Treatment of cariously involved fused maxillary primary lateral and central incisors.

A 3-and-a-half-year-old male child presented with fused cariously involved right maxillary primary central and lateral incisors as well as a previously traumatized non-vital left primary central incisor with a draining fistula. The child also had other restorative needs and the decision taken was to address all needs under a G.A. With respect to the fused incisors, these were split and root canals treatment was performed for all three incisors which were then restored with stainless steel crowns with esthetic facings.

Intrusion injuries of primary incisors. Part I: Review and management.

Intrusion injuries commonly occur in the primary dentition. They can be described as luxation injuries resulting from an axially directed impact, which drives the tooth deeper into the alveolar socket. The impact results in compression of and damage to the periodontal ligament as well as injury to the pulp of the intruded incisor. In addition to rendering treatment to the intruded primary tooth, the dentist must also be aware of the possibility of an injury to the developing permanent teeth germs located in close proximity to the roots of the injured primary teeth. This review will discuss the characteristics, implications, and management of intrusion injuries of primary incisors.

Intrusion injuries of primary incisors. Part II: Sequelae affecting the intruded primary incisors.

Luxation injuries to incisors, including intrusive displacement, occur with a high frequency in the primary dentition. Intrusion injuries are associated with damage to the pulpal and periodontal structures and possible fracture of the alveolar bone. The pulpal tissue of the intruded tooth sustains a severe shock during displacement, which may be reflected later by sequelae ranging from mild discoloration to pulpal necrosis and infection. Disintegration of pulpal tissue may result in periapical tissue inflammation, which in turn may induce developmental disturbances in the germ of the permanent successor tooth. Additionally, severe injury to the periodontal ligament during intrusion may lead to ankylosis of the primary incisor and consequently to delayed or ectopic eruption of its permanent successor. This article will review the possible sequelae affecting primary incisors following their intrusion.

Intrusion injuries of primary incisors. Part III: Effects on the permanent successors.

Intrusion injuries of the primary dentition are highly associated with developmental disturbances of their successor teeth. The age of the child at the time of injury, the direction and severity of the intrusion, and the presence of alveolar bone fracture are important variables influencing the effect of primary tooth intrusion on the developing permanent germ. The developmental defects of the permanent successor tooth range from mild alteration in enamel mineralization to severe sequestration of the developing germ. This article will review the developmental anomalies of the permanent incisors induced by intrusion injuries of their predecessors.

Interobserver variability in pediatric radiographic quality assessment.

Programs to monitor radiographic quality have been established in several Canadian provinces. These quality assurance programs depend in part on the evaluation of technical radiographic errors. Interobserver variability in the assessment of these errors reduces the reliability of such information. This study examined the interobserver variability of three dental specialists involved in documenting radiographic technical errors, and the need for retakes following the initial radiographic surveys of 200 children. Observers were trained and calibrated to standardize the evaluation of errors. The overall frequency at which errors were found in bitewing radiographs was consistent with the results of previous studies, but the number of periapical and panoramic technical errors was low. Interobserver variability occurred in the recording of radiographic technical errors, primarily in the recording of bitewing errors. There was also interobserver variability in the ordering of retakes. The interobserver variability in the assessment of radiographic quality could not be eliminated, despite prior observer training. This could indicate that the decision to retake a radiograph may be based on subjective criteria, especially in the absence of clinical information.

Interobserver variability in radiographic interpretation of pediatric dental diseases: a pilot study.

Interobserver variability in radiographic interpretation of dental disease may be a result of clinical bias, education, training, experience or other factors, and may potentially lead to misdiagnosis of disease. Few studies have investigated variability related to dental specialty. The purpose of this pilot study was to determine interob-server variability in radiographic interpretation of pediatric dental diseases using a small number of observers, consisting of a pedodontist, an orthodontist and an oral radiologist. These specialists interpreted initial radiographic surveys of 200 pediatric patients (4.5 to 15.5 years old). The results showed no differences in interpretations of radiographic signs of dental abnormalities except for caries, abnormal primary root resorption due to the eruptive path of a permanent tooth and presence of a congenital/developmental tooth abnormality. These findings will be used to design future studies which will include a larger number of observers from different dental specialties.

Maxillary protraction for early orthopedic correction of skeletal Class III malocclusion.

The clinical use of combined maxillary expansion and protraction headgear is reviewed. The diagnostic considerations necessary for appropriate case selection are discussed. A description of appliance technique is provided in sufficient detail to familiarize the pediatric dentist with the associated clinical procedures.

Effect of different adhesive systems on microleakage at the amalgam/composite resin interface.

The objective of this study was to evaluate the effect of different bonding systems on teh microleakage at the amalgam/composite interface. The microleakage at the amalgam/composite resin interface was evaluated with a quantitative dye penetration method. Amalgam cylinders were made and a 2 mm composite base was added after the application of five different bonding systems to the roughened interface of the amalgam cylinders. The cylinders were filled with an exact volume of 0.05% fuchsin solution, and the total weight of the sample was measured. The cylinders were placed on a filter paper with the composite base down and evaluated for leakage after 1, 3, 6, and 24 hours. Weight loss and coloring of the filter paper represented microleakage. The results indicated that the application of Prisma Universal Bond 2 adhesive, Cover Up II, or Amalgambond (groups E, F, and G) reduced the amount of microleakage significantly as compared to the groups in which no adhesive system, 3M Porcelain Repair Kit (with and without acid etching of the amalgam surface), or Prisma Universal Bond 2 primer and adhesive (groups A, B, C or D) was applied.

The influence of an adhesive system on shear bond strength of repaired high-copper amalgams.

The shear bond strengths of intact high-copper spherical and admixed amalgams were compared with repaired high-copper spherical and admixed amalgam specimens with and without the use of an adhesive system (Amalgambond). In the spherical group the shear bond strength of the repaired specimens was found to be 55 and 53.2% of the intact specimens without and with the use of the adhesive system. After thermocycling those percentages were 48.5 and 43. In the admixed groups those percentages were 39, 36.5, 34.5, and 35.2 respectively. It was found that the application of Amalgambond did not significantly increase the strength of the repaired amalgam. Thermocycling only had a significantly adverse effect on the repair strength in the admixed group repaired without an adhesive system.

A survey of Canadian pediatric dentists: practice characteristics and views on dental education.

The success of caries prevention in the developed countries has resulted in a marked decline in dental disease, especially in pediatric divisions of dental faculties, where an acute problem is finding patients to provide students with the clinical experience they will require in practice. It has become apparent that this changing disease pattern should be accompanied by a re-thinking of educational strategies and objectives to mirror the times and projected trends. While changes in educational strategies will likely be initiated from within the dental faculties, debate and discussion should include those in private practice as well as the academic field. With this in mind, 85 pediatric dentists nation-wide were surveyed regarding their views on educational matters as well as characteristics of their practice and their general profiles. There was widespread agreement on the need for changes in educational strategies and suggestions were made regarding the directions these changes should take.