ABSTRACT
PURPOSE: To collect long-term survival data in anterior traumatised teeth on the outcome of Regenerative Endodontic Treatments (RET) with a network of dentists working in different clinics to overcome the problem of anecdotical evidence. METHODS: The seven dentists from Paediatric REsearch Project (PREP) performed RET treatments following the same protocol in five different secondary dental care clinics in the Netherlands. Treatment resulting in pain, apical problems, sinus tracts, resorption or fracture were considered as failure of treatment. RESULTS: 47 teeth in 38 children were treated between January 2009 and September 2017 and had at least 6 month follow-up (mean 35 months). Apical closure was seen in 27 teeth (25 cases) and root length growth in 6 teeth (6 cases). Thickening of the root walls was seen in 20 teeth (20 cases) and obliteration of the root canal in 30 teeth (25 cases). Of 38 teeth with apical inflammation at the start of treatment, no radiographic sign of apical inflammation was visible at 3 months in 13 of 28 teeth; taking up to 42 months for radiographic signs of apical inflammation to be not visible. Nineteen of 35 teeth showed discoloration at the beginning of treatment. After 18 months two teeth showed signs of ankylosis, but were still functional. After 36 months one more tooth showed signs of new apical inflammation and 2 months later it was extracted. CONCLUSIONS: With three failures in 47 treated teeth, RET seems to be a promising treatment for difficult to treat anterior traumatised teeth with an open apex.
Subject(s)
Regenerative Endodontics , Child , Dental Pulp Necrosis/diagnostic imaging , Dental Pulp Necrosis/therapy , Follow-Up Studies , Humans , Netherlands , Root Canal TherapyABSTRACT
The aim of this study was to determine what the approach of Dutch dentists is in the treatment of children. Prevention, X-ray diagnostics and restorative care were compared in four consecutive age groups (< 6 years old, 6-8, 9-11, 12-17 years). The insurance claims of 4550 dentists over a period of 3 consecutive years were studied. The findings showed that dentists who made use of X-rays and provided restorative care for children younger than 6 also provided restorative care for subsequent age groups on average 1.4-2.9, 1.3-2.5 and 1.2-1.8 times more than, respectively, dentists who did not make use of X-rays but did provide restorative care for children under 6 and dentists who neither made use of X-rays nor provided restorative care for children under 6. The first group of dentists also made more use of X-rays in the subsequent age groups: 3.7, 3.4 and 1.9 times respectively. On the basis of these results it can be concluded that starting restorative treatment and the use of X-rays for children younger than 6 is predictive for the quantity of care provided by dentists for the older groups of children.
Subject(s)
Dental Care for Children/methods , Dental Restoration, Permanent/statistics & numerical data , Practice Patterns, Dentists' , Preventive Dentistry , Radiography, Dental/statistics & numerical data , Adolescent , Child , Child, Preschool , Female , General Practice, Dental/methods , Humans , Male , NetherlandsABSTRACT
AIM: This was to assess if Dutch dentists have comparable attitudes in providing diagnosis and consecutive dental treatment in children. Prevention, radiographic diagnostics and restorative care were compared in four consecutive age groups [<6 years old, 6-8, 9-11, 12-17]. METHODS: In a cross-sectional study calculations were made using the financial records of one of the largest Dutch health insurance companies. After Medical Ethics approval all dental records of 4,500 dentists over a period of three consecutive years were used to calculate correlations and odds ratios, using early treatment, oral diagnosis, preventive approach and the use of local analgesia as basic independent variables. RESULTS: Early diagnosis based on the use of radiographs in children younger than 6 years increased the likelihood of direct restorative care 2.8 times and the likelihood of restorative care in future age groups 2.2, 2.0 and 1.6 times respectively. Early radiographs increased the likelihood of diagnostics in consecutive older groups by 3.7, 3.4 and 1.9 times respectively. CONCLUSION: An early diagnostic approach based on radiographs in paediatric dental care seems to be indicative for dentists' pattern of dealing with older children. This child-centred approach is limited to a small number of dentists.
