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Prediction of behavior management problems in children.

The aim of the present investigation was to study non-dental and dental background variables with a view to estimating their influence on behavior management problems by means of a structured interview and analyzing their separate and combined predictive power. The material consisted of a case group, 101 children aged 3-16 yr, referred for management problems to clinics of specialized pedodontics, and a control group, individually matched with the cases as regards age, sex, residential area, number of tooth surfaces restored, and dentist. The children or their parents were interviewed concerning background variables. Logistic regression was used for the analyses. Three non-dental variables turned out to be statistically significant as predictors (P less than 0.05): problems on visiting a medical doctor, dental fear in the mother or father, and anxiety when meeting unfamiliar people. Management problems might be expected if one of these attributes is found. Four dental variables had significant predictive power: earlier problems on seeing a dentist, dislike of the dentist, not enough time to adjust to the dental situation, and fear of injection. However, none of these dental variables was found to have predictive power in 3-6-yr-olds, and none of them improved the predictive power of the three main non-dental variables.

Adolescent↗

Diagnosis of dentin involvement in occlusal caries based on visual and radiographic examination of the teeth.

The purpose of the present study was to examine the validity of visual, radiographic and combined visual-radiographic examination of occlusal caries, with special reference to the diagnosis of dentin lesions, using the microscopic diagnosis after sectioning the teeth as validating criterion. Thirty extracted permanent molar teeth with signs of occlusal caries were selected and radiographed using a standard method similar to bitewing. Ten dentists, five from the Department of Cariology and Endodontics and five from the Department of Pedodontics, were asked to make a visual, radiographic and combined visual-radiographic caries examination with an interval of at least 1 month between different examinations. The teeth were sectioned bucco-lingually and the caries assessed as enamel or dentin lesion in a stereomicroscope. The sensitivity/specificity of the diagnoses of dentin lesions was 0.72/0.41 for the visual, 0.66/0.50 for the radiographic, and 0.86/0.64 for the combined visual-radiographic examinations. The Receiver Operating Characteristic (ROC) method revealed a statistically significant difference between combined visual-radiographic examination and the two other, but not between the isolated visual or radiographic examination. It is concluded that the combined use of visual and radiographic examination is better than either visual or radiographic examination alone.

Dental Caries↗

Rapid orthodontic extrusion of crown root and cervical root fractured teeth.

This study concerns the relapse tendency and extent of root resorption in 33 extruded non-vital crown root fractured or cervical root fractured teeth in 32 patients 10-20 years old. They constitute all orthodontically extruded teeth at the Orthodontic or Pedodontic Departments, Eastman Institutet, Stockholm (1982-1987). A simple extrusion mechanism exerted a force of 60-70 p along the root axis of the tooth. An extrusion of 2-3 mm was obtained in most patients; the most extreme effect was 6 mm. In 16 patients the extrusion was achieved within 3 weeks, in 12 it lasted for 4-6 weeks and in 5, 7-9 weeks. The treatment was more complicated in the lower jaw. After the extrusion, a fibrotomy was done and in most patients also a gingival recontouring to create an optimal relation between the gingiva and the margin of the restoration. Periodically identical radiographs were taken immediately before and after the extrusion, after 3 months and after 1 year. A minor relapse, about 0.5 mm, was observed in 3 patients. Limited root resorption was found in 6 teeth and severe in only 1. The resorptions did not progress in the following 2 years of observation.

Adolescent↗

Traumatic injuries of the permanent incisors in children in southern Turkey: a retrospective study.

The aim of this study is to investigate the incidence, etiologic factors and results of dental trauma and the effects of age and gender on the trauma in permanent incisors. Over a 3-year period, 514 permanent incisor teeth in 317 patients with trauma history, who applied to Suleyman Demirel University School of Dentistry, Department of Pedodontics from the southern cities of Turkey, were evaluated. Standardized trauma forms were filled for each patient. In all age groups, the most frequent cause of trauma was found to be unspecified falls (47.6%). Maxillary teeth (88.5%) and central incisors (87.5%) were the most affected teeth from dental trauma. Ellis class II crown fracture was the most frequently seen type of injury (43.8%). The percent of the patients who applied to a dental clinic in the first 3 days after the trauma occurred (22.8%) was less than the percent of the patients who applied after 3 months and more time period (45.1%). It reveals that it is important to inform the public about dental trauma and the importance of time in these cases.

Accidental Falls↗

Diagnostic and preventive services in a national incremental dental plan for children.

A modelling exercise was carried out to examine the potential expenditure in a national incremental dental program for children aged six to 13. Using Relative Value Units (RVUs) as a proxy for dollars, the relative expenditures for care per child in fluoridated and fluoride-deficient areas were assessed. Dental treatment requirements were taken from existing data as far as possible. Arrangements for the delivery of care were based on existing pocicies of the American Dental Association, an services delivered were based on the recommendations of the American Academy of Pedodontics and the American Society of Dentistry for Children. Orthodontic care was limited to space maintainers and simple interceptive care. Children were assumed to receive initial care at age six, and annual maintenance care from ages seven to 13. The results showed that although restorative care would be 49.8 percent less expensive for children in fluoridated areas, total care would be only 11.9 percent less expensive. The major reason for this difference was the high proportion of annual maintenance-care costs that would be absorbed by diagnostic and preventive services using UCR fees. The necessity for much of this care is questioned under the conditions of this model, and some methods by which the dental profession might control the relatively high cost of diagnostic-preventive services are suggested.

Adolescent↗

Dental sealant usage in Virginia.

This trend study reports the results of a survey designed to determine usage of dental sealants in Virginia. A total of 2,434 general dentists, dental hygienists, and pedodontists were sent questionnaires regarding usage, technics, products, educational experience, and public interest in dental sealants. Increases in the provision of sealant coverage and in public interest for this preventive measure were noted. Approximately three-fourths of general dentists and dental hygienists working in a general or pedodontic practice are offering sealants to their patients. Pedodontists are the largest group of providers, with nearly 100 percent of pedodontists applying sealants. Recent graduates are applying sealants more often than earlier graduates. Preference for Delton clear color, light-cured material was shown. In general, a lack of professional knowledge about sealants continues to exist. Professional organizations and academic institutions may want to plan additional continuing education offerings for practitioners and to consider increased dental education instruction for students.

Dental Caries↗

Measuring parental perceptions of child oral health-related quality of life.

OBJECTIVES: The aim of this study was to develop and evaluate the P-CPQ, a measure of parental/caregiver perceptions of the oral health-related quality of life of children. This forms one component of the Child Oral Health Quality of Life Questionnaire (COHQOL). METHODS: An item pool was developed through a review of existing child health questionnaires and interviews with parents/caregivers of children with pedodontic, orthodontic, and orofacial conditions. The resulting 47 items were used in a study in which 208 parents/caregivers provided data on their frequency and importance. The 31 items rated the most frequent and important were selected for the final questionnaire (P-CPQ). The P-CPQ validity and reliability were assessed by a new sample of 231 parents, 79 of whom completed two copies for the assessment of test-retest reliability. RESULTS: The P-CPQ discriminated among the three clinical groups included in the expected direction. Within-group analyses using clinical data provided some evidence that scores were associated with the severity of the condition. The P-CPQ also showed good construct validity. It had excellent internal consistency reliability with a Cronbach's alpha of 0.94 and demonstrated perfect test-retest reliability (ICC=0.85). CONCLUSION: The study provides data to indicate that the P-CPQ is valid and reliable.

Adolescent↗

Use of filmed modeling to reduce uncooperative behavior of children during dental treatment.

Sixteen inner city children attending a pedodontic clinic were shown either a filmed demonstration of a child model cooperatively undergoing dental treatment or a film unrelated to dental activity. The group viewing the modeling film showed significantly fewer disruptive behaviors during restorative care and were rated as less fearful than the control group.

Anxiety↗

A further assessment of predictors of the child's behavior in dental treatment.

The child's disruptiveness during dental treatment was related modestly to his age as well as his state, trait, and dental anxiety. In three samples comprising 132 experienced and 49 inexperienced pedodontic patients, the child's behavior during treatment could not be predicted from any aspect of maternal anxiety -- trait, state, or dental. Previous conceptions of maternal influence on the child's dental anxiety should be re-evaluated.

Anxiety↗

Sex- and age-related differences in primary and secondary dentin formation.

Clinical studies carried out on dentin thickness in adults, as well as experimental studies carried out on ovariectomized animals, indicate that odontoblast activity, like that of osteoblastic cells, differs in the two sexes. To examine the evidence for differences in odontoblast activity before puberty, we have measured dentin thickness and other crown dimensions from bitewing radiographs of the lower first molars in 240 children aged 4-16 years. The radiographs were obtained from pedodontic clinics throughout Israel. Only teeth without caries or fillings were used, and the study population had minimal attrition. The results showed that dentin thickness, measured on the roof of the pulp chamber, was significantly greater in boys than in girls at all ages, and that the differences increased during puberty. The differences remained highly significant even when standardized for crown size. They demonstrate that dimorphism in dentin thickness is present even in the earliest stages of odontogenesis and increase with puberty.

Adolescent↗

Casting alloys: side-effects.

Side-effects from dental materials are a minor problem, but should be recognized. In recent questionnaire surveys about side-effects, the incidence was estimated to be 1:300 in periodontics and 1:2600 in pedodontics. None of these reactions was related to dental casting alloys. In prosthodontics, the incidence was calculated to be about 1:400, and about 27% were related to base-metal alloys for removable partial dentures (cobalt, chromium, nickel) and to noble/gold-based alloys for porcelain-fused-to-metal restorations. The complaints consisted of intra-oral reactions (such as redness, swelling, and pain of the oral mucosa and lips), oral/gingival lichenoid reactions, and a few instances of systemic reactions. In orthodontics, the incidence was 1:100, and most reactions (85%) were related to metal parts of the extra-oral anchorage devices. Even though the extensive use of base-metal alloys has been of major concern to the dental profession, relatively few case reports substantiate this concern. Allergy to gold-based dental restorations has been more commonly reported. Palladium-based alloys have been associated with several cases of stomatitis and oral lichenoid reactions. Palladium allergy seems to occur mainly in patients who are very sensitive to nickel. All casting alloys, except titanium, seem to have a potential for eliciting adverse reactions in individual hypersensitive patients. Tolerance induction may be a possible benefit of the use of intra-orally placed alloys. In non-sensitized individuals, oral antigenic contacts to nickel and chromium may induce tolerance rather than sensitization. A variety of systemic diseases and reactions has been claimed to be caused by dental materials. The claims are generally poorly documented.

Cobalt↗

Validity and reliability of a questionnaire for measuring child oral-health-related quality of life.

Oral-health-related quality of life measures that exist are designed for adults. This study aimed to develop and evaluate the CPQ(11-14), a self-report measure of the impact of oral and oro-facial conditions on 11- to 14-year-old children. An item pool was generated with the use of a literature review and interviews with health professionals, parents, and child patients. The 36 items rated the most frequent and bothersome by 83 children were selected for the CPQ(11-14). Validity testing involved a new sample of 123 children. Test-retest reliability was assessed in a subgroup of these children (n = 65). Mean CPQ(11-14) scores were highest for oro-facial (31.4), lower for orthodontic (24.3), and lowest for pedodontic (23.3) patients. There were significant associations between the CPQ(11-14) score and global ratings of oral health (p < 0.05) and overall well-being (p < 0.01). The Cronbach's alpha and intraclass correlation coefficient for the CPQ(11-14) were 0.91 and 0.90, respectively. These results suggest that the CPQ(11-14) is valid and reliable.

Adolescent↗

Quantitative trait loci on chromosomes 10 and 11 influencing mandible size of SMXA RI mouse strains.

Predicting the mandible size before the termination of growth of the maxillofacial bones is essential in pedodontics as well as for the predictions needed for genetic analysis. Here, Quantitative Trait Locus (QTL) analysis was used to detect the chromosomal regions responsible for the mandible length between the menton and gonion in an SMXA recombinant inbred strain of mice. Around the region 60 cM from the centromere in chromosome 10, the logarithm of the odds score showed a higher than suggestive level. Around the regions 13 cM and 16 cM in chromosome 11, two significant QTLs were detected. Analysis of genotypes from loci corresponding to those QTLs revealed a large mandible when the region between the markers Hba and D11Mit163 and D10Mit70 and D10Mit136 indicated the genotype from the A/J and SM/J alleles, respectively. These results suggest that the major gene(s) responsible for mandible length are located in these regions.

Animals↗

Reduction of fear-related dental management problems with use of filmed modeling.

In this study of the modification of anxiety-related disruptive behavior in dental treatment, matched groups of inner-city children attending a pedodontic clinic were shown a videotaped demonstration of a 4-year-old black child undergoing a dental restorative procedure or were given an unrelated drawing task before dental treatment. Children who viewed the videotape demonstration of a peer model coping with dental procedures showed significantly fewer fear-related disruptive behaviors during restoration of lesions. Observations of children's anxiety levels made by dentists and independent observers validated the effectiveness of viewing the videotaped demonstration. No significant correlation was found between the children's reports of their anxiety and their behavior during dental treatment.

Analysis of Variance↗

[Numerical anomaly of teeth in mongrel juvenile dogs. Canis familiaris].

As this study subjects, upper and lower dentitions of 49 mongrel dogs were used. X-ray films of the upper and lower dentitions of the dogs were taken. These films were from the collection of the Department of Pedodontics, School of Dentistry, Aichi-Gakuin University. Although the data on the sex and age of the dogs were not available, the dental ages were judged to range from the deciduous dentition to the early mixed dentition. Molars were not dealt with in this study for two reasons: 1) the molars of many of the subjects had not yet been calcified, and 2) the upper second and/or lower third molars, if present, had frequently been sacrificed when the jaws were separated. Numerical anomalies were observed in 16 dogs (32.7%). And infranumerary teeth were observed in 14 dogs (26.8%). Incidences of infranumerary teeth were higher in the secondary dentitions than in the primary ones. Most of the infranumerary teeth were found in both the upper and lower premolars, but not in the upper incisors and the upper and lower canines. Infranumerary teeth often occurred symmetrically whereas supernumerary teeth occurred asymmetrically. This investigation suggests that tendency of the reduction of the upper third premolar was considered to be caused by the reduction of the maxilla through the process of domestication. These results are inconsistent with Fujita's terminal reduction theory.

Animals↗

Pre-school children with uncooperative behavior in the dental situation. Some characteristics and background factors.

One hundred and eighty-six generally healthy pre-school children referred to a pedodontic clinic because of uncooperativeness in the dental situation were surveyed with regard to some characteristics and background factors considered of importance as possible origins of the uncooperative behavior. Information was gained from interviews with the referring dentists and the parents, from a developmental test of the child, and from dental records. In spite of a high prevalence of caries, dental treatment before referral was characterized by few restorative measures. The results also showed that the children constituted a heterogeneous group with regard to the variables studied. Further, the referring dentists represented various resources in terms of self-reported knowledge and time for treating this category of children. The data provide a basis for comparisons with a reference group, to be presented in a subsequent study.

Adult↗

Loss of space and changes in the dental arch after premature loss of the lower primary molar: a longitudinal study.

The purpose of the study was to evaluate the space changes, dental arch width, arch length and arch perimeter, after the unilateral extraction of lower first primary molar in the mixed dentition period. A longitudinal study was conducted among forty children in the age group of 6-9 years, who reported for extraction of lower first primary molar in the department of Pedodontics, Govt. Dental College, Trivandrum. Study models were made from alginate impression taken before extraction and after extraction at the periodical intervals of two months, four months, six months and eight months. The mesiodistal width of lower first primary molar of the non-extracted side was taken as the control. The results of the study showed statistically significant space loss in the extraction side ( P value < 0.01) and no significant space loss in the control side (P value > 0.05). The rate of loss was greatest in the first four months. The arch width, arch length and arch perimeter had no significant change from initial to eight months follow up. The present study challenges the use of a space maintenance under the circumstances of premature loss of mandibular primary molar for preventing space loss.

Cephalometry↗