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First permanent molar: first indicator of dental caries activity in initial mixed dentition.

The objective of the present study was to investigate among children in the initial mixed dentition phase the presence of clinical signs that might eventually function as more sensitive indicators of the development of caries disease, denoted here as caries activity. On this basis, we investigated the relationship between salivary levels of mutans streptococci (MS) and decayed, missing and filled permanent and deciduous tooth surfaces (DMFS and dmfs) using microbiological, clinical and radiographic examinations in 81 schoolchildren aged 7-8 years. Whereas dmfs did not present a positive correlation, DMFS was significantly correlated with salivary MS levels. The first permanent molars of the schoolchildren studied comprised 87.3% of the affected surfaces recorded in the DMFS, suggesting that the development of new lesions was preferentially located on the surfaces of the first permanent molars. These results permit us to conclude that the first permanent molars function as first indicators of dental caries activity in the schoolchildren examined.

Child↗

A review of impacted permanent maxillary cuspids--diagnosis and prevention.

As impacted permanent maxillary cuspids occur in 1-2% of the population, the general dentist should know the signs and symptoms of this condition and the interceptive treatment. Features of buccal or palatal cuspid impaction include lack of canine bulges in the buccal sulcus indicating a lingual eruption path and possible impaction; lack of symmetry between the exfoliation and eruption of cuspids that may indicate palatal or lingual impaction; and abnormal mesiodistal location and angulation of the developing maxillary permanent cuspids on radiographs. Diagnosis of impacted cuspid teeth at age 8-10 years can significantly reduce serious ramifications, including surgical exposure and orthodontic alignment as well as root resorption of the lateral incisors. In specific cases, extraction of the primary maxillary cuspids can prevent impaction of the permanent maxillary cuspids and additional sequelae.

Child↗

Unusual impaction of inverted primary incisor: report of case.

A tooth that fails to erupt into a normal functional position by the time it normally should is considered impacted. Impactions of primary teeth are extremely rare, but when it does occur it usually involves the first and second molar. The purpose of this article is to present a case of a four-year-old patient with an impaction of an inverted primary mandibular incisor. On the basis of the patient's family history, the case might be considered as microform of ectodermal dysplasia.

Child, Preschool↗

Retrospective survey of dental anomalies and pathology detected on maxillary occlusal radiographs in children between 3 and 5 years of age.

PURPOSE: Radiographs play an important role in the diagnosis of anomalies and pathology of the oral structures of young children as well as in the interception and management of developmental problems in the dentition. The occlusal film, commonly indicated in the young child, is a helpful tool in establishing a baseline and in revealing certain region-specific dental concerns in a timely fashion. The purpose of this retrospective study was to perform a comprehensive examination of maxillary occlusal radiographs in a clinical pediatric population and to determine the prevalence of dental anomalies and pathology in the premaxilla in children between 3 and 5 years of age. METHODS: Radiographs of healthy preschool children (236 males and 264 females), who received their initial examination at the University of Texas-Houston Pediatric Dentistry Graduate Clinic during 1997 and 1998, were reviewed independently by two pediatric dentists, using a 2X magnifying lens and a standard dental light box. Interexaminer discrepancies were resolved by consultation and mutual agreement. RESULTS: Ninety-two (18%) showed no evidence of dental caries, restorations, current pathological conditions, or other anomalies. Frequencies of anomalies such as congenitally missing and supernumerary teeth were consistent with other reports. CONCLUSIONS: These observations emphasize the importance of obtaining intraoral radiographs on preschool children who are in apparent good dental health.

Anodontia↗

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.

Child, Preschool↗

Lower incisor and second molar extraction in Class III treatment.

Although not fully accepted as routine orthodontic therapy, second molar and lower incisor extraction is well documented in the literature. The following cases show how both procedures can be used successfully to simplify the treatment of Class III malocclusion, while preserving the facial profile.

Adult↗

Epidemiology of dental pain and dental caries among children and adolescents.

OBJECTIVE: The aim was to critically evaluate published epidemiological studies of dental pain among children and adolescents, primarily to answer the question 'Does the probability of dental pain increase as the population level of dental caries increases?'. METHOD: The MEDLINE database was searched electronically for epidemiological studies of dental pain and caries, and supplemented with hand searching of bibliographies. Ecological associations were evaluated visually, by plotting published caries levels and dental pain prevalence, and quantitatively, by computing correlation coefficients between community-level caries experience (dmft and DMFT) and prevalence of toothache in those communities. RESULTS: Most studies enumerated dental pain by asking parents whether their child had ever experienced toothache, with reported prevalence ranging from 5 to 33% among countries. Lifetime prevalence was greater among older children and among children from lower socio-economic groups. Ecological analysis of published data revealed moderate to strong correlations (Spearman's coefficient 0.53 to 0.83) between caries experience and prevalence of toothache. Correlations were stronger (0.86 to 0.95) among lower social classes, consistent with a 5 to 6% increase in probability of toothache for each additional deciduous tooth with caries experience. The direction and magnitude of these ecological associations was similar to person-level correlations. CONCLUSION: Dental pain is highly prevalent among children, even in contemporary populations with historically low levels of caries experience. Dental pain is consistently associated with population levels of caries experience, the association being most apparent in lower socioeconomic groups with reduced access to care.

Adolescent↗

True oligodontia with microdontia in monozygous twins: implications for reappraisal of Butler's Field Theory.

Oligodontia, which may be defined as the congenital absence of six or more teeth apart from third molars, affects less than 0.5% of the population and may occur in isolation or as part of a syndrome. This paper aims to clarify the role of genetic factors in this condition by reporting a case of a pair of identical twins and their mother who display similar patterns of oligodontia without medical problems. Each twin has 13 missing permanent teeth and their mother 16 missing teeth, but the patterns of agenesis do not conform with Butler's Field Theory according to which the distal teeth in each class are most likely to be absent. Unerupted third molars are present in both twins and all three family members display maxillary lateral incisors. Dental crown size profile patterns were computed for all three individuals and highlight a marked reduction in mesiodistal and buccolingual dimensions of the remaining teeth in each. In addition, erupted teeth showed simplified crown morphology. Oligodontia should not be viewed in isolation, but rather considered as one manifestation of a variety of dental changes in genetically susceptible individuals.

Adult↗

Comparison of three nonradiographic methods of mixed dentition analysis in cleft lip and palate patients.

PURPOSE: The purpose of this study was to investigate whether the application of mixed dentition analyses in cleft lip and palate patients differed from noncleft patients and to investigate which method provided the most accurate prediction in cleft lip and palate patients. METHODS: Study casts of 30 cleft lip and palate patients and 30 noncleft patients were used in this study. Each patient had dental casts at two stages of dental development. The methods compared included the Moyers, the Tanaka & Johnston (T/J) and the Boston University (BU) prediction methods. RESULTS: Analyses for both groups indicated that the predicted values yielded by each method were significantly different from one another but were all significantly correlated with actual tooth size. Moyers 50% and BU had the smallest mean difference values and no significant difference between the predicted and actual values for both cleft and noncleft control groups. CONCLUSIONS: Types of cleft had no effect on the size of the mandibular permanent canines and premolars. The application of mixed dentition analyses in cleft lip and palate patients does not differ from noncleft patients. Both Moyers 50% and the BU method have high accuracy and correlation in prediction of unerupted teeth in both groups.

Age Factors↗

[Impacted maxillary cuspid. III. Orthodontic aspects].

Delayed eruption of impacted canines in more or less guaranteed by using the modified window technique. A decision for futher treatment can be made afterwards. If orthodontic treatment is required, fixed appliance is recommended for uneventful orthodontic positioning of these teeth.

Cuspid↗

Bilateral talon cusps in primary teeth: clinical significance and treatment.

Bilateral primary talon cusps are uncommon. This case report documents two new cases of bilateral talon cusps in the primary dentition. The clinical features, radiographic characteristics, and differential diagnosis of this developmental anomaly are described. The terminology, epidemiological data, potential complications, and various modes of treatment are reviewed and discussed. A new classification system was proposed. The dental anomalies of these two cases were not associated with any other somatic or dental abnormality. The general prognosis of this abnormality is satisfactorily good. However, the dentist needs to have early recognition of this anomaly in order to provide timely treatment in order to prevent potential complications.

Child, Preschool↗

[Double teeth].

Double teeth are not really rare, but it is still enigmatic why and how they develop. Based upon the clinical, morphological and anatomical appearance and the number of teeth in mouths with double teeth, the double teeth are labelled as products of 'fusion' and 'clefting', but the criteria to attach such etiological names are lacking. It is assumed that heredity is involved in the development of double teeth. Therefore it is attempted to explain why only one of a homozygotic twin had a double tooth.

Child, Preschool↗

Primary incisor triplication defect.

Conjoining abnormalities occur in less than 1 percent of the population. Triplication of primary teeth is even a rarer phenomenon with a prevalence of 0.02 percent. This study describes the clinical features and the light microscopic appearance of a case of triplicated primary teeth. The teeth with the conjoined defect were examined by light microscopy to evaluate the exact level and appearance of the fusion area. The light microscopic examination revealed grooves and cracks consisting of enamel and dentine in the fusion area, fusion was irregular and both dentin and cementum were confluent. It is concluded that the clinician should identify children were conjoined anomalies and should be aware of the oncoming problems.

Anodontia↗

Case report: restorative options in regional odontodysplasia.

A case of regional odontodysplasia in a 13 year old female is reported. The restorative options in this case are considered along with the rational for providing a dentine bonded all-porcelain bridge. This approach restored both function and aesthetics with minimum destruction to the hypoplastic tooth tissue of the abutment.

Adolescent↗

[Secondary retention of permanent molars. I. Clinical, radiologic and histologic characterization].

The clinical, radiographical and histological aspects of secondary retention in permanent molars were studied in a group of 53 patients with 81 secondarily retained permanent molars. First molars turned out to be affected most frequently. The mean infraocclusion at the patients' first visit was 4.3 mm. After six months, infraocclusion had increased in adolescents. It seemed to be stable in adults. Tilting of adjacent teeth was observed in 39 cases of secondary retention. A solid, clear percussion sound and a partial absence of the periodontal ligament space on radiographs was only noted in less than 20% of the affected molars, while histological examination of 38 removed molars revealed that local areas of ankylosis were present in all cases. During a follow-up period of four years, six new cases of secondary retention were observed in the same population.

Adolescent↗