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Objectives: Although minimally and noninvasive caries management are advocated in pediatric dentistry, extensive caries progression often requires endodontic treatment followed by crowning of the tooth. Thus, the aim of this study was to evaluate the success of esthetic preformed zirconia crowns (PZCs) compared to the standard preformed metal crowns (PMCs) after pulpotomy in primary molars retrospectively. Method and materials: Patients' digital records in a specialized pediatric clinic in Germany were analyzed to include 2- to 9-year-olds, who had received one or more PMCs or PZCs after a pulpotomy between 2016 and 2020. The main outcomes were success, minorfailure (restoration loss, wear, or fracture), or major failure (need for extraction or pulpectomy). Results: In total, 151 patients with 249 teeth (PMC, n = 149; PZC, n = 100) were included. The mean follow-up time was (19.9 months), with 90.4% of the crowns fol-lowed for at least 18 months. The majority of the crowns were considered successful (94.4%). The differences in the success rates between PMCs (96%) and PZCs (92%) did not reach the level of statistical significance (P = .182). All minor failures (1.6%) were in the PZC group and located in the maxilla. Independent of crown type, especially first primary molars were prone to failure (7.9%; second primary molars, 3.3%). Conclusion: PMCs and PZCs both show high clinical success rates as restorations of primary teeth after a pulpotomy. However, there was a tendency of greater minor or major failure in the PZC group. [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]

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.

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: 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 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]

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: 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]

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]

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]

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]

Abstract 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 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

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]

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: Recently, clinical trials have assessed the effectiveness of Silver Diamine Fluoride (SDF) as an indirect pulp capping material (IPC) in primary teeth. This systematic review aimed to assess the evidence presented in these trials. Data sources: A comprehensive search identified relevant studies through five electronic databases (PubMed, Scopus, ClinicalTrials.gov, ScienceDirect, and Cochrane). Search strategies were designed using the PICO model to identify all studies that investigated SDF as an IPC compared to calcium hydroxide (CaOH) or mineral trioxide aggregate (MTA). Quality assessment and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) were used to assess the level of evidence. Study selection: Four clinical trials were found to be suitable for inclusion in the qualitative synthesis and three studies were included in the quantitative analysis. Three studies compared SDF with CaOH and only one study compared SDF, CaOH, and MTA. Only one randomized controlled trial (RCT) had a low risk of bias, and the non-RCT study had a moderate risk of bias. The level of evidence based on the GRADE was low. Three out of four studies showed higher clinical and radiographic outcomes with SDF than with CaOH. One non-RCT study showed that SDF resulted in the least reparative dentin at the 6-months follow-up. The meta-analysis showed a non-significant difference between the SDF and CaOH groups (P = 0.36). Conclusion: There is little evidence showing a higher clinical and radiographic outcome of SDF compared to CaOH as an IPC material in primary molars. Clinical significance: This systematic review updates pediatric dentists regarding the effectiveness of using SDF as indirect pulp caping in primary teeth.

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]

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]

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 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 present prospective cohort study was conducted to evaluate the susceptibility of OXIS contact areas, namely, O (open type), X (point type), I (straight type), and S (curved type) in the development of approximal caries. We conducted this study among 953 school children with 3,812 contacts in Puducherry, India. At baseline, the contacts were assessed in accordance with OXIS criteria. At the end of 12 months, two calibrated dentists measured dental caries following the International Caries Detection and Assessment (ICDAS) criteria. Information about feeding practices, diet, and oral hygiene was collected by means of a structured questionnaire from each child's parent. Data were analyzed by unadjusted and adjusted Poisson regression analysis with a multilevel approach. The two levels of analysis were tooth and child. Of 3,812 contacts observed during the follow-up, 127 (3.3%) were observed as carious. Poisson regression analysis revealed a significant association between type of contact and caries prevalence (p < 0.05). The risk ratios for the development of approximal caries in X contacts were 2.4 (0.3–17.2), p value 0.38; in I contacts 4.9 (1.2–19.9), p value 0.027; and in S contacts 8.2 (1.9–34.2), p value 0.004, when compared with the O contacts. Among the child variables, male gender (relative risk [RR] = 2.1; 95% confidence interval [CI], 1.3, 3.5), parental supervision while toothbrushing (RR = 1.6; 95% CI, 1.1, 2.4), and the use of toothpaste (RR = 1.9; 95% CI, 1.3, 3.1) were found to be associated with approximal caries after adjustment for the other variables. Among the OXIS contacts, the S type was most susceptible to approximal caries due to its complex morphology, followed by I, X, and O. [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]

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.

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.

Introduction: Full-coronal restoration is the choice of treatment for restoring pulpally treated tooth or tooth with multiple surface involvement. In paediatric dentistry, semi-permanent stainless steel crowns (SSCs) are considered gold standard, but with increasing need of aesthetics, zirconia crowns have started gaining importance. Hence, this study was conducted to evaluate the clinical performance of SSCs and zirconia crowns and to compare the child satisfaction and parental ratings of impact of treatment using these preformed crowns. Materials and Methodology: This study was a part of randomised controlled trial performed on 60 children of 4–8 years old. The primary molars were cemented with either SSCs or zirconia crowns and were evaluated clinically at baseline, 6-month and 12-month follow-up for crown retention, crown fracture, gingival and debris index, wear, marginal integrity and recurrent caries. The trials also evaluated parental satisfaction and child satisfaction based on five-point Likert scale at the end of 12-month follow-up. The data were analysed using Chi-square test for categorical data and independent sample t-test for quantitative data. Results: Both the crowns were 100% retentive at 12-month follow-up. Fair debris score and mild gingivitis were reported in 3% with SSC at 6–12 months. One zirconia crown fractured at 12 months. Fifty-four per cent of parents in zirconia and 57% in SSC stated that the crowns improved masticatory function. Children reported a mean Likert score of 3.0 for SSC and 4.89 for zirconia which was highly significant. Conclusion: Both the crowns increased the overall health of crowned tooth and were fully retentive for the studied duration. However, zirconia crowns were more gingival friendly and had an edge over SSC in terms of aesthetics.

Introduction: Multiple systems are available for chemo-mechanical preparation during pulpectomy, but an evolution of the exclusive paediatric rotary single file system has opened new doors in paediatric endodontics. The aim was primarily to compare the quality of obturation and instrumentation time and secondarily to report pain perception between manual files and rotary file systems in deciduous molars. Materials and Methods: Pulpectomy was performed in 60 carious mandibular primary molars indicated for pulpectomy in children aged 4–8 years after considering the selection criteria. These teeth were divided randomly into three groups of 20 each, wherein canals were prepared using Hand K files in Group 1, HeroShaper Rotary File System in Group 2 and Kedo S Square single paediatric rotary file in Group 3. The quality of obturation was assessed using intraoral radiographs, and instrumentation time was recorded in seconds using a stopwatch. Pain during instrumentation was assessed using Wong Baker's FACES Pain Scale. Collected data were subjected to analysis using the Chi-square test, one-way ANOVA and Honestly Significant Difference post hoc test. Results: Mean instrumentation time was least for the Kedo-S Square file system (57.47 ± 9.26), followed by the HeroShaper group (99.6 ± 23.62), and maximum time was recorded for Hand files (255.99 ± 46.20), and this difference was statistically significant (P = 0.00), whereas there was no significant difference regarding the quality of obturation and pain perception between the three groups. Conclusion: As the Kedo S Square system showed the fastest canal preparation, it can be recommended for pulpectomy procedures in primary teeth because the length of appointment is directly proportional to the behaviour of the child.

Abstract 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). 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.

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.

Objective: To investigate the occurrence of caries associated with restorations in primary molars. Methods: Resin-modified glass ionomer cement (n=50) and compomer (n=50) restorations of primary molars were made in 100 children. The restorations were clinically evaluated on the 3rd, 6th, 12th and 18th month with the FDI criteria. Results: On the 3rd month recall, all restorations showed excellent clinical assessment scores for all FDI criteria. In regard to secondary caries, on the 6th month, clinically unacceptable was only one restoration. In the 12th month, 19.00% of the restorations were diagnosed with caries adjacent to the restoration. The relative share of secondary caries lesions assessed in restorations from glass ionomer cement (27.27%) was higher than that from compomer material (14.28%), as well as the restorations on the occlusal surface (38.46%), compared to those on the proximal surfaces (7.40%). Caries associated with restorations was diagnosed more frequently in relation to the caries lesions assessed as active at the first visit (29.62%) compared to the inactive lesions (7.69%). At the 18th month recall, the relative share of restorations diagnosed with secondary caries was lower (8.00%). Conclusion: The type of restorative material, type of affected surface and the activity of the carious lesion are factors that may influence the occurrence of caries associated with restorations in primary molars. Our study showed that a critical moment for the clinical condition of the followed restorations is the 12th month of the treatment.

Introduction: Multiple systems are available for chemo-mechanical preparation during pulpectomy, but an evolution of the exclusive paediatric rotary single file system has opened new doors in paediatric endodontics. The aim was primarily to compare the quality of obturation and instrumentation time and secondarily to report pain perception between manual files and rotary file systems in deciduous molars. Materials and Methods: Pulpectomy was performed in 60 carious mandibular primary molars indicated for pulpectomy in children aged 4-8 years after considering the selection criteria. These teeth were divided randomly into three groups of 20 each, wherein canals were prepared using Hand K files in Group 1, HeroShaper Rotary File System in Group 2 and Kedo S Square single paediatric rotary file in Group 3. The quality of obturation was assessed using intraoral radiographs, and instrumentation time was recorded in seconds using a stopwatch. Pain during instrumentation was assessed using Wong Baker's FACES Pain Scale. Collected data were subjected to analysis using the Chi-square test, one-way ANOVA and Honestly Significant Difference post hoc test. Results: Mean instrumentation time was least for the Kedo-S Square file system (57.47 ± 9.26), followed by the HeroShaper group (99.6 ± 23.62), and maximum time was recorded for Hand files (255.99 ± 46.20), and this difference was statistically significant (P = 0.00), whereas there was no significant difference regarding the quality of obturation and pain perception between the three groups. Conclusion: As the Kedo S Square system showed the fastest canal preparation, it can be recommended for pulpectomy procedures in primary teeth because the length of appointment is directly proportional to the behaviour of the child. [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 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]