Orofacial findings associated with obstructive sleep apnea in a group of Saudi Children

To evaluate orofacial and occlusion findings associated with obstructive sleep apnea [OSA] in a group of Saudi children. The sample consisted of 30 OSA patients, and 30 age and gender matched, healthy control. The following facial and occlusal features were evaluated: frontal view, facial profile, mandibular angle, tongue size, dental midline to facial midline, upper to lower dental midline, overjet, overbite, anterior open bite, cross bite, scissors bite, palatal vault, maxillary and mandibular arch crowding and spacing, molar and canine relationship. Participants age ranged from 3 to 8 years. Study group had steeper mandibular angle, deeper palatal vault, and less spaced upper and lower arches. There was no statistically significant difference between the two examined groups regarding facial morphology, facial profile, midline, anterior openbite, tongue size, posterior crossbite, overjet or molar relationship. OSA children have a relatively different orofacial morphology compared with control children. OSA subjects had deeper palatal vault, steeper mandibular plane angle and less spaced upper and lower arches compared to control

Evidence-based dentistry: a tool for pediatric dentists' clinical decision

The term evidence-based dentistry [EBD] has been widely used in recent years. The very definition of evidence-based practice is "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients." The purpose of this article is to highlight key aspects of EBD and outline the strategies for integrating EBD in contemporary practice which could help pediatric dentists in making evidence-based decision. EBD involves defining a question focused on a patient-related problem and searching for reliable evidence to provide an answer. Once potential evidence has been found, it is necessary to determine whether the information is credible and whether it is useful in practice. There is a need for evidence-based care by pediatric dentists. It represents a philosophical shift in the approach to practice, a shift that emphasizes evidence over opinion and, at the same time, judgment over blind adherence to rules. As more pediatric dentists in active practice develop evidence-based skills, refine their computer skills and embrace this paradigm, all barriers to EBD will come tumbling down. When this happens, the questions and outcomes most relevant to patients will be more readily identified and meaningful research activities can thus be planned. As pediatric dentists become more familiar and more comfortable with evaluating and applying research evidence, they will be less susceptible to the abuse of evidence by others

Initial management of avulsed maxillary permanent central incisor: case report

Teeth avulsions are common traumatic dental injuries which may be associated with poor post-treatment outcomes and their management is controversial. This article presents a case report of avulsion of a permanent maxillary central incisor including clinical and radiographic examinations as well as management

Enamel surface and resin tags morphology: sem study

OBJECTIVE: To evaluate surface treatment of enamel and enameloplasty preparation resin tags morphology of the following materials: Dyract, Compoglass, Photac-Fil and Delton Plus. MATERIAL AND METHODS: A total of 45 extracted caries free permanent teeth were divided into 9 groups of 5 teeth each. Groups 1, 2, 3 and 4 were used to evaluate surface treatment of enamel treated according to the manufacturer's instructions of each of the mentioned materials while group 5 serves as control. Groups 6, 7, 8 and 9 were used to evaluate the enameloplasty preparation resin tags morphology of those materials after teeth were demineralized in 0.1 N hydrochloric acid for 24 hours, which leaves the restorative materials previously in contact with cavity walls, exposed. Teeth in groups 1, 2, 3, 4 and 5 as well as fitting surfaces of restorative materials in groups 6, 7, 8 and 9 were prepared and examined using SEM to evaluate surface treatment pattern and resin tags morphology. Surface treatment of enamel and enameloplasty preparation resin tags morphology evaluation of Dyract, Compoglass, Photac-Fil and Delton Plus using SEM demonstrated different appearance. Control surfaces showed the longitudinal marks and the smear layer created during preparations. Surface treatment of the teeth using Dyract and Delton Plus resulted in disappearance of the longitudinal marks while surfaces treated with Compoglass and Photac-Fil showed the longitudinal marks. The fitting surfaces of Compoglass, Photac-Fil and Delton Plus were consistent with their surface treatment appearance, while Dyract fitting surfaces were consistent with the prepared teeth surfaces before Dyract PSA Prime/Adhesive application. CONCLUSIONS: Enamel surface of the teeth following Dyract and Delton Plus surface treatments cause disappearance of the longitudinal marks created during cutting while surfaces treated with Compoglass and Photac-Fil surface still show the longitudinal marks. The fitting surfaces of Compoglass, PhotacFil and Delton Plus are consistent with their surface treatment appearance while Dyract fitting surfaces are consistent with the prepared teeth surfaces before Dyract PSA Prime/Adhesive application

In-vitro evaluation of microleakage of conventional and resin-modified glass ionomer restorative materials

The aim of this in vitro study was to evaluate microleakage of two resin modified glass ionomer cements [Photac-Fil and vitremer] and one conventional glass ionomer cement [Ketac-Fil]. Forty-five freshly extracted human primary molars were selected and a standardized Class V cavities were prepared. Teeth were divided into 3 groups of 15 each and restored with each material. The teeth were prepared for microleakage test and then immersed in 5% methylene blue for 4 hours. The marginal microleakage was assessed according to the degree of dye penetration of the occlusal and cervical margins. Results showed significant difference between Ketac-Fil and Photac-Fil occlusally and cervically [P < 0.05] while no significant differences were found between Ketac-Fil and Vitremer nor between Photac-Fil and Vitremer occlusally and cervically. The microleakage scores for the three restorative materials showed that Ketac-Fil was higher than Vitremer while Photac-Fil was the lowest. CONCLUSIONS: Conventional and resin modified glass ionomer restorations placed in primary molars in vitro without thermocycling did not consistently prevent microleakage. Vitremer microleakage scores were comparable statistically to Photac-Fil and Ketac-Fil whereas it was lower in sealing ability than Photac-Fil but higher than Ketac-Fil. Generally, no significant difference in the microleakage between the occlusal and cervical margins of all glass ionomer materials tested was found

Surface texture and roughness of the soldered joints before and after finishing and polishing

The purpose of this study was to evaluate surface texture and roughness of the soldered joints of apace maintainers before and after finishing and polishing. Thirty-two solder joints were fabricated and used in this study. The fabricated solder joint was left untouched [no finishing car polishing] in-8 specimens [Group 1]. Another 8 specimens [Group 2] were polished lightly with a burlew wheel for 25 seconds. The rest of the specimens [16] were finished with a green abrasive wheel for 25 seconds, after Which 8 specimens [Group 3] were left finished while the other 8 specimens [Group 4] were further polished lightly with a burlew wheel for 25 seconds. Surface roughness analysis of all specimens was performed using a surface roughness analyzer to determine [R] values. Statistical analysis of surface roughness was performed using one-way analysis of variance and parametric Tukey's type multiple range tests. All specimens were prepared for scanning electron microscopic [SEM] and examined. for surface texture, The mean +SD of Ra for Groups 1-4 were 1.00 + 0.12, 0.79 0,14, 1.14 +0.12 and [1.311 +0.04 respectively. Specimens in Group 4 showed the smoothest surface and demonstrated significantly lower and values P<0.0001] compared to other groups. Group 2 showed the send, smoothest surface and demonstrated significantly lower Ra values compared to groups 3, and 4 [P<0.0001] as well group 1 [P<0.01]. Group 3 showed the highest mean surface roughness [1.14 micrometers] and demonstrated significantly high R. values compared to groups 2 and 4 [P<0.0001]. SEM evaluation of group 1 showed fused globular appearance with void and few grooves while group 2 displayed scratches lines typical of rotary, instrument and irregular, shaped gouges. The solder joints of group 3 showed deep and coarse grooves with pits, voids, and cracks while Group 4 resulted in a smooth surface with few irregular scratches. Untouched solder joints as well as finishing or polishing procedures used in this study could out reproduce the smoothness of the surfaces created by finishing and polishing. However, few irregular, scratches were still present after finishing and polishing. Finishing and polishing of solder joints is requited procedure in which abrasive wheel as well burlew wheel mot be used

Effect of home bleaching agents on the texture and surface roughness of glass ionomer and compomer restorative materials

Surface roughness of restorative materials contributes to plaque adhesion and surface discoloration of esthetic restorations. The purpose of this in vitro investigation was to measure the effect of home-use bleaching agents on surface texture and roughness of a conventional glass ionomer [Ketac-Fil] and a compomer [Dyract[R] AR] restorative material. Twenty-four flat cylindrical specimens of each material were prepared using teflon molds. Specimens of each material were divided into three groups of 8 each. Groups 1 and 2 served as controls [no bleaching agents]. Groups 3 and 4 were treated with 3 applications of Pearl Drops[R] on Ketac-Fil and Dyract[R] AR respectively. Groups 5 and 6 were treated with 3 applications of Natural White[R] on Ketac-Fil and Dyract[R] AR respectively. Before testing surface roughness, an impression was taken of each specimen to form a replica. All replicas were then prepared for SEM examination. Surface roughness [Ra value] was evaluated using a surface roughness analyzer. Statistical analysis was done using a non-parametric one-way analysis of variance [Kruskal-WalliS test] with a Tukey's post hoc test. Results showed highly significant differences among the six groups [alpha < 0.0001]. Group 4 [Pearl Drops[R] applied to Dyract[R] AP] demonstrated the lowest Ra value compared with all other groups [alpha < 0.001]. Group 5 [Natural White[R] applied to Ketac-Fil] demonstrated the highest RA value compared with all other groups [alpha < 0.0001]. Dyract[R] AR was significantly smoother than Ketac-Fil for all treatments with alpha<0.0001. SEM evaluation revealed different degrees of surface texture. It was concluded that Dyract[R] AR and Ketac-Fil showed significant differences in surface roughness and texture before and after application of Pearl Drops[R] and Natural White[R] home-use bleaching agents

Evaluation of the effects of finishing and polishing procedures on the surface texture of compomer materials

The purpose of this study was to evaluate the effects of finishing and polishing procedures on the surface texture of compomer materials [Dyract and Compoglass] using the Enhance finishing and polishing system. Forty-five cylindrical specimens were prepared from each material. Fifteen specimens of each material were light cured against a Mylar strip with no finishing or polishing [control]. 15 others were finished only using the Enhance finishing system [experimental] and another 15 specimens were finished and polished using the Enhance finishing and polishing system [experimental]. All specimens were prepared at room temperature and stored for 3 days in closed containers of distilled water [300 ml] in a laboratory oven at 37°C before testing. Both control and experimental specimens of each material were examined and photographed at different magnifications using a stereomicroscope and an SEM. Also, the surface roughness of all specimens was measured with a surface roughness analyzer. The surfaces cured against the Mylar strip demonstrated the smoothest surface. Following the Mylar strip surface, the next smoothest surface was seen in finished and polished Dyract followed by finished Compoglass. Finishing and polishing procedures of compomer materials failed to reproduce the smoothness of surfaces created by mylar strips

Current materials/methods of obturation of primary teeth following pulpectomy and a new method of obturation

Pulp therapy for primary teeth provides treatment options to save teeth with advanced pulpal pathosis resulting from caries or trauma. Pulpectomy is an acceptable treatment for saving infected primary teeth. The criteria for an ideal root canal filling material for primary teeth differ from those of permanent teeth. The four commonly used materials for filling primary teeth root canals are zinc oxide and eugenol, calcium hydroxide iodoform, and gutta percha. There are several methods of obturation [filling] of primary teeth root canals. At present time there is no known ideal root canal filling material or method of obturation of primary teeth root canals. The purpose of this paper is to review current materials and methods of obturation of primary teeth root canals following pulpectomy and to present a new method of obturation of primary teeth root canals

Pits and fissures morphology and enameloplasty technique evaluation

This in vitro study evaluated pits and fissures morphology and the use of enameloplasty technique in posterior permanent teeth. A total of 54 extracted caries free permanent posterior teeth were used in this study. Stereomicroscopic and SEM examination were used to evaluate pits and fissures and enamel thickness. Enameloplasty preparation of the occlusal surfaces was performed using diamond bur No. 582S. Preparations were evaluated using Stereomicroscopic and scanning electron microscope [SEM]. Pits and fissures evaluation of the molars and premolars using stereomicroscope demonstrated great variability in the number of grooves and pits. The highest mean enamel thickness was recorded for the lingual cusps in molars buccolingual sections [1.82 mm] while the lowest mean enamel thickness was recorded at the central fissure of premolars buccolingual sections [0.44 mm]. SEM examination revealed presence of debris in the fissures, despite prophylaxis procedure performed. The geometric configuration of pits and fissures varied from a shallow-wide fissure to a deep-narrow fissure. Evaluation of enameloplasty preparation in the molars and premolars using stereomicroscope showed continuous external outline form that involved all pits and fissures with rounded or slightly sharp line angles, rounded or slightly flat pulpal floor and rounded or slightly sharp internal line angles. In some teeth when preparations were limited to enamel, not all fissures depth were reached. SEM evaluation confirmed the stereoscopic examination and showed enlarged fissures with increased surface area and irregular pulpal and cavity walls. Occlusal surfaces of posterior permanent teeth show a great variability in the number of grooves, which varies from a shallow-wide fissure to a deep narrow fissure. Diamond bur No. 582S produces homogeneous enameloplasty preparation with minimal loss of tooth structure and more surface area. It did not always remove completely the deepest part of the fissures, but it did allow inspection of the repairing part of the fissures and extent of discolouration

Healing of experimental oral wounds following application of a hemostatic agent in dogs

The purpose of this study was to investigate the effect of a hemostatic agent [Hemocollagene] and evaluate the tissue-material interaction during the healing of experimental oral mucosa wounds in dogs. Sixteen mature dogs were used in this experiment. Scalpel incision wounds of standard size [2cm long and 1cm deep] were made on both sides of the buccal mucosa. The Hemocollagene was applied to one side [experimental] of the buccal mucosa while the opposite side was used as a control [no hemostatic agent]. Biopsy specimens of the wounds were taken at 4, 10, 20 and 45 days after the operation for evaluation by light microscopy. Clinically no signs of wound dehiscence, inflammation, or infection of the control and experimental sites at 4, 10, 20 and 45 days were noticed. Clinically the Hemocollagene did not affect the quality or the rate of healing. At 4-days, microscopic examination of both control and experimental wound sites showed an inflammatory reaction, which consisted of mononuclear cells, plasma cells and polymorphonuclear leukocytes. Fibroblastic and endothelial proliferation was present. In addition, experimental wound sites showed fragmented partially digested Hemocollagene, which penetrated by neutrophils and erythrocytes. In 10-days specimens, both the control and experimental wound sites showed a dense sheets of fibroblastic and capillary infiltration. The experimental wound sites showed less amounts of digested hemocollagene. In the 20-days specimens, the control and experimental would sites were well epithelialized with the lamina propria composed of numerous lightly woven, streaming interwinning collagen fibers. Areas of chronic inflammatory cells were scattered through out the specimen. The experimental wound sites showed no digested Hemocollagene. The 45-days control and experimental specimens exhibited a well-healed, epithelial layer with a few areas of chronic inflammatory cell remained, especially in association with the small blood vessels. The connective tissue appeared more saturated than at 20-days. No apparent differences in the healing between the control and experimental wound sites. Hemocollagene is well tolerated, undergo biodegradation with no adverse or structural changes, provide no barrier to the normal wound healing process, and does not affect the rate of healing of experimental oral mucosa wounds in dog

Emergency oral care for children, a prospective pilot study

The emergency visits for children may occur on an almost daily basis. The management of children's behavior at the emergency visits can run from easy to very difficult situations and both child and parent tend to be more anxious than usual. This study included 215 children who presented for treatment during-hours of emergency dental care provided by the College of Dentistry, King Saud University over the first three months of the year 1993. The percentage of children with caries as the presenting complaint was the highest [50%]. Aphthous ulcers and periapical infections were found in 1% and 17% respectively. Trauma was recorded in 8% of the cases. The pattern of caries treatment varied between pulpotomy [14%], pulpectomy [4%], restorations [29%], extractions [28%] and temporary restorations [25%]. Well arranged emergency services are of crucial importance for the image of dentistry as perceived by the public. Dentists have a legal, ethical and moral responsibility to provide emergency dental care for children. Improving oral health, better patient and parent awareness and education could have prevented some of the during-hours emergency visits

Electrical burn of the oral commissure

Electrical burns of the oral cavity are relatively rare occurrence. They often occur as a result of sucking or bitting on the [live] end of an extension cord or at the junction of an extension and appliance cord. The most common site of injury is the commissure and/or adjacent upper and lower lip. The purpose of this report is to present a case of a three-year old boy with electrical burn of the oral commissure. The course of treatment and appliance used were described. The successful use of the burn appliance ultimately depends on patient compliance and parent cooperation. The parents need to be made aware of the possible sequelae and all preventive measures

ingestion of fluoride toothpaste during toothbrushing by children

The purpose of this study was to determine the brushing time and the amount of fluoride not recovered from the mouth of children after brushing with a fluoride containing toothpaste. The fluoride recovered following tooth brushing was determined after HMDS diffusion using the fluoride electrode. Brushing time averaged [ +/- SE] 59 +/- 5 seconds, it did not correlate with age. Seven of the children did not expectorate. The average quantity of fluoride not recovered was 0.37 +/- 0.05 mg [range 0.08 to 0.82 mg]. It was concluded that the amount of ingested fluoride associated with a single brushing of the teeth exceeds the average dietary fluoride intake by young children living in areas without fluoridation and that it is about 75% of the dietary fluoride intake in fluoridated areas. Toothpastes containing fluoride should be considered as a major source of ingested fluoride, particularly for children at risk of dental fluorosis

Caries detection: an evaluation

The purpose of this in vitro study was to compare visual-tactile and electronic methods of caries diagnosis with the microscopic appearance of both pit and fissure caries and smooth surface caries. Twenty-eight teeth were extracted and preserved in 10% buffered formalin. A total of 94 sites [occlusal fissures [19], buccal pits [19] and smooth surfaces [56]] was examined for caries using visual tactile and electronic caries detector. Multiple facial-lingual sections were prepared from each tooth. These sections were examined microscopically andphotographed. The findings indicated that for occlusal pit and fissure cariesand buccal pit caries, the visual-tactile method have microscopic findingsthan did the electronic detector. However, the electronic detector has showeda much better correlation with the microscopic data than did thevisual-tactile method for smooth surface caries. These results indicated thatelectronic caries detection may assist in the diagnosis of facial surfacecaries

Histopathologic response of the human dental pulp to nursing caries

Nursing bottle caries [NBC] is a recognized disease entity associated withvarious nursing habits found in young children. This investigation studiedthe histopathological response of the dental pulp to NBC and correlated thedegree of carious involvement with depth of bacterial penetration and degreeof pulpal incisors with NBC was processed for routing paraffin embedding andstained with H and E and periodic acid Schiff. The degree of inflammation inthe superficial and deep pulpal tissue was graded on a scale of 0 to 3. Abscess formation or pulp necrosis was also recorded. The degree ofpenetration of bacteria was measured using Zeiss integration platt II. Pulpresponse to NBC varied from mild to severe inflammation. Five specimensshowed microabscesses of necrotic changes. Reparative dentin was observed in19 specimens with an average thickness of 21 +/- 04 mm [S.E]. The averageremaining dentin thickness between the deepest bacterial penetration and thepulp was 56 +/- 07 mm [S.E]. Superficial and deep inflammatory responsesaveraged 1.9 +/- 0.18 and 1.6 +/- 0.22 respectively. NBC caused milk tomoderate pulp inflammation when bacteria penetrated within 1.02 mm of the pulp