Changes in Oral-Health-Related Quality of Life of Egyptian Children Treated under Dental General Anesthesia: A Prospective Study.

BACKGROUND: Treatment of young children under dental general anesthesia (DGA) is sometimes necessary due to lack of cooperation and the complexity of dental treatment. The aim of this study was to assess the changes in oral-health-related quality of life (OHRQoL) in children following treatment under DGA. METHODS: A consecutive sample of 88 children aged 5 and younger who were referred to the department of pediatric dentistry, Cairo university, Egypt, for treatment under DGA was included. Parents were asked to complete the Arabic version of the Early Childhood Oral Health Impact Scale (A-ECOHIS) questionnaire before and 4 weeks after treatment. The Wilcoxon signed-rank test was used to compare baseline and follow up scores. Effect sizes (ES) were also calculated. RESULTS: The overall ECOHIS scores decreased significantly from 16.72 (±7.07) to 0.9 (±3.08); (p < 0.001, Wilcoxon signed-rank test) after treatment under DGA, demonstrating a large effect size of 2.2. The scores of the two subscales of the ECOHIS, the child impact scale (CIS) and the family impact scale (FIS), also decreased significantly (p < 0.001). CONCLUSIONS: Treatment under DGA not only improved the OHRQoL of the Egyptian children in our sample significantly, but also had a positive effect on their families' quality of life.

Effects of different splinting times on surgically extruded teeth with a crown-root fracture: A randomized controlled trial.

BACKGROUND/AIM: Clinical studies evaluating the splinting time for surgically extruded teeth with crown-root fractures are lacking. The aim of this study was to compare 2-week splinting versus functional splinting times after surgical extrusion. MATERIAL AND METHODS: Children aged 8-13 years who presented with crown-root fractures were included. Surgical extrusion was performed, and teeth were splinted either for 2 weeks or until normal Periotest values were achieved (functional splinting time). The outcome measures were tooth mobility, tooth loss, root resorption, marginal bone resorption and ankylosis. Measurements were taken at baseline, weekly after splint removal, and after 1, 3, 6 and 12 months. RESULTS: Nineteen patients were included in the analysis. Surgically extruded teeth splinted for 2 weeks showed significantly higher mobility directly after splint removal and at 1 month after splinting compared with the functional splinting time group. The mean differences for horizontal Periotest values were 14.96 (95% confidence interval: 8.52, 21.39) and 6.63 (95% confidence interval: 0.25, 13), respectively. The vertical Periotest values were 10.47 (95% confidence interval: 1.95, 18.99) and 4.81 (95% confidence interval: -1.57, 11.18), respectively. At the 3-, 6- and 12-month follow-up intervals, there were no statistically significant differences between the groups. One tooth in the 2-week splinting group was lost. None of the teeth had ankylosis, marginal bone resorption or root resorption. CONCLUSIONS: Although both groups showed neither statistical nor clinically significant differences after 12 months, there was a significant difference immediately after splint removal, with greater tooth mobility in the 2-week splinting group. Thus, a functional splinting time (4-6 weeks) can be suggested for better healing and optimal stability to allow placement of the final restoration directly after splint removal.

Clinical and radiographic evaluation of indirect pulp treatment of young permanent molars using photo-activated oral disinfection versus calcium hydroxide: a randomized controlled pilot trial.

BACKGROUND: Calcium hydroxide is the most commonly used material in indirect pulp treatment (IPT). However, its drawbacks required its replacement by other materials. AIM: This study aims to estimate clinically and radiographically the success of indirect pulp treatment of young permanent molars with either photo-activated oral disinfection (PAD) or calcium hydroxide. DESIGN: This Randomized Controlled Pilot Trial included 32 vital first permanent molars with deep caries that were treated by indirect pulp treatment with either PAD (group 1) or calcium hydroxide (group 2). Clinical and radiographic success in addition to newly-formed dentin thickness were evaluated regularly at 2, 6, 9, and 12 months. RESULTS: The success for both groups was 100% clinically and radiographically at all follow-up periods. Regarding the mean thickness of newly-formed dentin for both groups at different follow-up periods, there was no statistically significant difference between both groups at 2, 6, 9, and 12 months, with P values = 0.825, 0.146, 0.280, and 0.400, respectively. CONCLUSIONS: The clinical and radiographic success for indirect pulp treatment of young permanent molars with both PAD and calcium hydroxide were comparable.

Influence of luting cement on the clinical outcomes of Zirconia pediatric crowns: A 3-year split-mouth randomized controlled trial.

BACKGROUND: There is no scientific evidence supporting the choice of luting cement for cementation of zirconia crowns. AIM: The purpose of this split-mouth study was to compare the efficacy of using bioactive cement versus packable glass ionomer for cementation of posterior pediatric zirconia crowns. DESIGN: Fifty first mandibular primary molars were restored by zirconia crowns and were randomly divided to be luted with either (a) bioactive cement or (b) packable glass ionomer. Crowns' retention, fracture, and gingival condition were evaluated at 1 week, and 1-, 3-, 6-, 9-, 12-, 18-, 24-, and 36-month intervals. Statistical analysis was carried out using Fisher's exact test, Kaplan-Meier survival analysis, and Wilcoxon signed rank test. RESULTS: At 3- to 36-month follow-ups, there were statistically significant (P = .009-≤.001) less debonded crowns in packable glass ionomer group. There were no fractured crowns for either cements. There was no statistically significant difference between gingival index scores. CONCLUSIONS: Packable glass ionomer is more retentive than bioactive cement when used for cementing zirconia pediatric crowns. Posterior zirconia pediatric crowns have high fracture resistance after 36 months of clinical performance, irrespective of luting cement. Luting cement for zirconia pediatric crowns has no apparent effect on gingival condition around crowns.

Case Report: Single visit photo-activated disinfection in regenerative endodontics.

Background: Root canal disinfection is considered critical for achieving successful regenerative endodontic procedures. Photo-activated oral disinfection is a novel disinfection method that can help to achieve the goal of regenerative endodontics. This article reports the clinical and radiographic results after single visit regenerative endodontics using photo-activated oral disinfection. Methods: An 8.5-year-old girl complained of fractured upper right central incisor. Pulp necrosis was diagnosed on the basis of clinical findings. The root canal was irrigated with sodium hypochlorite solution (1.5%) followed by saline. Then, the canal was dried with paper points. A combination of a photosensitizer solution and low power laser light were applied. EDTA solution was used as a final irrigant. Bleeding was induced, followed by placement of collagen resorbable matrix and white mineral trioxide aggregate. Two days later, the tooth was sealed and restored with permanent filling. Results: Clinical findings revealed no pain on percussion or palpation tests. Radiographic examination revealed an increase in root length, an increase of apical root thickness and apical closure at the 12-month follow-up period. Conclusion: Regenerative endodontics using photo-activated oral disinfection achieved successful outcomes in the necrotic immature permanent tooth.

Case Report: Root resorption caused after pulp death of adjacent primary molar.

Necrotic decayed primary molars with necrotic pulp tissues may show periapical involvement and root resorption. In this case report, a pediatric patient with a very common chief complain and clinical picture of necrotic badly decayed molar, introduced a very interesting case when radiographic investigation was performed, which showed that root resorption of the adjacent healthy molar occurred. The current report is, to the best of our knowledge, the first to report such finding in primary dentition.