Biomedical subjects
Publications and source records attributed to S A Fayle.
Space maintainers have been in use in pediatric dentistry for many years. The use of these appliances, however, in terms of indications, contraindications, design, and construction, has gained little attention from researchers. It is clearly essential that when space maintainers are fitted, it is the result of careful planning and appropriate prescriptions.
PURPOSE: This study compares the accuracy of space prediction for the unerupted permanent canines and premolars by a recognized method of mixed dentition space analysis (Moyers technique) vs estimation by simple visual observation (SVO). METHODS: Twenty clinicians with varying levels of dental experience and training blindly assessed study models of 4 intact arches (2 maxillary and 2 mandibular) from 3 patients in the mixed dentition using both Moyers and SVO space prediction methods. Corresponding full-mouth panoramic radiographs were available for each case. Follow-up records of the eventual outcome in the permanent dentition for each case available (ie, study models prior to any form of orthodontic intervention) served as the standard for further comparison of the space predictions made. Predictions by both methods were compared with each other as well as with the eventual space situation in the permanent dentition. RESULTS: The differences in overall mean space prediction between the Moyers technique (excluding molar shift) and SVO ranged between 3.67 mm to 6.9 mm (lower arches) and 4.3 mm to 4.8 mm (upper arches). Diagnostic consistency between both methods' predictions was highly variable, with correlation ranging from moderate (r = 0.53, P = .01) to very weak (r = -0.1). Generally, more crowding was estimated with the SVO method's predictions. However, the inclusion of molar shift in the Moyers analysis resulted in the prediction of more crowding in the mandible compared to SVO and eventual outcome in the permanent dentition. The range and variability in predictions were always smaller with the Moyers technique compared to SVO. Neither technique's mean space prediction more closely resembled the eventual space situation in the permanent dentition. CONCLUSIONS: This study demonstrated that although the Moyers technique demonstrated less variation and more reproducibility than SVO in its space predictions, neither of the techniques was any more accurate in predicting the final space outcome in the permanent dentition.
This study investigated the oral problems occurring in children receiving treatment for malignant disease at a regional oncology center. Forty-three children 2 to 14 years old were followed longitudinally from initial diagnosis for periods ranging from eight to 30 weeks for the development of oral and dental problems. Fifteen children had untreated decay; two required the removal of primary teeth before they began chemotherapy. Three children developed acute dental infections during treatment. Forty (93%) developed oral problems associated with their disease or treatment during the study period. Oral mucosal ulceration was the most frequently encountered problem; it was observed in 28 (65%) patients. In light of the high prevalence of dental and oral problems in these patients, this study emphasizes the need for positive dental involvement, both in pretreatment assessment and in the ongoing care of the pediatric oncology patient.
METHODS: This retrospective study investigated the longevity of 301 space maintainers fitted in 141 patients aged 3.4-22.1 years in the Department of Pediatric Dentistry at Leeds Dental Institute between 1991 and 1995. RESULTS: Failure occurred in 190 space maintainers (63%), of which 36% were due to cement loss, 24% breakage, 10% design problems, and 9% were lost. Using the life table method, the median survival time (MST) for space maintainers was found to be 7 months. Band and loop (B&L) appliances had the highest MST of 13 months, while the lower lingual holding arch (LLHA) had the lowest of 4 months. Unilateral space maintainers survived longer than bilateral space maintainers (MST of 13 months vs. 5 months). Left B&Ls had a MST of 16 months, compared to only 4 months for right B&Ls, Gender, age, arch in which the appliance was placed, the operator planning it, fixed vs. removable, and adequacy of pretreatment assessment did not have a significant effect on survival time.