with autism spectrum disorder (ASD). Case presentation A child with ASD presented with rapidly progressive idiopathic internal resorption affecting multiple primary teeth. Early exfoliation necessitated space maintenance; preventive endodontic treatment was performed on at-risk molars, which subsequently exfoliated normally. Behavioral management tailored for ASD-facilitated treatment. Conclusion This case suggests that when idiopathic internal resorption is identified, the potential for rapid and multiple progressions should be considered. Therefore, regular radiographic follow-ups and preventive treatments are warranted.
Background: Osteogenesis imperfecta (OI), often associated with dentinogenesis imperfecta type I (DI-I), leads to structural alterations such as early pulp obliteration in primary teeth. This study evaluated the diagnostic utility of cone-beam computed tomography (CBCT) and periapical radiographs (PXR) in assessing pulp chamber volume and morphology in primary molars of children with OI, with and without DI. Methods: An observational in vitro case-control study was conducted on primary molars from children with OI (DI and non-DI groups) and healthy controls. Dental dimensions and pulpal measurements were obtained from PXR and CBCT. Three-dimensional volumetric reconstructions were generated using 3D Slicer to quantify pulp chamber volume. Statistical analyses included ANOVA, Kruskal-Wallis tests, intraclass correlation coefficients (ICC), and generalized linear models adjusted for tooth type, sex, and age. Results: Sixty-six molars were included: 20 with DI, 23 without DI, and 23 controls. Molars from OI patients with DI showed significantly reduced pulp volume compared with both OI without DI and controls (p < 0.001). Type III OI was associated with the lowest pulp volumes, independently of age, sex, and tooth type (p = 0.003). CBCT measurements demonstrated superior agreement with anatomical dimensions compared with PXR (ICC up to 0.99). Three-dimensional reconstructions revealed dysmorphic and partially obliterated pulp chambers in DIaffected molars. Conclusions: Primary molars of children with OI and DI present significant pulp volume reduction and morphological alterations, particularly in severe OI phenotypes. CBCT provides reliable quantitative assessment and may serve as a complementary diagnostic tool for identifying DI-related pulpal changes.
To avoid near-miss choking events, childcare facilities should ensure that staff members are properly trained, implement strict control strategies, and manage the physical environment. This study was based on an online survey conducted among staff members working at facilities belonging to the National Childcare Association, public childcare centers, and social welfare corporation-run facilities in Japan. It aimed to clarify the near-miss choking incidents occurring in childcare facilities and investigate the facility- and food-related factors to support risk alleviation and preventive approaches. In 79.1 % of children, no notable concerns regarding physical growth were recorded, whereas 31.7 % showed developmental concerns. With respect to the causes of near-miss events, 59.1 % were attributed to facility-related factors, such as food preparation practices and supervision arrangements. The most frequent way of information sharing between individual staff members was verbal communication (63.0 %), followed by staff meetings or morning briefings attended by all personnel (30.6 %). Near-miss events were associated most frequently with staple foods, including noodles, rice, and bread (32 %), followed by main dishes such as meat or fish (26 %). The findings revealed that immediate, on-site information sharing and routine safety practices serve as effective preventive measures for reducing event risk. Moreover, common staple foods, such as meat, bread, and rice, require proactive risk-reduction approaches by caregivers, including careful observation and texture modification. These events were affected not by a single factor, such as utensil use or food category, but by a combination of several interacting factors.
Aim This scoping review assessed the performance of regenerative endodontic treatment (RET) in avulsed immature permanent teeth, which presented a significant challenge in dental trauma management. This scoping review aims to evaluate RET outcomes, protocols, complications, and effectiveness in avulsed immature permanent teeth, identifying research gaps to advance clinical application. Materials and methods The review encompassed a comprehensive search of PubMed, Cochrane Central Register of Controlled Trials, Web of Science, Scopus, and Science Direct, spanning over 20 years, supplemented by snowball searching. Full-text articles in any language were eligible if they were randomized/non-randomized clinical trials or prospective/retrospective cohort studies with at least 12 months of follow-up, following the PCC framework. Data were extracted using standardized forms, including author(s), publication year, study origin, aim, sample size, intervention protocol, follow-up, outcome measures, and measurement methods. Results Of the 1623 records reviewed, 14 studies met the inclusion criteria. These studies, involving 82 avulsed immature anterior teeth, demonstrated an overall success rate of 44 % (36/82) over a minimum 12-month follow-up, with success defined by periapical radiolucency resolution and positive root development. The included studies showed significant variability in RET protocols, with calcium hydroxide as the primary intracanal medicament, blood clot as the main scaffold, and 17 % (Ethylenediaminetetraacetic acid) EDTA with saline as the most common irrigation method. Notably, extra-alveolar time and storage conditions significantly influenced outcomes, with replantation within 60 min using a physiological medium yielding the best results. Conclusion While RET demonstrates approximately 44 % success in treating avulsed immature teeth, the variability in treatment protocols and the limited sample sizes in current studies highlight the need for more extensive research and standardized protocols to validate its use by dental practitioners.
Background Enostosis of the jaw bones may rarely cause tooth eruption disturbances. Case presentation A 9-year-old girl presented with a mandibular first premolar displaced distally by enostosis at the alveolar ridge between the canine and premolar, resulting in loss of eruption space for the second premolar. To reduce bone resistance, pinhole perforations were drilled into the enostosis. This allowed the eruptive force of the second premolar to effectively push the first premolar mesially, restoring space and enabling proper eruption. Conclusion This is the first reported successful use of the pinhole perforation technique to correct eruption disturbances caused by enostosis.
Aim: Fixed-appliance therapy during occlusal guidance in children increases the risk of enamel demineralization, often presenting as white spot lesions (WSLs). This study evaluated the clinical performance of a hydroxyapatiteinducing coating (Bio Coat Ca) for preventing new WSLs and improving pre-existing hypomineralization in pediatric patients. Methods: This study evaluated 18 polycarbonate brackets bonded in three children undergoing occlusal guidance therapy. Bio Coat Ca was applied to labial enamel surfaces prior to bonding with Super Bond. Clinical outcomes included bracket retention, incidence of new WSLs, and changes in pre-existing hypomineralized enamel. Standardized intraoral photographs were analyzed using ImageJ to quantify lesion area ratios before and after treatment. Bracket survival was evaluated using Kaplan-Meier analysis. Results: Of the 18 polycarbonate brackets evaluated, with five bond failures within 377 days (overall retention 72.2 %). This retention rate is comparable to previously reported outcomes for polycarbonate brackets, indicating that Bio Coat Ca does not compromise bonding performance. No new WSLs were observed in any case. Pre-existing hypomineralized areas decreased markedly, with lesion area ratios reduced to 11.76 %, 11.83 %, and 0.34 % in the three cases, respectively. Conclusion: A single application of a calcium-releasing bioactive coating prior to bracket bonding was associated with the absence of new WSLs and the improvement of pre-existing enamel hypomineralization in children, without compromising bracket adhesion. This approach may be particularly beneficial for pediatric patients with limited cooperation or special health care needs.
Aim Molar-incisor hypomineralization (MIH) is a developmental enamel defect that presents diagnostic and treatment challenges for dental professionals. Understanding the knowledge, perception, attitude, practice, and awareness of MIH is essential for improving its management in pediatric dentistry. This systematic review evaluates the knowledge, perception, attitude, practice, and awareness of MIH among dentists and dental students. Methods A systematic search was conducted across PubMed, Scopus, ScienceDirect, Web of Science, EBSCO, and Google Scholar following PRISMA guidelines. Cross-sectional studies were included, and the methodological quality was assessed using the Joanna Briggs Institute (JBI) checklist. Results Out of 2499 identified articles, 38 met the inclusion criteria, comprising 11,129 participants. Data collection was primarily conducted via Email (44.73 %), Google Forms (31.57 %) and direct questionnaire (15.78 %). Most studies assessed knowledge (89.47 %), followed by perception (60.52 %), practice (47.36 %), attitude (34.21 %), and awareness (10.52 %). Pediatric dentists demonstrated higher levels in all domains. Conclusion The findings indicate a need for improved education and training on MIH. Dental institutions and regulatory bodies may use this informati-on to enhance curricula and clinical guidelines, promoting better MIH management in pediatric dentistry.
