Subtypes of early childhood caries predict future caries experience

Objectives: To test whether postulated subtypes of early childhood caries (ECC) are predictive of subsequent caries experience in a population-based cohort of Swedish children. Methods: The study included children aged between 3 and 5 years at study entry with dental records available for at least 5 years of follow-up. Dental record data were retrieved from the Swedish Quality Registry for Caries and Periodontal disease (SKaPa) for the initial and follow-up visits. Participants who had ECC at study entry were assigned to one of five ECC subtypes (termed classes 1 to 5) using latent class modelling of tooth surface-level caries experience. Subsequent experience of caries was assessed using the decayed, missing, and filled surfaces indices (dmfs/DMFS) at follow-up visits, and compared between ECC subtypes using logistic and negative binomial regression modelling. Results: The study included 128,355 children who had 3 or more dental visits spanning at least 5 years post baseline. Of these children, 31,919 had caries at the initial visit. Baseline ECC subtype was associated with differences in subsequent disease experience. As an example, 83% of children who had a severe form of ECC at age 5 went on to have caries in the permanent dentition by the end of the study, compared to 51% of children who were caries-free at age 5 (adjusted odds ratio of 4.9 for new disease at their third follow-up). Conclusions: ECC subtypes assigned at a baseline visit are associated with differences in subsequent caries experience in both primary and permanent teeth. This suggests that the development and future validation of an ECC classification can be used in addition to current prediction tools to help identify children at high risk of developing new caries lesions throughout childhood and adolescence.

Developmental Dental Defects in Permanent Teeth Resulting from Trauma in Primary Dentition. A Systematic Review

The objective was to determine whether trauma in primary dentition causes alterations in the development of permanent dentition. Searches were made in May 2020 using PubMed, MEDLINE, MEDES, Scopus, Lilacs, and Embase. Papers in English, German, and Spanish, without restrictions in the year of publication, were included. The quality of the studies was analyzed using the NOS Scale. The search retrieved 537 references, and seven studies were included for a qualitative analysis. The results showed that trauma to a deciduous tooth can damage the bud of the permanent tooth. Enamel discoloration and/or hypoplasia were the most common sequelae in the permanent teeth after trauma to the primary predecessor. The type and severity of sequelae in the permanent tooth are associated with the development phase of the bud. Children with trauma of their primary teeth should receive checkups until the eruption of the permanent teeth for the early diagnosis and treatment of possible sequelae. Intrusion of the primary tooth was the trauma that caused the most damage and enamel alterations the most frequent sequelae.

Evaluation of the effectiveness of the Chronological Dental Mineralization Table of Permanent Teeth among Brazilians in the city of Belo Horizonte

The knowledge of an individual age, especially children and young people, is important in civil and criminal cases, such as adoption and when is important determining criminal imputability. To estimate this age, when there are no suitable documents to prove it, body development factors are used, especially those that show the stages of mineralization of the teeth. To this estimation, numerous tables have been developed in the most diverse regions. The aim of this study was to analyze the accuracy of the Chronological Table of Mineralization of Permanent Teeth among Brazilians in a region different from that in which the method was developed, namely, Vale do Paraíba (SP - Brazil). For this purpose, 442 panoramic radiographs of individuals aged 5 years to 20 years and 4 months, taken in the central region of the city of Belo Horizonte (MG), were used. After applying the table, with the determination of the stages of each tooth present in the radiograph and an average between them, using the data developed by the authors, the total average percentage of correct answers was 63.5%, showing a low number, especially in the age range of 14 to 17 years. When the estimate was analyzed for sexual dimorphism, no significant differences were found. Through this study, one can perceive a need for standardization and detailing in the methodology, besides its updating and complementation with data that encompass dental development in the different regions of the country.

Effect of Different Instrumentation and Irrigation Methods on Apical Microbial Extrusion: An Ex Vivo Study

Background: Periapical extrusion of debris, irrigating solution and microorganism are the major contributing factors for flare-ups during root canal therapy. The aim of this ex vivo study was to evaluate the effect of different types of instrumentation in combination with different irrigation methods on apical bacterial expulsion. Material and Methods: Three hundred and ten extracted human permanent teeth were infected with Enterococcus faecalis. After incubation at 37°C for 24 h, three hundred teeth were instrumented with three different instrumentations using two irrigation methods. The remaining ten teeth were used as negative and positive control groups, in which no inoculation was done and no instrumentation was carried out respectively. Three hundred teeth were equally divided in three groups (n = 100), in which instrumentation was performed using a protaper universal rotary file (group 1), WaveOne reciprocating file (group 2) and a flexiCON rotary file (group 3). In each group, 50 samples were irrigated with conventional needle irrigation, and 50 samples were irrigated with the endoVac irrigation method. During instrumentation, apically extruded bacteria were collected in an Eppendorf tube. Microbiological samples were taken from the Eppendorf tube and incubated for 24h, and colony-forming units were counted. The data collected were statistically analysed. Results: The group 2 showed highest bacterial extrusion using conventional irrigation while group 3 showed lowest using endovac irrigation system. Conclusion: FlexiCON rotary instrumentation with the endoVac irrigation system produced significantly less bacterial extrusion than the other techniques.

Timings of Permanent Tooth Emergence in Children of Rural Vanuatu, Melanesia

Introduction Global patterning and timing of permanent tooth emergence is influenced by ethnicity, with no known timings reported for ethnic Melanesian children living in the tropical archipelago of Vanuatu. Aim To determine timings of permanent tooth emergence and sequencing for children who reside in rural Vanuatu. Methods Children aged 4-17 years (n=1026), part of a larger oral health cross-sectional study, were examined recording all permanent teeth present, across four spatially separated islands. Binary logistic modelling established children’s median age of emergence of each permanent tooth for each study area. Results The median emergence of first permanent molars for girls is 4.9-years and 5.3 -years for boys. In all locations, children had all permanent teeth emerge by age 11 years (excluding 3rd molars). Clinically important differences exist for permanent tooth emergence by study area. Discussion Permanent teeth emerge earlier for Ni-Vanuatu children compared to both Melanesian children of Papua New Guinea as well as other ethnicities across Oceanic countries. These results can be used as a set standard for Vanuatu. Early tooth emergence suggests oral health education programmes should target pregnant women with clinical preventive strategies commencing for their children before 5-years of age.

Physico-Chemical Properties of Calcium-Silicate vs. Resin Based Sealers—A Systematic Review and Meta-Analysis of Laboratory-Based Studies

Introduction: The aim of this systematic review is to analyse the effect of physico-chemical properties of calcium silicate-based sealers in comparison to epoxy resin sealers in permanent teeth using a single-cone obturation technique. Methods: The study was conducted according to the guidelines of Cochrane Handbook for Systematic Reviews of Interventions and Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement. Literature search was performed using the PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science, DOAJ, Open Gray with no language restrictions until October 2020. Two reviewers assessed the studies for eligibility. Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) was carried out to assess the evidence. Meta-analysis of the pooled data with subgroups was performed using the RevMan software (p < 0.05). Results: Results from the 28 included studies showed that the mean difference in adaptation to root canal walls (marginal adaptation, interfacial gaps and void volume) for both sealers were non-significant. However, void volume values showed a significant mean difference (p < 0.00001) favouring the calcium silicate-based sealers. The pooled meta-analysis reported statistically significant differences for apical microleakage (p = 0.0007) whilst there were non-significant mean differences for fracture resistance (p = 0.09) and push-out bond strength (p = 0.63). The heterogeneity among the included studies was 97% (I2). Conclusions: Within the limitations of this review, calcium silicate-based sealers demonstrated a similar or superior performance in comparison to resin-based sealers in terms of the physico-chemical properties.