Exploring the Compliance of Resilient High-Caries-Risk Patients Who Reversed Caries Severity

Background: Behavioural factors, such as compliance and regular dental attendance, have been proven to reverse caries severity. However, these factors have not been explored enough. The aim of this study was to explore the behavioural characteristics of compliant patients who had severe dental caries in primary dentition but whose dental conditions were considerably improved in mixed or permanent dentition.Methods: The 'w and W' criteria were designed to classify patients who had a worse or higher caries risk in primary and mixed or permanent dentition. Resilience, or reversal of caries severity, was thus defined as improvement based on these criteria. Interviews were performed with two groups of participants, including eight resilient children (M/F= 5/3) and their ten caregivers (M/F=2/8) in the patient group and ten paediatric dentists (M/F=6/4; clinical experience mean=26.9 years, minimum=16 years) in the dentist group. Thematic analyses were used to identify main themes.Results: Four themes were identified: (1) dental things/teeth are their priority, (2) normalising, (3) tiger parenting/conscientiousness and (4) trust. These ideas were identically described by both the patient and dentist groups.Conclusions: Resilience is the behavioural characteristic of children who outperform expectations, given their caries history and risk. Resilient patients reverse the fate of their teeth by their compliance with treatment protocols following dental guidelines, changing their dental behaviours, and thus, leading to treatment success. Dentists' suggestions are the priority and provide the norms in resilient patients' daily life. These patients find no excuses for not implementing dentists' advice, not only because they trust their dentists but also because they and their caregivers were conscientious about following dentists’ orders.

Three Distomolar in Single Patient: A Unique Case Report

Supernumerary teeth are defined as those in addition to the normal series of deciduous or permanent dentition. Supernumerary teeth are more prevalent among males and in the permanent dentition. The exact etiology of supernumerary teeth is unknown, they may occur anywhere in the oral cavity. They may appear as a single tooth or multiple teeth, unilaterally or bilaterally, erupted or impacted in maxilla or both jaws. Fourth molars, also called distomolars, are a variant in shape and number appearing as alterations during odontogenesis. They can be eumorphic or dismorphic, single or multiple, erupted or impacted, unilateral or bilateral, and can appear in both jaws. They are of unknown etiology, but there are several theories to justify these tooth alterations such as dental lamina duplication, its horizontal proliferation or its hyperactivity. Hereby, we are presenting a unique case report of presence of three distomolars in a single patient at maxillary left side and mandibular right and left side.

Differences of anteroposterior facial dimensions in male and female children on intermediate mixed and early permanent dentition using Cervical Vertebrae Maturation Index

Introduction: Cervical vertebrae are one of the indicators for craniofacial bones maturation. Timing of craniofacial bone maturation determined achievement of orthodontic early treatment. Some previous researchers recommended cervical vertebral maturation to assess craniofacial growth. This study was aimed to analyse the differences of anteroposterior facial dimensions in male and female children on intermediate mixed and early permanent dentition using Cervical Vertebrae Maturation Index (CVMI). Methods: An analytic observational study with a cross-sectional design was conducted on the students of Islamic Elementary School (Madrasah Ibtidaiyah) in Depok district, Sleman, Yogyakarta, from July 2019 to January 2020. Subjects consisted of 22 males and 22 females aged 8-11 years, obtained by a consecutive sampling technique. The anteroposterior facial analysis was performed on the lateral cephalometry for measuring the distance of Sella turcica to Nasion (S-N) representing the anterior cranial base, Posterior Nasal Spine to Anterior Nasal Spine (PNS-ANS) representing the maxilla and Gonion-Menton (Go-Me) and Condylion-Gnathion (Co-Gn) represents the mandible. Assessment of CVMI was decided by the Hassel and Farman methods. Data were analysed by One Way ANOVA. Results: The mean value of S-N, PNS-ANS, Go-Me, and Co-Gn dimensions, generally were higher in males than females; however, only dimensions of maxillary and mandibular were showed significant difference (p<0.05), while the S-N dimension was not significantly different (p>0.05). At the interval of CVMI 3 and 4, the Go-Me and Co-Gn dimensions showed a significant difference (p<0.05) both in males and females. Conclusion: There was a difference in anteroposterior dimensions of the maxillary and mandibular in cervical vertebral maturation in children with intermediate mixed and early permanent dentition, however, no difference was found in the anterior cranial base.

Prevalence of nonsyndromic hypodontia in a south-east Transylvanian region.

Introduction. Clinicians claim that the prevalence of hypodontia has skyrocketed in recent years. However, there is no clear evidence whether it is really a change in dentition in Homo Sapiens or a purely hypothetical observation, due to the advanced modern technology used in the diagnosis of dento-maxillary anomalies. The aim of this study was to establish the prevalence and distribution of nonsyndromic hypodontia in young patients from the South-East Transylvanian region of Romania. Material and methods. A number of 325 dental charts were selected. The patients who needed orthodontic treatment were treated in the Pedodontics Department and Orthodontic Department of UMFST “George Emil Palade“ Targu Mures and two private dental offices during 2017-2019. The age of the patients was between 12 and 25 at the moment when the clinical and paraclinical examination were performed. Results. From a total number of 275 cases investigated, 78 patients were diagnosed with hypodontia in permanent dentition, not taking into consideration the third molars. Hypodontia’s prevalence is 6.47% for patients which seek orthodontic treatment, without taking into consideration the third molars. This value is found in the range of 2.8%-11.3% reported in studies in the literature. The present study showed that hypodontia affects a greater proportion of females (6.83%) than males (5.74%), without statistically significant differences. Conclusions. The prevalence of non-syndromic hypodontia in permanent dentition, compared to the total number of patients who requested orthodontic treatment, is 6.47%, being higher than the data reported in the literature of our country, but falls within the range reported in the international literature in general.

Automatic detection of mesiodens on panoramic radiographs using artificial intelligence

This study aimed to develop an artificial intelligence model that can detect mesiodens on panoramic radiographs of various dentition groups. Panoramic radiographs of 612 patients were used for training. A convolutional neural network (CNN) model based on YOLOv3 for detecting mesiodens was developed. The model performance according to three dentition groups (primary, mixed, and permanent dentition) was evaluated, both internally (130 images) and externally (118 images), using a multi-center dataset. To investigate the effect of image preprocessing, contrast-limited histogram equalization (CLAHE) was applied to the original images. The accuracy of the internal test dataset was 96.2% and that of the external test dataset was 89.8% in the original images. For the primary, mixed, and permanent dentition, the accuracy of the internal test dataset was 96.7%, 97.5%, and 93.3%, respectively, and the accuracy of the external test dataset was 86.7%, 95.3%, and 86.7%, respectively. The CLAHE images yielded less accurate results than the original images in both test datasets. The proposed model showed good performance in the internal and external test datasets and had the potential for clinical use to detect mesiodens on panoramic radiographs of all dentition types. The CLAHE preprocessing had a negligible effect on model performance.

Management of Crossbite in Anterior Region Due to Over-retained Deciduous Teeth in an Adolescent – a Case Report

The deciduous teeth which are retained beyond the age of exfoliation are termed as over-retained deciduous teeth. There are numerous reasons for such teeth which include congenital absence or impaction or translation or transmigration of successor teeth or maybe because of existence of some kind of pathology, such as cysts, tumours, and odontoma under the primary tooth that results in the impaction of successor teeth. It may also be due to partial or total microdontia of permanent dentition. This leads to malalignment in permanent dentition which indirectly hampers the normal growth of the jaws. This case report shows several after-effects of over retained teeth along with the concerned multiple treatment options.

Non-syndromic supernumerary premolar tooth buds at a rare site in the mandible

Hyperdontia involving the premolar teeth can be single or multiple or even related to a syndrome. These are frequently encountered in permanent dentition, but their occurrence has ranged between 0.09 to 0.64% in the general population. These are rarely found between the first and second premolars.

Association Study on Nutrition in the First Year of Life and Molar-Incisor Hypomineralization (MIH)—Results from the GINIplus and LISA Birth Cohort Studies

Molar-incisor hypomineralization (MIH) is a condition with specific clinical presentation whose etiology to date still remains unknown. This study prospectively investigated the association between nutrition during the 1st year of life and the presence of MIH in the permanent dentition. Data from 1070 10-year-old children from two prospective birth cohort studies were included. Information on exclusive breastfeeding (EBF) and introduction of 48 food items into the child’s diet was assessed at 4-, 6-, and 12-month time-points. Food diversity was defined according to the number of food items or food groups introduced into the child’s diet and then subsequent categorization into low-, middle- and high-diversity groups was performed. MIH was scored in the permanent dentition at age of 10 years. The statistical analysis included logistic and Poisson hurdle regression models adjusted for potential confounders. EBF, food item and food group diversity at 4-, 6-, 12-month time-points were found to be non-significant in most of the categories for the development of MIH. However, significantly higher odds for the presence of MIH were found for certain categories. Despite the limitation of this study, such as arbitrary cut-offs for categorization of food items, the results of this study suggest the lack of an association between early nutrition in the first year of life and MIH in the permanent dentition.