Changes in Behavior Management and Treatment Modalities in Pediatric Dentistry during COVID-19 Pandemic.

OBJECTIVE: This study aims to assess the knowledge and confidence of dentists related to behavior management with extra personal protective equipment (PPE), non-aerosol-generating dental procedures in the course of the coronavirus disease-2019 (COVID-19) pandemic. MATERIALS AND METHODS: A cross-sectional online survey was conducted among a sample of dentists who worked in Jordan and India in June 2020 during the COVID-19 pandemic. RESULTS: This study included a total of 177 dentists in Jordan and India that were practicing during the early months of the pandemic. Most dentists were seeing <6 patients per day. The most common emergency treatments during the pandemic by Jordanian dentists were abscesses (51.8%) and cellulitis (44.6%) vs (44.6%) abscesses and (35.5%) pulpitis in India. There was a high adoption of all elements of the PPE protocol. Most participants never or rarely used N2O sedation to manage their patients in Jordan and India (80.4 and 71.1%), respectively. Participants in Jordan and India that considered treatment non-aerosol-generating procedures (non-AGP) were (82.1 vs 97.5%, p = 0.000), respectively. CONCLUSION: Most of the surveyed dentists believe the extra PPE acts as a barrier to patient communication and child behavior management and would consider modifying the PPE to be more child-friendly. Most dentists consider non-AGP procedures and silver diamine fluoride (SDF) to be practical ways to practice safer dentistry, yet more training and information is needed for dentists treating children to provide a more confident safe environment for both dentists and their patients. HOW TO CITE THIS ARTICLE: Alsaleh MM, Sabbarini JM, Al-Batayneh OB, et al. Changes in Behavior Management and Treatment Modalities in Pediatric Dentistry during COVID-19 Pandemic. Int J Clin Pediatr Dent 2020;13(S-1):S125-S131.

Comparison of enamel matrix derivative versus formocresol as pulpotomy agents in the primary dentition.

The purpose of this study was to compare the clinical and radiographic success rates of two different pulpotomy agents: one novel agent, the biologically active odontogenic protein enamel matrix derivative (EMD) versus formocresol (FC). A randomized, single-blind, split-mouth study was used with a sample of 15 children aged 4 to 7 years (mean age, 5 +/- 0.73 years). A total of 15 pairs of teeth, 1 pair per child, were selected for treatment. One tooth from each pair was randomly assigned to either the EMD pulpotomy group or the FC pulpotomy group. All teeth were followed up clinically and radiographically at 2, 4, and 6 months. After 6 months, the clinical success rates for the FC and EMD groups were 67% and 93%, respectively. Although most likely clinically relevant, the clinical success rate difference after 6 months was not statistically significant. After 6 months, the radiographic success rates for the FC and EMD groups were 13% and 60 %, respectively. There was a statistically significant difference at p < or = 0.05. The clinical and radiographic assessment of EMD pulpotomized teeth in this study offers preliminary evidence that EMD is a promising material which may be as successful, or more so, than other pulpotomy agents.

Histological evaluation of enamel matrix derivative as a pulpotomy agent in primary teeth.

PURPOSE: The purpose of this study was to evaluate histologically the effect of an enamel matrix derivative as a pulpotomy agent in primary canines. METHODS: Ten carious primary canines among teeth deemed for serial extraction were selected for this study. Emdogain gel was used as the pulp dressing material on the amputated pulp stumps. Teeth were extracted postoperatively after: (1) 1 week; (2) 2 weeks; and (3) 6 months. The extracted teeth were examined histologically to assess the response of the pulp to Emdogain gel after the pulpotomy procedure. RESULTS: Of the teeth extracted after 1 week, the amputated pulpal surface was lined by a thin, nearly continuous cellular layer. Generalized congestion was accompanied by an increase in angiogenesis. Of the teeth extracted after 2 weeks, most showed small islands of dentin-like tissue at different stages of mineralization. Of the teeth extracted after 6 months, several different histological pictures were viewed. Most of the teeth showed coalescing islands of dentin-like tissue trying to bridge the full width of the coronal pulp at the interface between the wounded and unharmed pulp tissue below the amputation site. CONCLUSION: Based on these experiments, Emdogain gel shows promising results as a valuable material for use in pulpotomy procedures, especially in the primary dentition.