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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]

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]

Objectives: The objective of this study was to analyze the success of primary molar pulpectomy with a minimum of 1 year and up to 4 years follow-up with focus on the treatment setting (general anesthesia, sedation, local anesthesia alone). Method and materials: Data were retrieved from 92 patients' records between 2012 and 2020. The pulpectomy treatment using calcium-hydroxide/iodoform paste was performed under general anesthesia (n = 45), nitrous oxide sedation (n = 21), or local anesthesia alone (n = 39). Bivariate and multivariate analyses were performed. Results: The overall success of pulpectomy was 59.5% 4 years post-treatment. The 4-years clinical success rate was clinically relevantly higher under general anesthesia (78.6% vs 57.1% under nitrous oxide sedation, 43.8% with local anesthesia only) and in the mandibular arch (70.8% vs 38.5% in the maxillary arch). This could be related to the strict case selection under sedation and especially general anesthesia. Despite statistically significant differences in the bivariate analysis for most outcomes and follow-up periods, this was not the case in multivariate regression. Conclusion: Pulpectomy performed in primary molars offers a successful long-term treatment option especially with a strict case selection as under general anesthesia. [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]

Objectives: The complex root canal anatomy of primary teeth keeps it very tricky to attain appropriate cleansing by biomechanical instrumentation, so obtaining an obturating material with excellent antimicrobial properties is a challenge in current clinical pulpectomy practice. So, this study aimed to assess the clinical and radiographic performance of zinc oxide-ozonated olive oil as a primary root canal filling material. Materials and methods: Ninety non-vital primary molars in children ranging from 4 to 8 years were allocated into three groups in which root canals were filled with zinc oxide-ozonated olive oil, zinc oxide-olive oil, and zinc oxide-eugenol (ZOE) according to each group after pulpectomy procedure. Clinical and radiographic evaluations were done at 3-, 6-, and 12-month follow-up periods. Statistical analysis was performed for the collected data. Results: All study groups showed a significant improvement regarding clinical signs and symptoms during follow-up periods. Ozonated-olive oil group revealed a significant increase in furcation radiodensity and a decrease in periodontal ligament space at 3-, 6-, and 12-month follow-up intervals compared to other groups. Conclusion: Zinc oxide-ozonated olive oil and zinc oxide-olive oil paste had shown good clinical and radiographic success for primary teeth pulpectomy. Clinical relevance: The intricate torturous primary root canal anatomy, in addition to the child's negative behavior, interferes with the complete debridement, so the long-lasting antibacterial effect of the primary root canal filling material aids in the pulpectomy success. [ABSTRACT FROM AUTHOR]

Objectives: In order to retain primary molars, eg with irreversible pulpitis or pulp necrosis, pulpectomy can be an alternative to extraction. However, reports on the success of pulpectomies in primary teeth vary widely in the literature. Thus, the objective of this study was not only to analyze the success rate of primary tooth pulpectomy 12 months posttreatment in the setting of a specialized clinic, but also to identify and analyze various factors that modify the outcome. Method and materials: Between 2012 and 2018, a total of 76 dental records of the Department of Preventive and Pediatric Dentistry at the University of Greifswald fulfilled the inclusion criteria, resulting in a 1-year analysis of 62 primary molars with an idoform-calcium hydroxide paste as root canal filling material almost exclusively covered by a stainless steel crown as restoration. Results: The pulpectomy treatment was successful after 1 year in 93.5%, with a significantly higher survival for mandibular primary molars (100.0% vs 83.3%; chi-square test P = .01). Apart from the very few cases in the mixed dentition, no other factors related to the patient (sex, caries level, general health conditions, distance to clinic), tooth (first or second primary molar, pulpal and periapical condition before treatment), or treatment (indication, academic qualification of the operator, number of visits) proved to be of significance for the treatment outcome due to the overall high success rate. Conclusion: Pulpectomies for pulpally involved or even necrotic primary molars followed by stainless steel crowns as restoration should be considered as a treatment option, especially in the mandible. [ABSTRACT FROM AUTHOR]

Background: Reducing the necessary time to restore primary teeth improves the cooperation of paediatric patients. This study aimed to investigate the marginal integrity of restorations prepared with a bulk-fill resin-based composite (RBC) containing additional fragmentation chain transfer (AFCT) compared to a conventional RBC when light cured with a rapid high-irradiance (3 s) and a regular (10 s) curing mode. Methods: Forty class-II cavities were prepared in 40 primary molars. The molars were randomly divided into four groups based on the applied light-curing modes (regular: 10 s @ 1200 mW/cm2 or high-irradiance: 3 s @ 3000 mW/cm2) and the used restorative material (AFCT-containing bulk-fill RBC "Power Fill" or AFCT-free conventional RBC "Prime"). After thermo-mechanical loading, the marginal integrity was analysed using scanning electron microscopy. A beta regression model and pairwise comparisons were used to statistically analyse the data. Results: The mean marginal integrity (% ± SD) of the restorations for each group was as follows: Power Fill (10 s: 79.7 ± 15.6) (3 s: 77.6 ± 11.3), Prime (10 s: 69.7 ± 11.1) (3 s: 75.0 ± 9.7). The difference between the RBCs for the same light-curing mode was statistically significant (p ≤ 0.05). The difference between the light-curing modes for the same RBC was not statistically significant (p ˃ 0.5). Conclusions: AFCT-containing bulk-fill RBC "Power Fill" achieves similar marginal integrity when light-cured with either high-irradiance or regular light-curing modes. "Power Fill" achieves better marginal integrity than the conventional RBC "Prime" regardless of the applied light-curing mode. [ABSTRACT FROM AUTHOR]

Background: Thorough disinfection of root canals in primary molars may be complicated by the complex root canal morphology. This in-vitro study aimed to compare direct and residual antimicrobial effect of 2% chlorhexidine (CHX) gel, 500 mg/ml double antibiotic paste (DAP) and chitosan-chlorhexidine nanoparticles (CS-CHX NPs) as intracanal medicaments against Enterococcus faecalis (E. faecalis) and Candida albicans (C. albicans) in primary molars. Methods: Mesial roots of 63 mandibular second primary molars were infected with E. faecalis and C. albicans. Teeth were divided into 9 groups: Ia: (CS-CHX NPs), IIa: (CHX), IIIa: (DAP), IVa: chitosan nanoparticles (CSNPs) in which medicaments were placed for 3 days, groups Ib: (CS-CHX NPs), IIb: CHX, IIIb: (DAP), IVb: (CSNPs) in which medicaments were placed for 7 days, and Group V (control): teeth were infected, irrigated with saline, and sampled 3- and 7-days post-infection. Microbiological samples were obtained after infection, 3, and 7 days after medicament placement and 7 days after medicament removal for both time points. One-way ANOVA, Tukey's post hoc test and paired t-test were used at p < 0.05. Results: CS-CHX NPs had the highest anticandidal effect which was comparable to CHX and significantly higher than other medicaments (p < 0.001) at both time points. CS-CHX NPs had the highest effect against E. faecalis which was comparable to DAP and significantly higher than other medicaments (p < 0.001) at 3 days. All medicaments showed similar effect against E. faecalis after 7 days. The 7-days placement significantly increased the antimicrobial effect against both micro-organisms in all groups, except CS-CHX NPs which showed an insignificant increase. CS-CHX NPs showed the highest residual effect against both micro-organisms that increased with 7-days placement. Conclusion: CSNPs and CHX combination showed a synergistic effect against both micro-organisms. CS-CHX NPs displayed a higher effect at a shorter period compared to other medicaments, yet its residual effect was higher with 7-days placement. [ABSTRACT FROM AUTHOR]

Introduction: Glass ionomer cements (GICs) are commonly used for restorations in primary molars due to their adhesive, hydrophilic, and bioactive properties. However, their low mechanical resistance may limit their use in proximal cavities. Recent advancements in GICs, such as the high viscosity GIC EQUIA Forte®, have improved their mechanical properties. The effect of a Cavo superficial bevel on the mechanical strength of GIC restorations has been previously studied. Objectives: To investigate the effect of a Cavo superficial bevel on fracture resistance and the type of fracture (adhesive, cohesive, or catastrophic) in EQUIA Forte® GIC restorations in primary molars. Methods: A total of 66 standardized proximal cavities were created on 51 temporary molars. The cavities were randomly divided into two groups: group I without a Cavo superficial bevel (n=33) and group II with a 45° Cavo superficial bevel (n=33). The cavities were restored with EQUIA Forte®. The samples were subjected to thermocycling and artificial aging, then, an axial speed loading of 1 mm/min was applied until fracture. Fracture toughness was recorded, and the type of fracture was observed under an optical microscope. A Mann-Whitney U test was used to compare the average fracture resistance between the groups. All tests were two-tailed and the level of significance was set at 5%. Results: The average fracture resistance for group I was (237.57 ± 139.97 N) and for group II was (294.89 ± 171.07 N). There was no statistically significant difference in fracture resistance between the two groups (p>0.05). Mixed fractures were observed in all samples, with adhesive fractures only present in group I and cohesive fractures only present in group II. Conclusions: The Cavo superficial bevel does not significantly affect the fracture resistance of GIC restorations in primary molars. However, the bevel design may prevent adhesive and catastrophic fractures. [ABSTRACT FROM AUTHOR]

Background: Endodontic treatment of primary molars represents one of the challenges in pediatric dentistry. There is a lack of consensus in the literature about the endodontic techniques and filling paste for primary teeth with pulp necrosis. Aim: To compare the effectiveness of the LSTR technique (lesion sterilization and tissue repair) with CTZ paste (chloramphenicol, tetracycline, zinc oxide and eugenol) and pulpectomy with ZOE paste (zinc oxide and eugenol) in the treatment of primary molars with pulp necrosis. Design: Eighty‐eight primary molars with pulp necrosis from 70 children between the ages of 3 and 8 years were included. The teeth were randomized to the LSTR with CTZ paste group or pulpectomy with ZOE paste group. Clinical and radiographic evaluations were performed at 18, 24, 30 and 36 months. Results: At 36 months, clinical success was 86.4% in LSTR with CTZ paste and 90.9% in pulpectomy with ZOE paste (p =.45). Radiographic success was 43.2% in both groups (p = 1.00). The overall success was 40.9% in LSTR with CTZ paste and 43.2% in pulpectomy with ZOE paste (p = 1.00). Conclusion: After 36 months of evaluation, the effectiveness of the LSTR technique with CTZ paste and pulpectomy with ZOE paste was similar for the treatment of primary molars with pulp necrosis. [ABSTRACT FROM AUTHOR]

Introduction: The cornerstone of preventative therapy is made up of pit and fissure sealants and fluorides. Resin sealants have been shown to help reduce fissure decay in both primary and permanent teeth. Etching of primary molars is not effective due to prismless enamel, higher organic content, and diversity in fissure shape. Methods of pretreatment of pits and fissures have been hypothesized to promote microporosities in etched enamel and hence sealant adherence. Examining the etching pattern and surface roughness of the enamel surface can be used to gauge these. Objective: This study aimed to evaluate the effect of pretreatment with ozone gas and 5.25% sodium hypochlorite solution on pits and fissures of primary teeth to check for the etching pattern and surface roughness. Materials and Methods: Thirty noncarious primary molars were sectioned to retain the crowns, and randomly divided into three groups, sodium hypochlorite, ozone gas, and control. Each sample was pretreated with the agent, washed, followed by etching with 37% phosphoric acid. Samples were sectioned and subjected to scanning electron microscope analysis to evaluate the etching pattern and surface roughness. Results: Comparison of the etching pattern in three groups showed a statistically insignificant difference (P=0.364). Surface roughness was highest in the hypochlorite group followed by ozone and control which showed a statistically significant difference (P = 0.001). The surface area between the three groups showed a statistically insignificant difference. Conclusion: Sodium hypochlorite is a better pretreatment agent compared to ozone gas and acid etching alone. However, as all results were not statistically significant further research must be carried out to prove the effectiveness of these agents. [ABSTRACT FROM AUTHOR]

Introduction: The objective of this study was to assess an original learning intervention to train students and paediatric dentistry teachers in radiographic diagnostic accuracy of pulpo‐periodontal complications in primary molars. Materials and Methods: The learning intervention was based on 250 different randomly ordered radiographs of primary molars within three quizzes (A, B and C) for 5 sessions (S): quiz A (50 X‐rays), B and C (100 X‐rays) were, respectively, completed in S1 to assess the extent of agreement with 5 experts' diagnoses, in S2 and S3 (B at days 8 and 23) and in S4 and S5 (C at days 90 and 105). During S1 and at the end of S3 and S5, the participants (48 students and 16 teachers) were informed of correct diagnoses. A satisfaction questionnaire was completed by all the students. Alongside the descriptive analyses, generalised linear mixed model (GLMM) analyses assessed the odds of participants' correct diagnosis over the study duration. Results: At S1, the odds of diagnostic accuracy among students were significantly lower than those among the teachers. After receiving feedback at S1, GLMM analyses showed that among all the participants, accuracy improved over time with the odds of correct diagnoses higher in S2‐5 than in S1; and there were similar increases across sessions between teachers and students, except in S3, where the improvement among teachers tended to be greater than that among the students. All students were satisfied though one‐third reported that quizzes with 100 radiographs felt too long. Conclusion: The online case‐based learning was a good training format for dental education. [ABSTRACT FROM AUTHOR]

The purpose of this randomized clinical trial was to evaluate the clinical and radiographic success of the premixed bioceramic (NeoPUTTY ) as pulpotomy medicament in primary molars in comparison to NeoMTA® 2. Methods: Seventy primary molars indicated for pulpotomy in 42 children were randomly allocated into two groups: (I) a mineral trioxide aggregate (MTA) group (NeoMTA® 2); and (2) a premixed bioceramic group (NeoPUTTY®). Clinical and radiographic examinations of the molars following pulpotomy were conducted by two independent evaluators at six and 12 months. The data were analyzed using Fisher"s exact tests. Results: At 12 months, the clinical and radiographic success for the MTA group were 100 percent (34 out of 34) and 94.1 percent (32 out of 34), respectively. For the NeoPUTTY® group, the clinical and radiographic success were 97.1 percent (34 out of 35) and 92.8 percent (32 out of 35), respectively. No significant differences were found between the two materials. Conclusions: NeoPUTTY® showed a comparable success to mineral trioxide aggregate in primary molar pulpotomies over 12 months. Further clinical trials with larger sample sizes and longer follow-up periods are recommended. [ABSTRACT FROM AUTHOR]

Aims: Impact of primary molars is a significant problem for children with early caries, as they are the ones that predominate in the structure of damage to primary teeth. The goal of our study was to investigate the peculiarities of the primary molars occlusal surfaces with the study of their types and possibilities of caries occurrence in them. Methods: To study the odontoglyphics of primary molars, a clinical preventive dental examination of 335 children of preschool institutions in the city of Poltava and Poltava region was conducted with the written consent of their parents. As a part of this examination, the occlusal surface of primary molars was studied according to the classic dental examination method with the examination card of each examined child being filled in. After a detailed study of odontoglyphic patterns of occlusal surfaces, photoprotocoling was carried out. A total of 2484 primary molars were examined: 622 maxillary first molars, 634 maxillary second molars, 608 mandibular first molars, and 620 mandibular second molars. Results: We found that both maxillary and mandibular primary molars which have a complex relief of the occlusal surface are most often affected by caries. Conclusions: The obtained data indicate that the primary molars of the upper and lower jaw, which have a complex pattern of the chewing surface, are most often affected. However, there is a need for preventive measures in children with such types of structure of the chewing surface. [ABSTRACT FROM AUTHOR]

Background: Manual or mechanized instruments can be used for root canal preparation. Manual instrumentation using K‐files is widely used in primary teeth, but there are many limitations. Mechanized root canal preparation can lead to easy access to all canals, decrease instrumentation time, and result in more funnel‐shaped root canals, resulting in a more predictable uniform paste fill. Aim: This study aimed to evaluate the shaping ability and instrumentation time of VDW.ROTATE™ and EdgeTaper Platinum™ during the preparation of resin‐printed primary molars. Hand K‐files were used as a reference for comparison. Design: Sixty‐six resin‐based maxillary second primary molars, obtained from extracted tooth cone‐beam computed tomography (CBCT) image and printed on a three‐dimensional printer, were divided into three groups: VDW.ROTATE™, EdgeTaper Platinum™, and K‐files. The specimens were scanned using CBCT imaging before and after root canal preparation. Images were registered using a dedicated software, and changes (Δ) in the canal area, volume, and untouched canal surface were calculated. Instrumentation time was evaluated. Data were statistically analyzed using the SPSS program. Results: There was no significant difference among the tested file systems for Δ canal volume and area (p >.05). VDW.ROTATE™, however, showed significantly lower untouched canal surface area than other systems in all roots (p <.001). The VDW.ROTATE™ was found to be significantly faster (6.47 ± 0.39 min) than EdgeTaper Platinum™ (7.71 ± 0.73 min) and K‐files (8.22 ± 0.72 min), (p <.05). Conclusions: The shaping ability and the instrumentation time were directly influenced by the root canal instrumentation system used during the preparation of resin‐printed primary molars, with VDW.ROTATE™ being the faster system and associated with the lower amount of untouched canal surface area. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the clinical performance of Glass Carbomer (GC) (GCP Dental) in restoring Class II cavities in primary molars in comparison with resin-modified glass-ionomer cement (RMGIC) and composite resin (CR) restorations. Method and materials: Healthy children aged between 4 and 8 years with a proximal lesion in at least one primary molar were recruited from the Pediatric Dental Clinics. A sample of 162 molars was randomly assigned to one of the following restoration types: GC, RMGIC, and CR. The restorations were evaluated clinically using the Cvar and Ryge criteria at 6 and 12 months postoperatively. Results: At 12 months, the success rates of anatomical form and marginal adaptation were 67% and 54% for GC, 98% and 93% for RMGIC, and 98% and 98% for CR, respectively. The GC restorations were significantly less successful than RMGIC and CR restorations in terms of anatomical form (P < .001) and marginal adaptation (P < .001). Secondary caries formation was not observed in any of the restorations in the three restorative material groups. Conclusion: The 12-month clinical performance of the GC restorative material was not satisfactory in restoring Class II cavities in primary molars. RMGIC and composite resin restorations performed significantly better. The use of GC cannot be recommended for restoring Class II cavities in primary molars. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the clinical performance of high viscosity GIC sealant applied with or without additional light curing in children with early childhood caries (ECC).Materials and Methods: A split-mouth clinical trial was conducted in a total of 111 3- to 5-year-old children with ECC. 180 pairs of non-carious primary second molars were selected and divided into two groups: study and control. On the basis of the application technique, selected teeth in the study group were further allotted to group A (sealant application with additional light curing) and group B (sealant application without additional light curing). Caries incidence was observed for 1 year in the anatomical pits and grooves, along with sealant retention and marginal discolouration at various intervals over the 1-year period.Results: Group A (GIC sealant with additional light curing) (44.2%) showed sealant retention similar to that of group B (GIC sealant without additional light curing) (43.0%) (p = 0.885). Caries incidence was significantly higher in the control group (26%) than the sealant groups (1%) (p < 0.001). No marginal discolouration adjacent to the sealant was observed in either anatomical grooves or pits in both sealant groups for the duration of the study.Conclusion: Retention and caries prevention by high-viscosity GIC sealant applied with or without additional light curing was found to be similar. At the 12-month assessment, mean dmfs scores and caries incidence in primary second molars were higher in the control than in both study groups. [ABSTRACT FROM AUTHOR]

A natal tooth is a rare condition of the presence of a tooth in the oral cavity at birth. A mother of a crying and dehydrated 3-day-old newborn boy came with a complaint of a severely mobile tooth preventing breastfeeding. The surrounding soft tissues were anesthetized by spray anesthesia, and the tooth was removed by one of the upper extraction forceps. The boy was seen after 8 years; clinical and radiographic examination revealed a missing deciduous maxillary first molar and drifting/spacing of the maxillary anterior teeth on the right side. In conclusion, the natal tooth is most probably a deciduous one. Long follow-up is recommended to assess and prevent any unwanted consequences of missing teeth during primary dentition. [ABSTRACT FROM AUTHOR]

Objective: To evaluate and compare clinical performance and caries inhibition of Resin modified glass ionomer cement and composite restoration in primary molars Study Design: Quasi-experimental study. Place and Duration of Study: Department of Operative Dentistry, Armed Forces Institute of Dentistry, Rawalpindi Pakistan, from Feb 2019 to Jan 2020. Methodology: Eighty-three patients fulfilling the selection criteria having at least one carious mandibular primary molar on both sides were divided by split-mouth design. Resin-modified Glass ionomer restorations were done on one side and termed Group-A, and Composite Restorations were done on the other side and termed Group-B. Each restoration was clinically evaluated regarding the appearance of secondary caries at 3, 6 and 12 months after placement by the same operator who performed the treatment. Results: A total of 166 conventional restorations were placed in the 83 children having carious mandibular primary molars, at least one on each side of the arch. The assessment of restorations, performed after six months, showed an 89.2% success rate of Resin modified Glass ionomer restorations and a 66% success rate of Composite Restoration. One year of follow-up showed an 80% success rate for Resin modified Glass ionomer restorations and 60% for Composite Restoration, as regards secondary caries; statistically significant differences were found in both groups. Conclusion: The study results showed that Resin modified Glass ionomer cement used to restore primary molars affected by caries performed better clinically than composite in assessing secondary caries. [ABSTRACT FROM AUTHOR]

Purpose: The aim was to compare the remaining dentine thickness (RDT) following instrumentation with hand and rotary endodontic files during pulpectomy in primary molars. Research question was 'Is there any difference between the remaining dentine thickness following instrumentation with hand and rotary endodontic files during pulpectomy in primary molars?'. Methods: Electronic Databases like MEDLINE PubMed, Cochrane Library, EBSCOhost, Google scholar and grey literature were searched between January 1, 2006 and August 31, 2022 for in vitro and ex vivo studies that compared hand and rotary endodontic instrumentation to evaluate the RDT in primary molars. Articles published in English or which could be translated into English were searched. Two reviewers independently selected studies, extracted data, assessed risk of bias using the Revised, validated version of MINORS criteria. Results: Twelve studies were included in qualitative analysis. All included studies showed low risk of bias. Six studies showed more RDT with rotary instrumentation compared to manual instrumentation. Whereas, five studies showed variable results for RDT with manual and rotary instrumentation at different levels of root canals. One study showed no significant difference between manual and rotary instrumentation. In view of methodological heterogeneity of the findings, a meta-analysis was not conducted. Conclusion: High quality of evidence based on low risk of bias was found in all the included studies. Statistically, rotary instrumentation showed more RDT than manual instrumentation according to majority of studies. Despite the shortcomings of this systematic review, it is possible to infer that the use of rotary instrumentation provides more RDT and thus there is considerable conservation of tooth structure. [ABSTRACT FROM AUTHOR]

Aim: To evaluate and compare the clinical outcomes of Cention-N (CN) and stainless steel crowns (SSCs) as restorations for pulpotomised primary molars, and to study clinical and radiographic outcomes of pulpotomies restored with these materials. Methods: The study was conducted on 60 pulpotomised molars with occlusoproximal caries. These were randomly divided into two groups and restored with either stainless steel crowns or Cention-N. Clinical performance of restorations and clinical and radiographic success of pulpotomy was examined at 6, 9 and 12 months. Results: The mean scores for marginal integrity deteriorated significantly at 6, 9 and 12 months in both groups but in comparison were insignificant. The mean for proximal contact deteriorated significantly for the Cention-N group, whereas the mean for gingival health deteriorated remarkably for the stainless steel crown group at successive evaluations. No tooth in either group showed secondary caries or discomfort on biting, except for one tooth in Cention-N group which presented with secondary caries. The clinical success rate for pulpotomised molars was 100% for both groups until nine months, although this had reduced by the end of 12 months. Radiographically, the success rate was 79.3% for Cention-N, while it was 86.6% for stainless steel crowns at 12 months. There was no significant difference in clinical and radiographic success between either group. Conclusion: Cention-N and stainless steel crowns are comparable for marginal integrity. However, crowns maintain significantly better proximal contacts while Cention-N was notably better for gingival health of the restored tooth. Both materials do not show secondary caries and discomfort on biting and are comparable in clinical and radiographic success of pulpotomy at the end of one year. [ABSTRACT FROM AUTHOR]

Objectives: We performed this network meta-analysis to determine the comparative efficacy of formocresol (FC), ferric sulfate (FS), sodium hypochlorite (NaOCl), calcium hydroxide (CH), mineral trioxide aggregate (MTA), biodentine, and laser for pulpotomy of molar teeth. Materials and methods: An updated search was conducted in PubMed, Embase, and the Cochrane Library to identify relevant randomized controlled trials (RCTs) published before October 30, 2022, after screening previous meta-analyses. The Cochrane risk of bias assessment tool was used to appraise the methodological quality of included studies. Clinical and radiographic success rates were assessed as outcomes. Random network meta-analysis was performed by using STATA software (version 14.0) with "network" command. Results: A total of 43 RCTs were included. Network meta-analysis indicated that CH was inferior to other medicaments and techniques in all outcomes, and MTA and biodentine was better than FC, FS, and NaOCl in terms of clinical and radiographic success rates. Results of ranking probabilities suggested that MTA ranked first in all outcomes except for clinical success at both 6 months. Conclusions: Our results suggested that MTA was associated with significant improvement in both clinical and radiographic success than other pulpotomy medicaments and techniques, with the highest probability of being the optimal option. Clinical relevance: The current network meta-analysis determined the comparative efficacy and safety of 7 common pulpotomy medicaments in molar pulpotomy, including FC, FS, NaOCl, CH, MTA, biodentine, and laser, and the pooled results revealed comparable efficacy in clinical and radiographic success rates at 6 and 12 months between FC, FS, and NaOCl in primary molars pulpotomies. However, MTA, biodentine and laser may have more advantages than other pulpotomy medicaments for clinical and radiographic success. Therefore, in clinical practice, practitioners should select MTA, biodentine, or laser as pulpotomy medicaments in molar pulpotomy. [ABSTRACT FROM AUTHOR]

Background: Pulpotomy is the most common pulp treatment of primary molars, where surgical amputation of infected coronal pulp results in preserving the vitality and function of radicular pulp. With introduction of newer materials, the emphasis has shifted towards regeneration, in this scenario; novel materials such as platelet derived growth factor (PDGF) and propolis (PS) have been considered. Materials and Methods: This was a single-blind in vivo study; ninety human primary teeth from children aged between 5 and 10 years were divided into three equal groups in whom pulpotomy procedure was performed and they were recalled after 3- and 6-month interval for histological evaluation. Observations were subjected to statistical analysis using Pearson's Chi-square test. Results: No statistically significant difference was found between the three materials with respect to inflammatory response, soft-tissue organization, and dentin bridge formation (P > 0.05). Majority of the samples in both growth factor and propolis exhibited dentin bridges at the interface of the exposed pulp, bringing or attempting to bridge the site exposed to the pulpotomy material. The ability of the material to evoke a foreign and inflammatory cell response in the pulpal tissue was not significant. The samples of both formocresol and growth factor group showed signs of pulpal necrosis which revealed the presence of a mild necrotic zone in one specimen at 3 months. One specimen from the propolis group showed mild areas of necrosis at the end of 6 months, where none of the specimens in the growth factor group showed areas of necrosis at the end of 6 months. Conclusion: The results of the present study showed a positive outcome for growth factor and propolis groups. Further clinical trials with a larger sample size and long-term review have to be conducted for the material to be used widely. [ABSTRACT FROM AUTHOR]

Background: To retrospectively investigate the success rate of primary-molar pulpectomy performed under general anaesthesia and the potential risk factors that affect the 24-month success rate. Methods: The case data and two-year follow-up records of children (aged 3–6 years) who received pulpectomy in primary molars performed under general anaesthesia were reviewed and assessed. Potential risk factors included age, gender, decayed-missing-filled teeth, endodontic diagnosis, tooth location, and postobturation sealing of the pulp chamber floor with MTA. With a two-year follow-up period, the outcomes of all the primary molars were classified into success and failure. Survival analysis was used to assess the outcomes. The Kaplan–Meier method was used to analyse the success rate. Univariate and multivariate Cox proportional hazards regression models were used to evaluate the potential risk factors associated with the overall survival of primary molars. Results: A total of 410 teeth from 163 children (88 boys and 75 girls) were included in this study. The overall two-year success rate was 66.1% for all primary molars. The mean overall survival time for this study was 22.1 (95% CI, 21.73‒22.48) months. Multivariate Cox regression analysis demonstrated that endodontic diagnosis (irreversible pulpitis or periapical periodontitis), tooth location (maxillary or mandibular primary molar), and postobturation sealing of the pulp chamber floor (MTA or no-MTA) were significant risk factors for overall survival in this study (P <.05). The differences in success rates were not statistically significant in terms of age, gender, and decayed-missing-filled teeth (P >.05). Conclusions: When compared to teeth diagnosed with irreversible pulpitis, those with periapical periodontitis failed more frequently. Postobturation sealing of the pulp chamber floor with MTA improved the success rate of pulpectomy in primary molars, especially when the inflammation did not spread to the periradicular area. [ABSTRACT FROM AUTHOR]

This study aimed to compare the amount of debris extrusion of four endodontic systems made of Nickle‐Titanium alloy. This in vitro study was done on 80 extracted primary molars. They were selected by cone‐beam computed tomography and randomly divided into four groups (n = 20) to be prepared to the apical size of 25 by one of the systems: Reciproc, Protaper Universal, Neolix, or Hyflex CM. Debris was collected into Eppendorf microtubes and placed in an incubator to evaporate the washing solution. Debris was weighed by a digital scale of 0.01 g precision. Data were statistically analysed using SPSS software. Tukey's comparison was used to determine the difference between the four file systems (α = 0.05). Debris extrusion after Reciproc preparation (0.00320) was significantly higher than the other (P < 0.05), with no significant difference having been observed among the other systems (P > 0.05). It can be concluded that all systems under investigation exhibited debris extrusion. [ABSTRACT FROM AUTHOR]

Introduction: Evidence regarding the impact of early loss of primary molars (ELPM) on Oral Health‐Related Quality of Life (OHRQoL) is lacking. The aim of the present study was evaluating the impact of ELPM on OHRQoL of Brazilian schoolchildren aged 6–10 years. Methods: This observational prospective cohort study was conducted with 163 schoolchildren, assigned in the primary tooth loss group (PTLG), in which all tooth loss was caused by carious lesions, and in a control group without tooth loss (CG). Two calibrated examiners conducted the clinical oral assessments to determine caries experience and tooth loss. OHRQoL was assessed using the Child Perception Questionnaire 8–10 years (CPQ8‐10) instrument administered at baseline and at 10–12 months of follow‐up. Results: Children in PTLG exhibited significantly more negative impact on OHRQoL at baseline (p < 0.01) than CG, and also after the follow‐up period (p < 0.01). It was also possible to observe a significant reduction in the negative impact on OHRQoL in both CG and PTLG in the longitudinal analysis (p < 0.01). Nevertheless, there was an even more substantial reduction in the negative impact on OHRQoL in children in PTLG. Conclusions: This study provides evidence that early tooth loss is associated with negative impact on OHRQoL. Moreover, it indicates that access to dental treatment can have a positive impact on the OHRQoL of children with dental caries and ELPM. [ABSTRACT FROM AUTHOR]

Aim: The current in vivo study is done to compare the retention, marginal staining, marginal integrity, and development of new carious lesions between a hydrophilic resin-based sealant and a giomer-based pit and fissure sealant on primary molars. Study Design:180 primary molars from 45 participants are taken into consideration in this randomised clinical investigation. 90 primary molars were sealed with Beautisealant (Group 1) and the other 90 primary molars were sealed with Embrace Wet Bond sealant (Group 2). To evaluate the clinical performance Modified USPHS criteria will be used and applied immediately following sealant application, at 3, 6, and 12 months. The entire set of data was gathered, enteredinto MS Excel, and examined with SPSS 16.0. The parameters of clinical evaluation were compared using the Fisher's exact test and the Pearson Chi-Square test. Result: At the end of 12 months, 75.9% of group 2 primary molars still had sealants in place, compared to 26.2 percent of group 1, which is statistically significant (p.001). Conclusion: Hydrophilic sealants may be employed as efficient fissure sealants, particularly in children who are at high risk for tooth decay, overly salivate, are physically and intellectually challenged, have partially erupted molars, and for children enrolled in community care programs. [ABSTRACT FROM AUTHOR]

Introduction: Endodontic working length determination requires an understanding of anatomy, the degree of root curvature, and the interaction between the tooth and its surrounding structures. Endodontic instruments may penetrate beyond the apical foramen due to errors in determining the tooth length, resulting in extravasation of irrigating solutions and restorative material into the periradicular tissues. Root canal instrumentation in primary teeth is risky because it can harm the tooth germ of the permanent tooth. The aim of this study is to analyse the working length determination in primary molars during pulpectomy. Materials and methods: The case sheet records (DIAS data) of Pulpectomy in Primary molars were extracted. The data were analysed and transferred to MS Excel. Descriptive statistics (Percentage, Mean, Standard deviation) and Inferential test (Chi square test) were performed. Results: Among the 1844 patients who underwent pulpectomy, 29.5 % of males and 20% of females have a working length of 11-15 mm. Most common working length in primary molars is 11-15 mm irrespective of quadrant (teeth number) and age. 20% of males and 15.6% of females had undergone pulpectomy in quadrant 4 followed by quadrant 3. Conclusion: Within the limitations of the study, we can conclude that there was no statistical significance found between age and working length, gender and working length, tooth number and working length. Working length of 11 to 15 mm was more prevalent than working length less than 10. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the clinical efficacy at 6 months (6 M) and 12 months (12 M) of 3 adhesive strategies (two-step etch-and-rinse; two-step self-etch; one step self-etch) used in composite resin restorations in primary molars. Methods: This randomized clinical study involved 101 class II restorations in primary molars of 34 children (4–8 years old), distributed by 3 groups according to the 3 tested adhesive systems: GI- ClearfilTMS3Bond Plus (CSB); GII- ClearfilTMSE Protect Bond (CSEPB); GIII- Prime&Bond®XP (PBXP). Restorations were evaluated according to FDI criteria, immediately after execution, at 6 M and 12 M. All ethical and legal requirements were met. Statistical analysis was performed using IBM®SPSS®v26 and MS Excel® (5% significance level). Results: The aesthetic, biological and most of the functional parameters evaluated remained without significant changes over time. Statistically significant differences were only found regarding the "marginal adaptation" parameter at 12 M, with worsening of scores for the three groups (p < 0.001). Comparing the groups, no significant differences were detected between any of the evaluated parameters (aesthetics properties: p = 0.721; functional properties: p = 0.122). Conclusions: After a one-year period, the self-etch adhesives tested presented a clinical efficacy similar to the etch-and-rinse adhesive in restoring class II cavities in primary molars. Trial registration number: ISRCTN11458186. [ABSTRACT FROM AUTHOR]

Purpose: Τo assess the outcome of direct pulp capping in asymptomatic carious primary molars using three pulp capping materials. Methods: In this prospective clinical trial, carious primary molars free of irreversible pulp inflammation signs and symptoms, with negative pain history and pulp exposure following caries removal were included. Teeth were divided into groups: A: Ca(OH)2, B: Pure Portland cement®, C: Biodentine™. Following anaesthesia, isolation, caries removal, pulp exposure, hemorrhage control, pulp capping, additional lining in groups A, B, teeth were restored with composite resin. Descriptive statistics, Chi-squared and Fisher's exact tests, Kaplan–Meier survival curves, multivariable random effects Cox regression model were performed. Results: Sixty-six patients (25 girls, 41 boys) with mean age 7.2 (± 1.7) years participated. The mean follow-up time was 13 months. Seventy-nine primary molars were assigned to groups A (n = 27), B (29), C (n = 23). The overall failure was 16% and the distribution by group was: A: 5 teeth, B: 5 teeth, C: 3 teeth. No significant differences in failure rates between capping materials, tooth types, age bands and genders were identified. Conclusions: Direct pulp capping in asymptomatic carious primary molars may be an acceptable option, when treating an exposed pulp with bioceramic materials as pulp capping agents. [ABSTRACT FROM AUTHOR]

Background: Lately, a paradigm shift from radical to conservative approach has popularized the selective caries removal over complete excavation in deep caries. Indirect pulp therapy over pulpotomy is being preferred due to risk of questionable pulp vitality in carious exposure of pulp. Silver diamine fluoride can be a useful tool for noninvasive caries management due to its antimicrobial and remineralization properties. Aim: The study aims to evaluate the success of minimum intervention approach using silver-modified atraumatic restorative technique (SMART) as indirect pulp treatment compared to conventional vital pulp therapy in symptomless deep carious lesions of primary molars. Materials and Methods: In this comparative, prospective, double-blinded, clinical interventional study, 60 asymptomatic primary molar teeth with international caries detection and assessment system score 4–6 were selected in children aged 4–8 years and were randomly allocated into SMART and conventional groups. The success of the treatment approach was assessed using clinical and radiographic criteria at baseline, 3, 6, and 12 months interval. Results: Data were analyzed using Pearson Chi-Square test at a significance level of 0.05. Conventional group showed 100% and SMART observed 96.15% clinical success at 12 months follow up (P > 0.05). One radiographic failure due to internal resorption at 6 months in SMART and one in the conventional group at 12 months was reported though the difference was insignificant (P > 0.05). Conclusion: Removal of all infected dentin in deep carious lesions is not required for successful caries treatment and SMART can be recommended as a potential biologic approach to manage asymptomatic deep dentinal lesions, based on optimal case selection. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Internal root resorption after pulpotomy is a pathological phenomenon and can lead to early root resorption and subsequent loss of the tooth. Purpose: To assess the relationship between initial inflammatory coronal pulp status in decayed primary molars treated by pulpotomy and internal root resorption after one-year follow-up. Materials and Method: In this clinical in vivo and in vitro experiment, vital pulpotomies were performed on 50 primary molars from 50 patients aged 5 to 10 years. Coronal pulp was carefully removed followed by hemostasis and placement of a reinforced zinc oxide eugenol over the vital radicular pulp. Enzyme-linked immunosorbent assay (ELISA) assay was done on coronal pulp samples and the level of tumor necrosis factor-alpha (TNF- α) and interlukin-6 (IL-6) was measured. After a 12-month follow-up, periapical radiographs were taken from pulpotomized teeth. Kolmogorov-Smirnov, Chi-square, Kruskal–Wallis, and Mann-Whitney tests were implemented. Results: 11 treated teeth (22%) showed an internal root resorption as diagnosed on X-rays. No significant association was found between TNF- α, IL-6 levels, and pathological root resorption respectively (p= 0.953) and (p= 0.944). A significant association between age and pathological root resorption was observed (p= 0.031). No significant association between remaining dentin thickness and pathological root resorption was established (p= 0.346). Conclusion: There was no association between pro-inflammatory cytokines levels/ TNF- α, IL-6 and internal root resorption following pulpotomy in pediatric patients. [ABSTRACT FROM AUTHOR]

Background: Prefabricated fibreglass crowns (PFCs) require less tooth structure reduction than prefabricated zirconium crowns (PZCs) for restoring primary molars. Little is known, however, about their mechanical properties. Aim: To investigate the fatigue survival and fracture resistance of PZCs and PFCs cemented with two different types of luting cement [glass‐ionomer cement (GIC) and resin‐modified GIC (RMGIC)]. Design: One hundred and twenty extracted human primary molars were randomly divided into subgroups (n = 15) according to the crown type (PFCs/PZCs), the luting cement (GIC/RMGIC) and crowns subjected to the chewing simulation test with thermocycling mechanical loading (CSTTML). The surfaces of the teeth were reduced by approximately 2 mm in the PZC group and 1 mm in the PFC group. All the samples were subjected to fracture tests. Results: None of the samples subjected to CSTTML exhibited signs of surface damage, fracture or premature debonding. The forces required to fracture PFCs were higher than those required for PZCs in all groups (p =.001). The highest mean fracture resistance values were obtained from the group of PFCs cemented with GIC that were subjected to the CSTTML (2515.8 N ± 619.2 N). Conclusions: PFCs presented high fatigue survival and could be used as alternatives to PZCs as they require less tooth structure reduction. Crowns cemented with GIC had a similar fracture resistance value when compared with RMGIC. [ABSTRACT FROM AUTHOR]

Dental ankylosis is a serious condition defined as the process that causes the fusion between the dentin or the cementum of the root and the alveolar bone, with the obliteration of the periodontal ligament becoming progressively replaced by bone tissue. The aim of the study was to determine the prevalence, location, severity, and association of dental ankylosis in primary molars with other dental anomalies such as the agenesis of permanent buds. For this study 150 panoramic x-rays were selected from patients with temporary or mixed dentition, aged six to twelve years old, from a private dentistry office and from the Pediatric Dentistry Department of UMFST in Targu-Mures, Romania. In order to identify the cases with dental ankylosis, the presence and severity of the infraocclusion, displacements of the neighboring teeth, the appearance of the root area, and the relationship with the bone tissue were examined. For evaluation of the categorical data we used Fischer's exact test and the Chi-squared test and the chosen significance level was set at 0.05. The results showed that the highest percentage of cases with ankylosis was found in the first group (six to nine years old), respectively, with 72% of cases compared with the second group (ten to twelve years old) with 28% of cases. Findings showed that there was no positive association between dental ankylosis and gender, but a strong correlation was found regarding the location on the dental arches. Most cases were identified on the lower arch with a higher percentage in quadrant three. Of the two primary molars, the most affected by ankylosis was the first molar in quadrant three, followed by the second molar, and finally the first molar in quadrant four. Most cases diagnosed with ankylosis had a mild to moderate degree of infraocclusion; therefore, changes in the functional balance of the dental arch and on neighboring teeth were insignificant. There were some differences obtained between our results and studies from the literature, especially regarding the localization in the lower left dental arch, but these differences can be attributed to the number of the subjects selected and from the methodology of dental ankylosis diagnosis. Based on the data obtained, it was concluded that ankylosis is a dental condition which occurs in children in early mixed dentition, especially in the lower arch, with the first primary molar being the most affected tooth. The presence of infraocclusion and the absence of dental mobility, especially during the stage of primary molars' root resorption, are the main signs which must be followed to make an early diagnosis and prevent further complications. [ABSTRACT FROM AUTHOR]

Introduction: Fanconi anemia is a rare autosomal recessive disease that is associated with chromosome failure and impaired DNA repair. The aim of this study was to report a case of Fanconi anemia and to manage the treatment of deciduous tooth pulp and its periodic clinical follow-up. Case Report: The patient is a six-year-old boy with a definitive diagnosis of Fanconi anemia who referred to the Pediatric Dentistry Department of Isfahan University of Medical Sciences with a complaint of deciduous tooth decay and pain on chewing food. The patient had prominent signs like short stature, hirsutism, pigmented face, contiguous eyebrows, coarse hair, protruding forehead, flat nose bridge and large ears. Conclusion: Despite the low platelet count, it was possible to treat two teeth simultaneously in one session and no particular problem has been observed until the case is reported. It is recommended that taking into account the general health of the patient is very important in providing a treatment plan. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to evaluate the dental arch spatial changes in maxillary and mandibular arches after premature loss of primary molars.Introduction: Primary teeth must be maintained during the change from primary to mixed and then permanent dentition, to preserve and maintain the dental arch. When this normal process is disturbed, usually due to severe decay requiring extraction before normal exfoliation, it can result in migration of adjacent teeth toward the missing space resulting in decreased arch length and malocclusion in the permanent dentition.Materials and Methods: A comprehensive search was conducted using electronic databases such as PubMed Central, Cochrane Database of Systematic Reviews, Google Scholar, LILACS, and ScienceDirect. The title and abstract were screened to find relevant articles, which were then reviewed in full to see if they were worthy of inclusion. All longitudinal and observational studies that looked at space changes after the loss of primary first or second molars were included. Quality assessment of the studies was done based on the Newcastle-Ottawa scale as all the included studies were non-randomized studies.Results: Four thousand five hundred and seventy-eight articles were identified by screening electronic database and assessed for eligibility, 12 full-text articles were assessed, and 4 full-text articles were excluded as they did not match the inclusion criteria. Thus, eight articles were included in this systematic review. Short term and long term space changes and loss of maxillary and mandibular molars were studied individually. In the short term changes, the distal migration of the primary cuspid towards the missing space within 1 month was attributable to early space changes after premature loss of the mandibular first molar, and the greatest space loss was recorded in the first 3 months after premature loss. After the premature loss of the maxillary first molar, immediate space loss of 1mm was documented due to distal migration of the primary canine. Studies found that space loss was caused by the distal migration of primary canines in the case of mandibular primary first molar loss, and that space loss was larger in the mandibular arch after premature loss of second primary molars.Conclusion: The greatest repercussions occurred during the first 3 months after the deciduous molars were extracted, and a space maintainer was recommended in the majority of cases, mainly when there is premature loss of mandibular second primary molar as it leads to mesial displacement of the first permanent molar. [ABSTRACT FROM AUTHOR]

Objective: To explore the long-term in-vivo effect of different dental restorative materials on the surrounding enamel and dentin, in primary molars. Method and Materials: Sixteen naturally exfoliated primary molars restored with amalgam, compomer, and glass-ionomer cement were collected after 2 to 5 years of function in the mouth. Four intact molars served as control. The teeth were sliced buccolingually and the ion content in the restorative material, the enamel, and the dentin surrounding the restoration was determined using a scanning electron microscopy-energy dispersive x-ray spectroscopy (SEM-EDS) program. Results: Amalgam released copper to the enamel and dentin causing a bluish discoloration. No traces of mercury or other ions were detected in the enamel or dentin. The enamel and dentin surrounding the restoration showed reduced inorganic components and increased organic components. The enamel and dentin surrounding the compomer restoration showed similar to amalgam reduction in inorganic components and increased organic components. Traces of fluoride, aluminum, and silicon were found. The enamel and dentin of teeth restored with glass-ionomer cement showed the least reduction in inorganic components, with higher fluoride content and traces of aluminum, silicon, and strontium. Conclusion: This long-term in-vivo study showed release of copper ions from amalgam material to the enamel and dentin, but no traces of mercury. Amalgam and compomers showed no remineralization effect on the dentin surrounding the restoration. Glass-ionomer restorations showed remineralization effect on the tooth components and migration of inorganic ions from the enamel and dentin to the material. [ABSTRACT FROM AUTHOR]