Retrospective record review: reinforced zinc oxide-eugenol pulpotomy: a retrospective study.

PURPOSE: The purpose of this retrospective study was to evaluate pulpotomies completed without the use of a fixative, preservative, or astringent agent prior to placement of a reinforced zinc oxide-eugenol (ZOE) sub-base in the pulp chamber and subsequent restoration. METHODS: Clinical and radiographic data were collected from a private pediatric dental office in Toronto, Ontario, Canada. The pulpotomy technique used involved: amputation of coronal pulp; radicular hemostasis via pressure with dry cotton pellet; placement of ZOE into the pulp chamber; and restoration with stainless steel crown or amalgam. RESULTS: One-hundred-ninety primary molars in 116 children (follow-up=6-94 months; mean=35.8 months) met the inclusion criteria. The radiographic, clinical, and overall success rates were approximately 95%, 97%, and 94%, respectively. The most frequently observed pathologic pulpal response was furcation radiolucency (N=7, ∼4%). The patient's age at time of pulpotomy, restoration type, tooth type, arch, and location of treatment (in-office vs general anesthesia) were not statistically significant factors influencing the success of the reinforced ZOE pulpotomy technique. CONCLUSION: The success rates indicate that the reinforced zinc oxide-eugenol pulpotomy technique may be an acceptable treatment modality for primary molars requiring vital pulp therapy.

Factors influencing candidates' choice of a pediatric dental residency program.

The goal of this study was to identify the factors and program characteristics that influenced the program ranking decisions of applicants to pediatric dentistry residency programs. A questionnaire was sent to the first-year resident class in 2005 with a response rate of 69.2 percent (n=260). Approximately 55 percent were female (104/180) and 61 percent were non-His-panic white (110/180). The respondents reported that they applied to an average of nine programs, of which five were ranked. Most applicants were interested in a program that had a hospital component with a duration of two years. A program's ability to prepare the resident for an academic career was a minimal influence for 48.6 percent (87/179), and 57.5 percent (103/179) were not interested in a master's or Ph.D. degree. Factors associated with program ranking included modern clinical facilities, high ratio of dental assistants and faculty to residents, availability of assistants for sedation and general anesthesia cases, availability of a salary or stipend, and amount of clinical experience. Important non-clinical factors included hospitality during the interview, geographic location, and perceived reputation of the program. Opportunity to speak with the current residents in private, observing the interaction between residents and faculty, and touring the facilities were also highly considered. These findings may help program directors tailor their interviews and programs to suit the needs of applicants.

Does oral health affect self perceptions, parental ratings and video-based assessments of children's smiles?

OBJECTIVES: To explore whether there is a relationship between children's objectively determined oral health status and their oral health-related quality of life, specifically the evaluations of their smiles as assessed by the children, their parents, and through measurements of the children's videotaped smiles. METHODS: Chart review data were collected from 99 children (56 boys, 43 girls; average age: 7.06 years; range: 4-12 years) to determine their oral health status. The children responded to the Michigan Oral Health-Related Quality of Life Scale - Child Version (MOHRQOL-C), and the parents responded to the Michigan Oral Health-Related Quality of Life Scale - Parent Version (MOHRQOL-P) to assess the smiling-related aspect of the children's oral health-related quality of life. Parents also responded to questions concerning their own evaluations of their child's smile. The children were videotaped while they watched a funny cartoon. Two independent raters measured the width and openness of the children's mouth plus the number of teeth shown at 25 predetermined time points during these taped sessions to assess the children's video-based smiling patterns. RESULTS: The children's self evaluated smile scores correlated with the video-based ratings of the children's smiles, and with the number of positive adjectives parents chose to describe their children's smiles. There were significant relationships between several indicators of oral health status and all smile assessment scores. Children without caries evaluated their own smiles more positively, showed more teeth when smiling, and received more positive parent evaluations for their smiles than children with decay. CONCLUSION: Poor oral health is significantly related to children's smiling patterns and the way others perceived their smiles. Poor oral health may prevent children from expressing positive emotions, which can impact their social interactions and the way they feel about themselves.

A preventive approach to oral self-mutilation in Lesch-Nyhan syndrome: a case report.

Lesch-Nyhan syndrome is a rare X-linked recessive disorder of purine metabolism, caused by complete absence of the enzyme hypoxanthine-guanine phosphoribosyl transferase. Persons affected with this incurable disease are developmentally and physically delayed, and suffer from self-injurious behavior. The most typical feature results in partial or total destruction of perioral tissues. The purpose of this paper was to discuss a case of Lesch-Nyhan syndrome with self-mutilative behavior and lip injuries, including some suggestions of a preventive approach avoiding the extraction of teeth. A soft mouthguard fabricated to prevent the destruction of perioral soft tissues and combined psychiatric pharmacologic therapy proved to have satisfactory results.