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Background: Paediatric‐preformed zirconia crowns have been associated with several issues, primarily their inability to be crimped and the need for extensive tooth preparation. Additionally, the capacity to adjust the size, shape, and fit of these crowns is very limited. Aim: To evaluate and compare the fracture strength of four different types of dental crowns intended for paediatric patients. Design: The fracture resistance of four types of paediatric crowns was evaluated using the universal testing machine; freshly extracted primary molars received one of the following: preformed zirconia crowns, custom‐made computer‐aided design and computer‐aided manufacturing (CAD–CAM) zirconia crowns, custom‐made CAD–CAM ceramic crowns, and custom‐made CAD–CAM hybrid composite crowns. Data were statistically compared using the Kruskal–Wallis test followed by the Bonferroni test, and the level of significance was set at 5%. Results: Results showed that there was a statistically significant difference among the four groups (p <.001). The highest value of fracture force was observed for the milled zirconia crown and the lowest for the prefabricated zirconia. Conclusion: The implementation of the CAD–CAM digital crown fabrication technique has the potential to address issues associated with preformed crowns in paediatric patients, particularly in terms of fracture resistance. [ABSTRACT FROM AUTHOR]

Background: Currently, the indications for pulpectomy of primary molars performed under dental general anesthesia vary across countries. Therefore, we retrospectively investigated the five-year survival rate of primary molars following pulpectomy performed under dental general anesthesia and the impact of this treatment on permanent successors, assessed the risk factors related to overall survival and clarified the indications for pulpectomy. Methods: The medical records of children receiving pulpectomy of primary molars under dental general anesthesia from August 1, 2013, to November 30, 2023, were reviewed. Potential risk factors, including gender, age, general health, tooth type, tooth location, endodontic diagnosis and quality of root filling, were assessed via univariate and multivariate Cox proportional hazards regression models, and the survival rate was examined via the Kaplan‒Meier technique. Moreover, the rate of resorption of the root canal filling materials, degree of resorption of the overfilled/over-extended root canal filling materials and development of permanent successors were assessed by clinical and radiographic examination. Results: The study included 320 teeth from 161 children (86 boys and 75 girls). The overall five-year survival rate was 38.2%, and the mean overall survival time was 54.2 months. Endodontic diagnosis was considered a significant risk factor (P < 0.05). In the first, second and third years, 57.4%, 81.8%, and 94.8%, respectively, of obturation materials in the root canals were resorbed at a faster rate than the roots. There was an altered eruption direction in 7 permanent teeth, and 4 permanent teeth were diagnosed with enamel hypoplasia. Conclusions: In this study, the 60-month survival rate of primary molars treated by pulpectomy under dental general anesthesia was 38.32%. Operators should have an accurate assessment of the status of the pulp, have a strict grasp of the preoperative indications and select the appropriate treatment method according to the guidelines. Individual cases suggest overfilling, overextension and periapical periodontitis in primary molars have an impact on enamel hypoplasia and altered eruption direction in permanent teeth. [ABSTRACT FROM AUTHOR]

Purpose: Although a series of studies on OXIS contacts have been performed, studies regarding changes in OXIS contacts over time are lacking. Therefore, this study aimed to evaluate the change in contact type between primary molars after 3 years in children aged 3–7 years. Methods: This longitudinal study was conducted using 2922 sectional die models of 926 children. At baseline (T0), the contact type between the primary molars was scored using replication via the sectional die model method according to the OXIS criteria. After 3 years, the sectional die models of the same children were scored using the same criteria (T1). Results: McNemar's tests revealed a significant change in contacts from baseline to 3 years. The post hoc test explained specific changes in the contacts that were observed to be significant. These were O to X (p < 0.001), O to I (p < 0.001), O to S (p = 0.035), and I to X (p < 0.001). Conclusions: A significant change in OXIS contact over time was observed. The O-type contact underwent the maximum change. The least and most stable contacts are the "O" and "I" types, respectively. This change in contact type with age may alter the risk of caries in children. [ABSTRACT FROM AUTHOR]

Background: Pulpotomy is a crucial method to preserve primary teeth until natural exfoliation. This study aimed to evaluate the clinical and radiographic outcomes of pulpotomy with iRoot BP Plus in primary molars and to explore the association between hemostasis time and these outcomes. Methods: Primary molars that underwent iRoot BP Plus pulpotomy and were followed for at least 12 months were selected for this study. Clinical and radiographic data were collected, and the success rate was analyzed in relation to factors such as hemostasis time, tooth type, and arch type. The tests of significance used were the chi-square test, Fisher's exact test, or Kruskal-Wallis test. Statistical significance was set at P < 0.05. Results: A total of 183 teeth in 106 patients were included in the analysis. The follow-up period fell into a range of 1–3 years, with a mean of 1.6 years. The clinical and radiographic success rates were 96.7% and 92.9%, respectively. The earliest time to observe the radiographic failures was half a year after the treatment, and the latest time was two years after the treatment. Among all the teeth, 130 were recorded with hemostasis time before the application of iRoot BP Plus. Compared to teeth with a hemostasis time of 5 min or less, teeth with a hemostasis time exceeding 5 min showed no significant differences in clinical and radiographic success (P = 1.000 and 0.879). Additionally, neither arch nor teeth type showed a relationship with the pulpotomy success rate (P > 0.05). Conclusions: Pulpotomy using iRoot BP Plus in primary molars achieved favorable results. The hemostasis time may not significantly impact the outcomes of pulpotomy using iRoot BP Plus in primary molars. [ABSTRACT FROM AUTHOR]

Abstract Background Currently, the indications for pulpectomy of primary molars performed under dental general anesthesia vary across countries. Therefore, we retrospectively investigated the five-year survival rate of primary molars following pulpectomy performed under dental general anesthesia and the impact of this treatment on permanent successors, assessed the risk factors related to overall survival and clarified the indications for pulpectomy. Methods The medical records of children receiving pulpectomy of primary molars under dental general anesthesia from August 1, 2013, to November 30, 2023, were reviewed. Potential risk factors, including gender, age, general health, tooth type, tooth location, endodontic diagnosis and quality of root filling, were assessed via univariate and multivariate Cox proportional hazards regression models, and the survival rate was examined via the Kaplan‒Meier technique. Moreover, the rate of resorption of the root canal filling materials, degree of resorption of the overfilled/over-extended root canal filling materials and development of permanent successors were assessed by clinical and radiographic examination. Results The study included 320 teeth from 161 children (86 boys and 75 girls). The overall five-year survival rate was 38.2%, and the mean overall survival time was 54.2 months. Endodontic diagnosis was considered a significant risk factor (P

Abstract Background Pulpotomy is a crucial method to preserve primary teeth until natural exfoliation. This study aimed to evaluate the clinical and radiographic outcomes of pulpotomy with iRoot BP Plus in primary molars and to explore the association between hemostasis time and these outcomes. Methods Primary molars that underwent iRoot BP Plus pulpotomy and were followed for at least 12 months were selected for this study. Clinical and radiographic data were collected, and the success rate was analyzed in relation to factors such as hemostasis time, tooth type, and arch type. The tests of significance used were the chi-square test, Fisher’s exact test, or Kruskal-Wallis test. Statistical significance was set at P 0.05). Conclusions Pulpotomy using iRoot BP Plus in primary molars achieved favorable results. The hemostasis time may not significantly impact the outcomes of pulpotomy using iRoot BP Plus in primary molars.

Abstract Rehabilitation of pulpotomized primary molars with an appropriate restoration is essential for recovering function and safeguarding the durability of the treatment. This study aimed to assess and compare the surface roughness of stainless steel (ST) crowns, zirconia (ZR) crowns, fiberglass (FG) crowns, and lithium disilicate (LD) endo-crowns as a restoration for pulpotomized primary molars also, evaluating the surface roughness of their antagonists. Sixty pulpotomized primary mandibular first molars were used for qualitative surface roughness evaluation and divided into four groups (n = 15/group) according to the crown type (group-ST, group-ZR, group-FG, group-LD). While the other sixty sound, unprepared primary maxillary first molars were used for evaluation of their surface roughness against the tested crowns. Specimens’ preparation and cementation were carried out according to each crown type and manufacturer’s instructions. The surface roughness was done using a two-body wear test. The data were statistically analyzed. All tested crowns showed an increased change in surface roughness, except group-ZR, which had the least change in surface roughness after mechanical wear with no statistically significant difference(P = 0.681). All crown types significantly increased the surface roughness of their antagonists after mechanical wear, except group-ST which showed insignificant affection (p ≥ 0.05). Zirconia crowns and lithium disilicate endo-crowns had the least change in surface roughness compared to other groups while SSCs showed the least tooth loss in the antagonist enamel.

Background: Many practitioners have questioned whether the construction method of pediatric zirconia crowns impacts the periodontal health and clinical performance of severely decayed primary molars. The objective of this study was to compare the periodontal health and clinical performance of primary molars restored with custom-made zirconia crowns (CZCs) and prefabricated zirconia crowns. Methods: Twenty primary molars indicated for crown restorations were selected from ten patients (5–9 years old) randomly. Each patient received two pediatric zirconia crowns constructed by two different methods: one custom-made and one prefabricated. The primary molars were divided into two groups: Group 1: primary molars received CZCs and Group 2: primary molars received prefabricated zirconia crowns (PZCs). Results: After a 12-month follow-up, there was no statistically significant difference between the periodontal health of primary molars restored with custom-made and prefabricated zirconia crowns. The clinical performance of primary molars restored with CZCs was statistically significantly higher than those restored with PZCs in terms of retention and fracture resistance (P ≤ 0.05). Conclusions: The construction method of pediatric zirconia crowns does not significantly affect the periodontal health of primary molars; however, clinical performance is significantly affected in terms of retention and fracture resistance. Clinical Significance: A CZC is an excellent alternative option, especially for primary molars whose permanent successors still have a long time to erupt. The PZC is a quick and easy restoration, but the technique is sensitive.

Abstract Background The aim of this retrospective study was to determine the long-term clinical and radiographic success of our previous randomized clinical trial and to compare the success of hyaluronic acid, with the widely used formocresol and ferric sulphate agents. Methods This retrospective study is the extension of the 1-year survey of our randomized clinical trial that had compared the effectiveness of a hyaluronic acid pulpotomy over formocresol and ferric sulphate pulpotomies and included clinical and radiographic evaluations with a follow-up period of over 24 months for 44 children who applied to our clinic between May 2019 and September 2019. Long-term clinical and radiographic data were obtained from the periodic files of our department, wherein each tooth’s file was examined to identify any clinical and radiographic findings. Descriptive statistics and Pearson’s chi-square tests were used to evaluate the data. Statistical significance was considered as p 24 months. None of the teeth in the hyaluronic acid group showed any clinical findings at > 24 months. Conclusions Hyaluronic acid pulpotomies exhibited comparable success rates to formocresol and ferric sulphate materials spanning over 24 months examinations. Because of convenient accessibility and applicability of hyaluronic acid, it may be recommended as a promising alternative medicament for pulpotomy treatments of primary molars. However, further long-term follow-up human studies are needed to better understand the effect of hyaluronic acid on the dental pulp of human primary molars.

Rehabilitation of pulpotomized primary molars with an appropriate restoration is essential for recovering function and safeguarding the durability of the treatment. This study aimed to assess and compare the surface roughness of stainless steel (ST) crowns, zirconia (ZR) crowns, fiberglass (FG) crowns, and lithium disilicate (LD) endo-crowns as a restoration for pulpotomized primary molars also, evaluating the surface roughness of their antagonists. Sixty pulpotomized primary mandibular first molars were used for qualitative surface roughness evaluation and divided into four groups (n = 15/group) according to the crown type (group-ST, group-ZR, group-FG, group-LD). While the other sixty sound, unprepared primary maxillary first molars were used for evaluation of their surface roughness against the tested crowns. Specimens' preparation and cementation were carried out according to each crown type and manufacturer's instructions. The surface roughness was done using a two-body wear test. The data were statistically analyzed. All tested crowns showed an increased change in surface roughness, except group-ZR, which had the least change in surface roughness after mechanical wear with no statistically significant difference(P = 0.681). All crown types significantly increased the surface roughness of their antagonists after mechanical wear, except group-ST which showed insignificant affection (p ≥ 0.05). Zirconia crowns and lithium disilicate endo-crowns had the least change in surface roughness compared to other groups while SSCs showed the least tooth loss in the antagonist enamel. [ABSTRACT FROM AUTHOR]

Purpose: The variations in interproximal contact areas have been categorised open (O), point (X), straight (I), and curved contact (S). This is based on their shapes and termed as OXIS classification. The interactive OXIS calibration website was developed to assist researchers seeking appropriate knowledge, minimise the overload of material, optimise efficiency in calibration and, to provide repositories for clinicians, healthcare workers, and policymakers. Methods: The website was developed in two phases. The first phase of development included expert group discussion, Focus Group Discussion (FGD), and the implementation of FGD recommendations. The second phase emphasised registration and development of the interactive web portal on OXIS classification. The developed website was subjected to user experience testing, functional testing, performance testing, security testing, device, platform testing, and then hosted. Calibrated students and faculties evaluated it with the help of Suitability Assessment of Materials (SAM) and System Usability Scale (SUS). Finally, after amendments, the website was evaluated by non-calibrated researchers and multidisciplinary experts. Results: The total agreement was 74% for overall SAM category. Pooled mean total score of SUS was 52.7 (SD 7.17; range 45–67.5), indicating an average score. Conclusion: The content of the developed website has been evaluated as "satisfactory" and its technical quality as "of higher standards". [ABSTRACT FROM AUTHOR]

Background: The Hall Technique (HT) is now regarded as one of the biological management options for carious primary molars and has shown significant clinical success. Aim: To investigate the perception and the use of the HT among dentists engaging in paediatric dentistry in East China. Design: This was an electronic questionnaire‐based cross‐sectional study. A quick response code of the questionnaire via WeChat, a common communication tool in China, was sent to dentists in East China. Results: A total of 313 dentists participated in this study. Most surveyed clinicians had heard about the HT (n = 286, 91.4%). Of them, 40.2% (n = 115) reported having used the HT. Of 67 dentists working in private clinics, 34 (50.7%) had used the HT, whereas only 37% of dentists from public hospitals had used the HT. Of 115 dentists having used the HT, 91.3% (n = 105) would consider using the HT for Class II cavitated molars; 23.5% (n = 27) would consider using the HT for Class I cavitated molars. Most dentists who had not used the HT were concerned about complications such as pulp inflammation or necrosis after applying the HT. Conclusion: The HT is well known in East China; the lack of systematic training or courses, however, may decrease its utilization. [ABSTRACT FROM AUTHOR]

Purpose: To determine the variation of OXIS contact areas in primary molars using digital impressions generated from an intraoral scanner (IOS). Methods: A cross-sectional study was carried out on 214 caries-free posterior quadrants of 80 children (38 males and 42 females) aged 3–6 years. Calibration of taking digital impressions with the IOS procedure was performed initially through scanning of ten quadrants of children to provide a learning environment to the examiner. The digital impressions were then exported, and the type of interproximal contact areas present between the distal surface of the primary first molar and the mesial surface of the primary second molar were identified according to the OXIS classification. The prevalence of the types of OXIS contact areas was expressed in the form of numbers and percentages. The chi-square test was applied to investigate the variability among the arches and to understand the association of OXIS contact areas across age, gender, and arches. Results: The most common contact area type observed was I-type (59.8%), followed by S-type (15.4%), X-type (12.6%), and O-type (12.2%). The I-type contact area was most frequently seen in both males (51.6%) and females (65.5%), while the S-type contact area in males (14.7%) and X-type contact area in females (8.4% each) were the least frequent with no statistical significance between genders (p > 0.05). All three age groups studied showed the highest prevalence of the I-type contact area, which increased with an increase in age (p < 0.05). The inter-arch comparison showed a significant result in terms of the X-type contact area on the right side, and O-type, X-type, and I-type contact areas on the left side, while no statistical difference was seen in the intra-arch comparison for all contact types. Conclusion: I-type contact areas were the most prevalent across the arches, age groups and genders. [ABSTRACT FROM AUTHOR]

Background Pulpotomy is a widely recommended treatment for deep caries and reversible pulpitis in primary teeth. However, there is a significant lack of large-scale clinical studies evaluating the long-term efficacy of pulpotomy in primary molars, especially in studies with follow-up periods extending beyond a two years. Aim This study aimed to evaluate the long-term efficacy of mineral trioxide aggregate (MTA) and iRoot BP Plus for pulpotomy in primary molars performed under general anesthesia and to investigate factors influencing the success rate. Methods In this retrospective study, a total of 942 primary molars from 422 children who met the inclusion criteria underwent pulpotomy. Propensity score matching method (PSM) was used to match the MTA and iRoot BP Plus groups in a 1:1 ratio based on covariates. Efficacy was assessed using the Zurn & Seale criteria. Kaplan-Meier survival analysis and Cox proportional hazards model were performed to analyze the outcomes. Results PSM resulted in 266 pairs of matched teeth from 532 teeth of 291 children (mean age: 4.64 ± 1.07 years, ranging from 2 to 8 years). Long-term clinical and radiographic evaluations revealed higher success rates for iRoot BP Plus (24-month: 99.54%/97.25%; 36-month: 97.22%/95.83%) compared to MTA (24-month: 94.76%/95.29%; 36-month: 92.50%/91.25%). Survival analysis indicated a statistically significant difference between two groups (P = 0.0042). Age, gender, tooth position, and decayed tooth surface showed no significant impact on pulpotomy success, whereas the choice of pulp capping materials significantly influenced the outcome (HR [95% CI]=0.3745[0.1857-0.7552], P = 0.006). Conclusion Clinical and radiographic evaluations support the use of iRoot BP Plus for pulpotomy in primary molars.

Introduction: We aimed to evaluate the effects of 38% silver diamine fluoride (SDF) application on the progression of secondary caries (SC) around resin-based composite (RBC) restoration margins in extracted human primary molars compared to 2.5% fluoride varnish (NaF) with hydroxyapatite and no intervention. Methods: Standardized box-shaped cavities were prepared on 30 primary teeth and restored with RBC restorations. The teeth were thermo-cycled and then immersed in a demineralizing solution for 10 days. The baseline volumes of the demineralized lesions were measured using Micro-CT (first evaluation). Next, the teeth were randomly divided into three equal groups of 10 teeth: the experimental group (38% SDF), the positive control group (2.5% NaF varnish with hydroxyapatite), and the negative control group (no intervention). All teeth were immersed again in the demineralizing solution for 10 days, followed by a second micro-CT evaluation. Results: There was a statistically significant difference in the rate of change of demineralization areas between the three groups (p < 0.001). The SDF group showed the least change in the mean volume of the demineralization area between the baseline and after the second exposure (3.4 ± 0.94 mm3) compared to NaF (4.85 ± 1.97 mm3) and the negative control groups (8.78 ± 2.03 mm3). Conclusion: SDF was effective in managing primary molars with SC around resin-based composite restorations.

Abstract Objectives The trial aimed to compare the clinical performance and radiographic success of ACTIVA BioACTIVE versus Compomer in restoring class-II cavities of primary molars. Materials and methods A non-inferior split-mouth design was considered. A pre-calculated sample size of 96 molars (48 per group) with class-2 cavities of twenty-one children whose ages ranged from 5 to 10 years were randomly included in the trial. Pre-operative Plaque Index (PI), DMFT/dmft scores and the time required to fill the cavity were recorded. Over 24 months, the teeth were clinically evaluated every six months and radiographically every 12 months by two calibrated and blinded evaluators using the United States public health service (USPHS)-Ryge criteria. The two-sided 95% confidence interval (CI) for the difference in success rate was considered to assess non-inferiority, and the margin was set at -18%. The linear mixed model and Firth’s logistic regression model were used for data analysis (P 0.05). ACTIVA took significantly less placement time than Dyract, with a mean difference of 2.37 (± 0.63) minutes (P

Objectives: This ex vivo human study aimed to evaluate the efficacy of NaOCl and chlorhexidine gluconate (CHG) irrigations in eliminating Enterococcus faecalis from the RCS of primary molars. Materials and methods: Disinfected extracted primary molars were inoculated with E. faecalis for 24 h. Then, the RCS samples were then irrigated with either 2.5% NaOCl, 0.2% and 2% CHG, or sham saline. The samples were collected immediately after irrigation; and 24 h later, the bacterial viability and counts were measured using blood agar and qRT-PCR, respectively. Histological sections were used to measure E. faecalis penetration and viability in dentin tubules using fluorescence microscopy. Results: The recovery of viable E. faecalis after the irrigation of the primary molars showed more significant bactericidal effects of NaOCl and 0.2% and 2% CHG than of saline. Immediately after the irrigation, the NaOCl group showed the greatest reduction in E. faecalis; and 24 h later, all the groups had lower viable E. faecalis than the saline control. The bacterial penetration was also lowest in the NaOCl group, although there was no difference in bacterial viability in the tubules between the groups. Conclusion: In primary teeth, NaOCl and CHG showed similar degrees of bacterial elimination efficacy in terms of E.faecalis. Clinical relevance: Within the limitations of this study, NaOCl and CHG have the similar ability to perform endodontic irrigation of primary ex vivo teeth regarding the elimination of E.faecalis, but NaOCl penetrates dentin tubules better. [ABSTRACT FROM AUTHOR]

Objectives: The trial aimed to compare the clinical performance and radiographic success of ACTIVA BioACTIVE versus Compomer in restoring class-II cavities of primary molars. Materials and methods: A non-inferior split-mouth design was considered. A pre-calculated sample size of 96 molars (48 per group) with class-2 cavities of twenty-one children whose ages ranged from 5 to 10 years were randomly included in the trial. Pre-operative Plaque Index (PI), DMFT/dmft scores and the time required to fill the cavity were recorded. Over 24 months, the teeth were clinically evaluated every six months and radiographically every 12 months by two calibrated and blinded evaluators using the United States public health service (USPHS)-Ryge criteria. The two-sided 95% confidence interval (CI) for the difference in success rate was considered to assess non-inferiority, and the margin was set at -18%. The linear mixed model and Firth's logistic regression model were used for data analysis (P < 0.05). Results: After 24 months, 86 teeth (43 per group) were evaluated. The mean PI score was 1.1(± 0.9), while DMFT/dmft was 0.35 (± 0.74) and 6.55 (± 2.25) respectively. The clinical and radiographic success rate of Dyract vs. ACTIVA was 95.3% and 88.3% vs. 93% and 86%, respectively. The two-sided 95% CI for the difference in success rate (-2.3%) was − 3.2 to 1.3% and didn't reach the predetermined margin of -18% which had been anticipated as the non-inferiority margin. Clinically, ACTIVA had a significantly better colour match (P = 0.002) but worse marginal discolouration (P = 0.0143). There were no significant differences regarding other clinical or radiographic criteria (P > 0.05). ACTIVA took significantly less placement time than Dyract, with a mean difference of 2.37 (± 0.63) minutes (P < 0.001). Conclusion: The performance of ACTIVA was not inferior to Dyract and both materials had a comparable high clinical and radiographic performance in children with high-caries experience. ACTIVA had a significantly better colour match but more marginal discolouration. It took significantly less time to be placed in the oral cavity. Trial registration: The study was registered at ClinicalTrials.gov on 4 May 2018 (#NCT03516838). [ABSTRACT FROM AUTHOR]

Purpose: Pulpectomy can be used for the management of deep dentinal carious lesions in primary teeth which can be restored. Mechanical preparation of root canals can be performed using hand or NiTi rotary files. However, this may cause dentinal stress and consequently dentinal microcracks. Hence, the aim was comparative evaluation of hand and rotary file systems on dentinal microcrack formation during pulpectomy procedure in primary teeth. Methods: 60 extracted primary molar teeth were selected comprising of 80 root canals. Simple random sampling was used to divide root canals into four groups (n = 20): Group A—Hedstrom file, Group B—Pro AF Baby Gold rotary, Group C—ProTaper Next rotary, and Group D—unprepared group. Assessment was conducted on presence or absence of microcracks using Chi square test (p < 0.05). Results: The total number of microcracks in Group A: one (5%), Group B: four (20%), Group C: nine (45%) and Group D: zero (0%) which was statistically significant (p = 0.002). At cervical third, the number of microcracks seen with Group A: one (5%), Group B: zero (0%), Group C: five (25%) and Group D: zero (0%) (p = 0.005). At the middle third, the number of microcracks seen in Group A: zero (0%), Group B: four (20%), Group C: four (20%) and Group D: zero (0%) (p = 0.029). Conclusion: The study concluded that dentinal microcracks are formed with both hand and rotary file systems in primary teeth. ProTaper Next showed significantly higher number of microcracks, followed by ProAF Baby Gold and H files. [ABSTRACT FROM AUTHOR]

Background: Many practitioners have questioned whether the construction method of pediatric zirconia crowns impacts the periodontal health and clinical performance of severely decayed primary molars. The objective of this study was to compare the periodontal health and clinical performance of primary molars restored with custom‑made zirconia crowns (CZCs) and prefabricated zirconia crowns. Methods: Twenty primary molars indicated for crown restorations were selected from ten patients (5–9 years old) randomly. Each patient received two pediatric zirconia crowns constructed by two different methods: one custom‑made and one prefabricated. The primary molars were divided into two groups: Group 1: primary molars received CZCs and Group 2: primary molars received prefabricated zirconia crowns (PZCs). Results: After a 12‑month follow‑up, there was no statistically significant difference between the periodontal health of primary molars restored with custom‑made and prefabricated zirconia crowns. The clinical performance of primary molars restored with CZCs was statistically significantly higher than those restored with PZCs in terms of retention and fracture resistance (P ≤ 0.05). Conclusions: The construction method of pediatric zirconia crowns does not significantly affect the periodontal health of primary molars; however, clinical performance is significantly affected in terms of retention and fracture resistance. Clinical Significance: A CZC is an excellent alternative option, especially for primary molars whose permanent successors still have a long time to erupt. The PZC is a quick and easy restoration, but the technique is sensitive. [ABSTRACT FROM AUTHOR]

Introduction: We aimed to evaluate the effects of 38% silver diamine fluoride (SDF) application on the progression of secondary caries (SC) around resin-based composite (RBC) restoration margins in extracted human primary molars compared to 2.5% fluoride varnish (NaF) with hydroxyapatite and no intervention. Methods: Standardized box-shaped cavities were prepared on 30 primary teeth and restored with RBC restorations. The teeth were thermo-cycled and then immersed in a demineralizing solution for 10 days. The baseline volumes of the demineralized lesions were measured using Micro-CT (first evaluation). Next, the teeth were randomly divided into three equal groups of 10 teeth: the experimental group (38% SDF), the positive control group (2.5% NaF varnish with hydroxyapatite), and the negative control group (no intervention). All teeth were immersed again in the demineralizing solution for 10 days, followed by a second micro-CT evaluation. Results: There was a statistically significant difference in the rate of change of demineralization areas between the three groups (p < 0.001). The SDF group showed the least change in the mean volume of the demineralization area between the baseline and after the second exposure (3.4 ±0.94 mm³) compared to NaF (4.85 ± 1.97 mm³) and the negative control groups (8.78 ± 2.03 mm³). Conclusion: SDF was effective in managing primary molars with SC around resin-based composite restorations. [ABSTRACT FROM AUTHOR]

In recent years, pediatric dentistry has evolved considerably in terms of both the techniques and materials used. A clear, odorless liquid called silver diamine fluoride (SDF) is recommended for molars affected by hypoplasia and dentinal hypersensitivity. In adults and children who are at a high risk of developing caries, it is also helpful to prevent the progression of carious lesions. Teeth too compromised to be reconstructed that are not accompanied by discomfort or infection can be treated with SDF. The current review aims to provide an overview of the most recent research over the last 10 years on the potential of SDF, focusing on the clinical evidence of professionally applied fluoride therapy to prevent and arrest caries in children's primary molars. Research was conducted according to the guidelines of the PRISMA statement. "silver diamine fluoride", "primary molar", and "primary molars" were the search terms utilized on the databases Scopus, Web of Science, and PubMed, with the Boolean operator "AND" and "OR". Of these 195 studies, 13 primary studies were included in this review. The quality of the included papers was assessed using the reputable Cochrane risk of bias assessment for randomized trials. The studies reviewed consistently support the effectiveness of SDF in stopping the progression of existing caries in deciduous molars; on the contrary, there is insufficient evidence to draw conclusions about SDF being effective for the prevention of carious lesions in deciduous molars. [ABSTRACT FROM AUTHOR]

Amelogenesis Imperfecta (AI) is a rare genetic disease that affects the structure and appearance of the enamel. The etiology of AI can be various such as genetic, vitamin deficiency, local infection caused by trauma, birth defects, or idiopathic factors. Due to the fact that AI patients have thin layer of enamel, the treatment should cover all the surface and not alter or reduce the enamel structures. To cover all the teeth surface, preformed metal crowns (PMC) can be done by the technique called Hall technique. It is a method for managing primary molar with caries or other defects where the tooth is sealed under PMC without local anaesthesia, tooth preparation, and caries removal. An 8-year-old girl came to our attention showing yellowish teeth with rough surface, very sensitive to both cold and warm temperature on both upper and lower dentition. It was diagnosed as Amelogenesis Imperfecta. A complete treatment plan was carried. [ABSTRACT FROM AUTHOR]

Introduction: The presence of a gap between the tooth that has been prepared and the crown that has been cemented can lead to a phenomenon known as microleakage. This occurrence facilitates the entry of microorganisms into the area, which can subsequently result in the degradation of the luting cement. In order to achieve an optimal fit, it is important to consider some factors, such as the type of crown utilized, the taper of tooth preparation, and the choice of the cementing agent. Aim: The primary objective of this study is to evaluate the extent of microleakage observed in zirconia crowns that have been bonded using glass ionomer cement, selfadhesive resin cement and resin-modified glass ionomer cement. Materials and methods: Forty five primary mandibular molars were carefully categorized into three groups for the treatment. Group I was treated with glass ionomer cement, Group II received resin modified glass ionomer cement, and Group III underwent treatment with self adhesive resin cement. These cements were used for luting the tooth with Kedo zirconia crowns. The restored samples underwent thermal cycling and were assessed for microleakage under a stereomicroscope. Statistical analysis SPSS version 23.0 was used. Expressions for descriptive statistics included frequency and percentages. Analytical statistics, including the Mann Whitney U test, were employed to evaluate the variations in the level of microleakage among the groups, with a significance level set at p<0.05. Results and discussion: The Mann Whitney U test findings indicate no statistically significant distinction in the level of microleakage between Glass Ionomer Cement (GIC) and Resin Modified Glass Ionomer Cement (RMGIC) cements (p=0.072). However, a comparison between the GIC and Self-adhesive resin cement revealed that the latter had much less microleakage than the former (p=0.000). It was observed that both RMGIC (Resin Modified Glass Ionomer Cement) and Self-adhesive resin cement exhibited a higher level of microleakage, compared to Self-adhesive resin alone (p=0.001). Conclusions: Mandibular first molar cemented with kedo zirconia crown had highest microleakage when luted with GIC, followed by RMGIC, and was lowest when luted with self-adhesive resin cement. [ABSTRACT FROM AUTHOR]

Maintaining primary teeth until they naturally exfoliate is extremely important in preventive and interceptive orthodontics. Losing a primary tooth or a set of teeth prematurely can have various consequences. If the primary second molar is lost before the permanent first molar erupts, it is recommended to use an intra-alveolar space maintainer. This article discusses the use of a distal shoe appliance in cases where the primary second molar is lost before the permanent mandibular first molar erupts. [ABSTRACT FROM AUTHOR]

In recent years, pediatric dentistry has evolved considerably in terms of both the techniques and materials used. A clear, odorless liquid called silver diamine fluoride (SDF) is recommended for molars affected by hypoplasia and dentinal hypersensitivity. In adults and children who are at a high risk of developing caries, it is also helpful to prevent the progression of carious lesions. Teeth too compromised to be reconstructed that are not accompanied by discomfort or infection can be treated with SDF. The current review aims to provide an overview of the most recent research over the last 10 years on the potential of SDF, focusing on the clinical evidence of professionally applied fluoride therapy to prevent and arrest caries in children’s primary molars. Research was conducted according to the guidelines of the PRISMA statement. “silver diamine fluoride”, “primary molar”, and “primary molars” were the search terms utilized on the databases Scopus, Web of Science, and PubMed, with the Boolean operator “AND” and “OR”. Of these 195 studies, 13 primary studies were included in this review. The quality of the included papers was assessed using the reputable Cochrane risk of bias assessment for randomized trials. The studies reviewed consistently support the effectiveness of SDF in stopping the progression of existing caries in deciduous molars; on the contrary, there is insufficient evidence to draw conclusions about SDF being effective for the prevention of carious lesions in deciduous molars.

Introduction: Both pulpotomy and pulpectomy are indicated in deciduous teeth with carious pulp exposure. Pulpotomy is recommended for treating carious pulp exposure in primary molars with the development of dental biomaterials. However, it is difficult to determine the severity of pulpitis as children frequently have difficulty communicating their clinical symptoms and there is no objective diagnostic method to assess pulpal status. Thus, therapeutic interventions for deciduous teeth with carious pulp involvement are controversial in clinical applications. This study compared the clinical and radiographic survival time of iRoot BP Plus pulpotomy and Vitapex pulpectomy in treating extremely deep caries with carious pulp exposure in deciduous molars under general anaesthesia., Methods: The 876 deciduous teeth in patients aged 3 to 6 years diagnosed with extremely deep caries were categorised into Group A (iRoot BP Plus pulpotomy) and Group B (Vitapex pulpectomy) based on treatment methods in this retrospective cohort study. The Kaplan-Meier survival curves were used to compare the survival rates and time between the groups. The Cox proportional hazards model was used to evaluate the factors associated with success., Results: 876 primary molars were collected, including Group A (504) and Group B (372). The clinical and radiographic survival time in Group A (54.394 ± 1.388(months) and 48.978 ± 1.413(months)) were significantly higher than that in Group B (47.867 ± 0.956 (months) and 38.834 ± 0.981 (months)) (P < 0.05). The clinical and radiographic survival rates of Group A at 48 months were 77.0% and 69.5%, respectively. Group B's clinical and radiographic survival rates at 48 months were 53.1% and 29.1%. Younger age and treatment with iRoot BP Plus pulpotomy might predict higher success rates (P < 0.05)., Conclusions: The long-term prognosis of iRoot BP Plus pulpotomy for treating extremely deep caries with carious pulp exposure in primary molars under general anesthesia was better than Vitapex pulpectomy., Competing Interests: Declarations Ethics approval and consent to participate This study was approved by the Ethics Committee of Shenzhen Children’s Hospital (No.2022127). The written informed consents were signed by the guardians of the participating children. Consent for publication Not applicable. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Aim: to compare two-year clinical success rates of caries management in children (Hall Technique HT, Nonrestorative caries treatment NRCT, Conventional restorations CR), and to evaluate pain perception, behaviour, technique acceptability by patients, parents and dentists., Methods: 122, 3-8-year-olds were enrolled in 2-year parallel group randomised controlled trial (CR, n = 52, HT, n = 35, NRCT, n = 35). Caries was recorded using Nyvad criteria to measure clinical success/ failure rates. Child's pain perception (Visual Analogue Scale of Faces), child behaviour (Frankl scale), parents' and dentists' treatment opinions (5-point Likert scale) were assessed. Statistical analysis included Chi-square, non-parametric Kruskal-Wallis, Bonferroni-corrected Mann-Whitney U tests (p < 0.05), absolute risk reduction (ARR) and number needed to treat (NNT)., Results: After two years, with 116 participants, clinical success rates were: CR=60.8 % (n = 31), HT=93.8 % (n = 30), NRCT=42.5 % (n = 14) (p < 0.001). Major/minor failure rates differed: CR=17.6 % (n = 9) / 21.6 % (n = 11); HT=6.2 % (n = 2)/ 0 %, NRCT=33.3 % (n = 11)/ 24.2 % (n = 8), (p < 0.05). When comparing HT to CR, ARR = 0.33; NNT= 3 (95 % CI 0.02 -0.58); NRCT to CR, - no observed benefit from NRCT. More than 70 % of children demonstrated "positive/definitely positive" behaviour during treatment. Pain intensity was "very low/low" in 92.3 % of cases for CR, 88.6 % for HT, and 77.1 % for NRCT . NRCT was "very easy" to perform for 82.9 % of participants, compared to 42.3 % for CR and 17.1 % for HT (p < 0.05). CR were reported to take longer than NRCT and HT (p < 0.05)., Conclusion: Clinical success rates of HT were superior to CR and NRCT. All treatment techniques were well tolerated by children, CR was more time-consuming and HT - technically more difficult to perform., Clinical Significance: caries management in primary molars can be successfully performed using minimal intervention, particularly, sealing in caries lesions with Hall technique. NRCT can prevent caries progression when adequate access to mechanical plaque disruption and fluoride is provided. However, occasional fluoride application, and uncontrolled toothbrushing with fluoride toothpaste cannot replace restorative procedures., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Introduction A space between the prepared tooth and the cemented crown can cause microleakage, allowing microorganisms to enter, which in turn leads to the breakdown of the luting cement. To achieve an optimum fit, several factors should be considered, including the type of crown used, the taper of tooth preparation, and the type of cementing agent. Aim The purpose of the current study is to evaluate the microleakage of zirconia crowns cemented with glass ionomer cement (GIC), resin-modified GIC (RMGIC), and self-adhesive resin cement. Materials Forty-five primary mandibular molars were divided into three groups: Group I receiving GIC, Group II receiving RMGIC, and Group III receiving self-adhesive resin cement. These cements were used to lute the teeth with Kedo zirconia crowns. The restored samples underwent thermal cycling and were assessed for microleakage under a stereomicroscope. For the statistical analysis, SPSS version 23.0 was used. Descriptive statistics were presented as frequencies and percentages. Analytical statistics, including the Mann Whitney U test, were used to assess the differences in the level of microleakage between the groups at p < 0.05. Results The Mann Whitney U test revealed no significant difference in the level of microleakage between GIC and RMGIC (p = 0.072). However, self-adhesive resin cement showed significantly less microleakage than GIC (p = 0.000). Similarly, when comparing RMGIC and self-adhesive resin cement, the latter showed significantly less microleakage than the former (p = 0.001). Conclusion Microleakage of Kedo zirconia crowns on mandibular first molars was highest when luted with GIC, followed by RMGIC, and was least when luted with self-adhesive resin cement., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Scientific Review Board issued approval SRB/SDC/PEDO-2105/23/159. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Vishnu et al.)

Background: The aim of this retrospective study was to determine the long-term clinical and radiographic success of our previous randomized clinical trial and to compare the success of hyaluronic acid, with the widely used formocresol and ferric sulphate agents., Methods: This retrospective study is the extension of the 1-year survey of our randomized clinical trial that had compared the effectiveness of a hyaluronic acid pulpotomy over formocresol and ferric sulphate pulpotomies and included clinical and radiographic evaluations with a follow-up period of over 24 months for 44 children who applied to our clinic between May 2019 and September 2019. Long-term clinical and radiographic data were obtained from the periodic files of our department, wherein each tooth's file was examined to identify any clinical and radiographic findings. Descriptive statistics and Pearson's chi-square tests were used to evaluate the data. Statistical significance was considered as p < 0.05., Results: The clinical and radiographic success rates of the hyaluronic acid, formocresol, and ferric sulphate groups were not statistically different at > 24 months. None of the teeth in the hyaluronic acid group showed any clinical findings at > 24 months., Conclusions: Hyaluronic acid pulpotomies exhibited comparable success rates to formocresol and ferric sulphate materials spanning over 24 months examinations. Because of convenient accessibility and applicability of hyaluronic acid, it may be recommended as a promising alternative medicament for pulpotomy treatments of primary molars. However, further long-term follow-up human studies are needed to better understand the effect of hyaluronic acid on the dental pulp of human primary molars., (© 2024. The Author(s).)

Objective: To evaluate the effectiveness of mineral trioxide aggregate (MTA) on pulpotomy in primary molars., Methods: Two hundred and sixty-three cases (310 teeth) of children with early pulpitis of primary molars admitted between February 2019 to February 2022 were enrolled, and their clinical data were retrospectively analyzed. Of them, 130 cases with 155 teeth treated with root canal treatment were set as the control group (CG) and 133 cases with 155 teeth receiving MTA pulpotomy were set as the observation group (OG). Clinical data such as efficacy evaluation, inflammatory factor levels, postoperative adverse reactions, and quality of life (QoL) were compared., Results: After surgery, the overall response rate in the OG was statistically higher than that in the CG, while the levels of inflammatory factors in the OG were significantly lower than those in the CG (all P<0.05). Moreover, the total incidence of complications was significantly lower in OG at 3, 6, and 12 months after surgery (P=0.018, P=0.007, P=0.015, respectively). The QoL of the two groups differed insignificantly before surgery; however, after the treatment, the QoL in OG was significantly higher than those in the CG at 3, 6, and 12 months after surgery (P=0.037, P=0.012, P=0.028, respectively). Moreover, the teeth location and treatment method were independent factors of efficacy (P=0.047, P=0.001, respectively)., Conclusions: MTA pulpotomy outperformed root canal treatment for superior efficacy in children with early pulpitis of primary molars, with a positive effect on improving QoL, and patient prognosis., Competing Interests: None., (AJTR Copyright © 2024.)

This retrospective chart review study investigates the long-term clinical outcome of Biodentine® (Tricalcium silicate) as a medicament for pulpotomy in primary molars. Data in this retrospective study was collected from the dental records of all patients that had at least one primary molar receive pulpotomy treatment (CDT code: D3221) between 01 July 2012 and 01 July 2015. This data includes child's age, medical history, dental history, dental radiographs, pulpotomy procedure details and follow-up clinical notes. Kaplan-Meier Estimate was used to measure the fraction of successful pulpotomy procedures for up to 24 months. A total of 1758 pulpotomy procedures were performed on 1032 patients in our institute in the three-year period and 21.4% of them (N = 376) had follow-up dental records that qualified for the study. Eleven teeth out of 376 teeth were excluded from the statistical analysis due to loss of/broken stainless steel crowns (3.1%). Seventeen pulpotomy failures were identified out of the remaining 365 procedures. The survival probablity of using Biodentine® as a pulpotomy medicament is 96.3% for 18-month follow-up and 95.4% for 24-month follow-up. Biodentine®, a tricalcium silicate formulation, used as a pulpotomy medicament demonstrates a high clinical success rate (95.4%) over a 24-month peroid in primary molars., Competing Interests: The authors declare no conflict of interest. Gerald A. Ferretti is serving as one of the Editorial Board members of this journal. We declare that Gerald A. Ferretti had no involvement in the peer review of this article and has no access to information regarding its peer review. Full responsibility for the editorial process for this article was delegated to GS., (©2024 The Author(s). Published by MRE Press.)