ABSTRACT
Dental general anesthesia (DGA) can be a preferred approach for treating children with special health needs (CSHCN). It has many benefits, most importantly, the support of the anesthesia team to control the medical status and treat the patient safely. The aim of this study was to evaluate the dental treatment provided to (CSHCN) under (DGA) in a tertiary-care hospital. Moreover, to compare the dental procedures between different medical conditions. This retrospective study involves a sample of 730 children aged between (1-16 years) with complex medical conditions treated under DGA between January 2009 until April 2022. The results show that 4.93 % of these patients had DGA twice. For those children who had DGA only once, the most frequent medical conditions were neuro-developmental disorders (31.8 %), pediatric oncology (17.4 %), and behavioral disorders (autism, ADHD, etc.) (15.1 %). The average age was 6.9 years; almost half were preschool children (4-6 years old, 48.41 %) followed by younger school children (7-9 years old, 28.82 %). The most common dental procedures done were extractions followed by restorative procedures. The use of fissure sealant was significantly higher in neuro-developmental and behavioral disabilities patients than other medical conditions.
ABSTRACT
The prevalence of dental caries in Saudi children is estimated to be 80% for primary dentition and 70% for permanent dentition. Dental treatment under general anesthesia (GA) might be recommended for children with uncooperative behavior or complicated dental treatment requirements. Despite its advantages, some parents have concerns regarding this approach. Nonetheless, little is known about Saudi parents' perceptions and concerns regarding pediatric dental treatment under GA. The main objective of this study was to determine parents' concerns and perceptions on pediatric dental treatment under GA in Saudi Arabia. It is a cross-sectional survey study. The inclusion criteria were: Arabic-speaking parents of healthy children aged 1-14 years referred to GA screening for dental treatment in a hospital. The final study cohort comprised 319 participants. The first part of the questionnaire included the children's and parents' demographic and clinical input, while the second part comprised the parents' perceptions and concerns. The survey was distributed in the dental office during GA screening visits. Our findings revealed that most parents were concerned about possible GA-related complications (78%), followed by postoperative pain (51%), intravenous line and cannula (49%) and coma or death (46%). This study highlights that most Saudi parents were concerned about the use of GA in pediatric dental treatment and the need for more awareness regarding the risks, benefits and expected outcomes of pediatric dental care under GA.
Subject(s)
Dental Care for Children , Dental Caries , Child , Humans , Anesthesia, General , Cross-Sectional Studies , Dental Caries/epidemiology , Dental Caries/therapy , Parents , Saudi ArabiaABSTRACT
This article describes the clinical management of delayed eruption of the upper left permanent central incisor of an eight-year-old child with a history of overlooked intrusive trauma to the primary maxillary incisors. Initial conservative management involved simple extraction of the over-retained upper right primary left incisor. At the recall visit, the decision was made to expose permanent incisors surgically aiming to facilitate its eruption. Two years later, the upper right central and lateral incisors have been erupted into the oral cavity, improving patient aesthetics. This case report aims to demonstrate the clinical diagnosis and intervention for delayed eruption of maxillary permanent central incisor as a consequence of an overlooked intrusive trauma in the primary dentition. Additionally, to emphasize the importance of periodic radiographic examination in monitoring the sequence of eruption in mixed dentition.
ABSTRACT
The term molar incisor hypomineralization (MIH) describes the clinical manifestation of enamel hypomineralization of systemic origin affecting one or more permanent first molars and incisors. The purpose of this case report is to discuss the management of two mandibular molars with hypomineralization and to emphasize endodontic treatment for pediatric patients. An 8-year-old girl was referred to the pediatric dental clinic for restorations of multiple carious teeth. Upon clinical examination, based on the pattern of enamel hypomineralization and posteruptive breakdown presented, the diagnosis of MIH was established. As a part of the comprehensive treatment, one molar was restored with resin-based composite restorations. The other was endodontically involved and was treated with apexification and then covered with a stainless-steel crown. A two-year recall appointment revealed both molars to be free from signs and symptoms of inflammation. Management of MIH-affected molars should follow a conservative approach and endodontic treatment should be considered.
ABSTRACT
PURPOSE: To examine the effect of different torque application techniques (torqued, retorqued once, and retorqued twice) on the removal torque of implant-supported fixed complete dental prostheses. MATERIALS AND METHODS: Four Nobel Biocare implants (4.3 × 13 + 3; 13-mm thread height + 3-mm collar height) were stabilized temporarily inside four holes made in an acrylic mandibular master model. A metal framework was constructed, casted, and finished using a standardized technique. A passively fitting framework was achieved by removing the implants from the acrylic master model and hand-screwing them to the metal framework. Then, the whole assembly was restabilized in the acrylic master model. The torque experiment consisted of three protocols: (1) torquing screws to 35 Ncm a single time; (2) torquing the screws to 35 Ncm and then immediately retorquing the same screws to the same value; and (3) torquing the same screws to 35 Ncm three consecutive times. Removal torque was recorded for each implant using a digital torque meter. RESULTS: The highest torque value was recorded for the retorqued-once application technique (29.5 ± 1.5 Ncm); next was the torqued technique (27.9 ± 0.7 Ncm); and, last was the retorqued-twice technique (27.2 ± 1.6 Ncm). The Games-Howell post hoc test showed that the retorqued-once application technique resulted in significantly higher torque values than the torqued and retorqued-twice torque application techniques (P ≤ .05). CONCLUSION: Retightening abutment screws once after the initial torquing could enhance the removal torque of the screw. Care must be taken when retorquing the screws more than once, as this may inversely affect the removal torque.
