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[Clinical studies on 16 cases of odontoma in children].

16 cases of odontoma (male: 12, female: 4) in young patients from 1 year 2 months to 14 years of age at the Pedodontic Clinic of Niigata University Dental Hospital in a recent 9 year period were investigated clinically. As for the pathologic histology, 12 cases were of the compound type, 2 were of the complex type, 1 was of the intermediate type between compound and complex, and 1 was of ameloblastic fibro-odontoma type. 9 cases occurred in the maxilla, 7 cases occurred in the mandible. Most of the compound type were observed in the area of the maxillary incisors and cuspids, and the complex type cases were noted in the anterior part of the maxilla. In many cases, there were clinical symptoms such as retarded eruption. Some cases of odontoma in children were small in scale and showed a low degree of calcification. Therefore they showed a tendency not to be found out at radiography, and it is difficult to diagnose them as odontoma. By finding odontoma prematurely and removing it in time, the retarded eruption teeth were able to erupt spontaneously or to be guided to a normal position.

Child↗

[A case report: occlusal guidance of Angle Class II malocclusion with dysfunction of the masticatory system].

The purpose of this study was to evaluate the condylar changes induced by Bionator therapy. The pre and post treatment Cephalometric, tomographic, and dental cast record were evaluated. An 11-Year, 8 month-old boy with malocclusion class II div. 1 was referred to the Pedodontic clinic of the Nippon Dental University Hospital with a chief complaint of Brxism and Protrusion. The medical history was non-contributory. The period of the observation was 3 years 2 months. Normal permanent occlusion was obtained after treatment. The cephalometric findings showed a favorable relationship between the results of the skeletal and dental changes. Also the results showed an effect on the maxilla and mandible stimulation, class II skeletal correction. Favorable changes in the mandibular condylar position using the Bionator were observed in tomographic records before and after treatment.

Activator Appliances↗

Report of project USAP: the use of sedative agents in pediatric dentistry.

Project USAP was performed to examine the use of sedation in pedodontics; part one studied the use of sedative agents by pediatric dentists, and part two examined the use of sedation in postgraduate teaching programs. In part I all 2,040 members of the American Academy of Pediatric Dentistry were sent questionnaires in 1985 concerning their use of sedation, and 1,105 responded. In regard to their use of nitrous oxide alone, 55 percent of practitioners responded that they used nitrous oxide less than 10 percent of the time. In regard to other types of sedative agents, most practitioners used little, if any sedation; 88 percent of practitioners used sedation for less than 10 percent of their patients. In a typical three-month period, the 1,105 respondents performed 33,465 sedations. Of that number, almost half (14,802) were administered by only 64 practitioners. Compared with other geographic areas, there appeared to be greater use of sedation in the south/southeast and west regions of the United States. The heavier use of sedation by some practitioners was not related to the percentage of their handicapped patients who received sedation. In part II, all 59 postgraduate programs in pediatric dentistry were surveyed during 1985 to examine the use of sedation by postgraduate students. There were wide differences in frequency and type of experience of students with different drugs. It is concluded that when a healthy child receives a sedative agent for dental treatment, the type of drug and drug dosage depend more on the biases of the individual practitioner, than on the requirements of the patient.

Child, Preschool↗

[Dental treatment and the prognosis for handicapped children].

We analysed a survey made on oral examinations at the first visit, the kind of dental treatment and the prognosis. The subjects were 77 handicapped children who received dental treatment at the pedodontic clinic of the Aichi-Gakuin University Dental Hospital and periodic examinations after the completion of dental treatment. The average age of the subjects was 7.4 (2.11 to 16.7 years old). (1) At the first visit, the mean number of untreated decayed teeth was 7.1 for the group of children who received dental treatment without general anesthesia, and 12.0 for the group of children who received dental treatment with general anesthesia. And the rate of untreated decayed teeth was 40.1% of the deciduous and 21.0% of the permanent teeth for the group of children who had received dental treatment without general anesthesia, and 65.5% of the deciduous and 34.2% of the permanent teeth for the group of children who had received dental treatment with general anesthesia. (2) For the group of children who received dental treatment without general anesthesia, restoration was performed on 62.5% of the deciduous and 87.5% of the permanent teeth; the remaining 37.5% of the deciduous and 12.5% of the permanent teeth were extracted. Endodontic treatment was performed on 20.6% of the deciduous and 8.9% of the permanent teeth. (3) For the group of children who received dental treatment with general anesthesia, restoration was performed on 57.0% of the deciduous and 95.1% of the permanent teeth; the remaining 42.9% of the deciduous and 4.9% of the permanent teeth were extracted. Endodontic treatment was performed on 25.3% of the deciduous teeth and 12.2% of the permanent teeth. (4) In the case of restorative treatment, the highest incidence was in metal crowns on the deciduous teeth, and amalgam fillings in the permanent teeth for the groups of children who received dental treatment with or without general anesthesia. In the case of endodontic treatment, the highest incidence was in pulp amputation for the groups of children who received dental treatment with or without general anesthesia. (5) During the past year of completed dental treatment, unsuccessful cases were 5.4% for the restorative treatment and 0% for the endodontic treatment for the group of children who received dental treatment without general anesthesia; unsuccessful cases were 14.1% for the restorative treatment and 4.1% for the endodontic treatment for the group of children who received dental treatment with general

Adolescent↗

[The behavior of mothers during dental treatment for their handicapped children. 1. Relationship between mothers' behavior and child patients' factors].

The purpose of this study was to find out factors which determine whether or not mothers of handicapped children chose to be with their children while receiving dental care. The subjects were 46 pairs consisting of a handicapped child and his or her mother who came to the pedodontic clinic of Aichi-Gakuin University Dental School. Such factors of the patients as the various abilities of the patients, their behavior and other items were surveyed with a behavior evaluation. These factors are considered to be related to determining the behavior of the mothers. The results of the survey are summarized as follows: 1. Patients whose mothers chose to be with them tended to be slightly inferior in basic language use and mouth rinsing ability, when compared with patients whose mothers chose to stay in the waiting room. 2. Patients who were autistic more often had mothers who chose to be with them than patients with other disabilities. 3. Patients whose mothers chose to be with them got higher Behavior Evaluation Scores in all dental care situations so that they tended not to adapt to dental care, when compared with patients whose mothers chose to stay in waiting room. 4. From the analyses of Quantification Type II, a height correlation ratio was obtained in the distinction efficiency of the mothers' behavior. Also the behavior of the mothers could be predicted by the factors of the children. 5. There were four factors present in those handicapped children which are considered to have determined their behavior of the mothers: the kind of disability, verbal expression ability, mouth rinsing ability and adaptation to dental care.

Adult↗

[Clinical effects of training in behavior management on handicapped patients in dentistry].

Behavior-therapeutic training was applied to patients who were not cooperative in dental surroundings and could not be managed for dental treatment. The training was continued from the first to the final visit and also at periodical checkups. The clinical effects of training were evaluated. The subjects were 150 handicapped child patients who visited the pedodontic clinic of Aichi-Gakuin University. The patients were classified into two groups according to the degree of cooperation regarding dental treatment during the first visit; 1) the slightly uncooperative group and 2) the uncooperative group. The results were as follows: 1. Training applied prior to actual dental treatment caused 48.7 per cent of the patients to accept routine dental treatment. 2. When N2O/O2 inhalation sedation was added to the training, 79.0 per cent of the slightly uncooperative group were able to accept dental treatment under conseious situation, and 46.0 per cent of the uncooperative group were able to accept it. 3. Continuous training caused 60.7 per cent of all patients to become cooperative. 4. Continuous training was effective with 95.3 per cent of the patients who experienced N2O/O2 sedation, 76.8 per cent of the patients who experienced general anesthesia and 71.2 per cent of the patients who experienced routine dental treatment.

Anesthesia, Dental↗

[Treatment of Riga-Fede's disease by resin-coverage of the incisal edges and seven cases of natal and neonatal teeth].

This report concerned 2 cases (1-month and 8-day-old boy and 5-month and 27-day-old boy) of Riga-Fede's disease. The cases were treated with photopolymerized resin coverage of the incisal edges. Generally, the treatment methods for Riga-Fede's disease are discing and extraction of the traumatized teeth. The photopolymerized resin coverage proved to help in the rapid healing of the ulcerations. This method is useful because it is easy and is able to avoid a false pulp exposure of the hypoplastic natal and neonatal teeth by discing. 7 cases of natal and neonatal teeth were encountered at the Pedodontic Clinic of Niigata University Dental Hospital during 8 years from September 1979 to August 1987. 1) 7 cases were 3 boys and 4 girls, aging from 21 days after birth to 3 months 19 days. 2) Only one baby had a low birth weight. 3) The natal teeth accounted for 6 cases and the neonatal teeth accounted for 1 case. All were lower central primary incisors (5 on the right side, 1 on the left side and 1 bilateral). There were no supernumerary teeth. 4) 5 cases were of hypoplastic teeth. 5) Riga-Fede's disease was recognized in 3 cases. 6) The prognosis was 1 case of shedding, 2 cases extracted and 4 cases remaining. 7) Mesial inclination of the neighboring teeth and narrowness of the extracted space wee observed in the cases where extraction was performed at an early age. 8) Microradiogram and undemineralized specimens of the extracted tooth revealed that the tooth was very thin and mineralization was so poor and there was almost no root formation.

Child, Preschool↗

[A treated case of facial tic caused by a psychological factor. Successful case approached by psychosomatic dentistry].

As the oral psychosomatic diseases of infants appear connected with a predisposition of their environment, environmental adjustment and psychotherapy on the basis of psychosomatic dentistry are necessary in the treatment. We encountered a 9-year-old boy who seemed to be suffering from a facial tic caused by psychological factors. An attempt of therapy on the basis of psychosomatic dentistry was made in this case. The results as follows were obtained: 1. Intake interview to a mother was carried out regarding a cause of the tic. It was shown that the attitude of the mother will bring up the child and her meddling as well as the stress of school life caused his facial tic. 2. With our guidance, the mother reconsidered her meddling attitude toward the patient. And she was able to handle the patient with a kind attitude. 3. After play therapy as preparation, catharsis was carried out on the patient, the tic decreased rapidly. 4. Finally a token economy method was used. 5. It was thought that sufficient correspondence on the basis of psychosomatic dentistry was beneficial in the therapy of patient with psychosomatic disease in pedodontics.

Child↗

[Clinical study of ectopic eruption of permanent incisors and first molars].

UNLABELLED: Using the X-ray films, plastic models and pathological photograph of 4824 patients seen at the Department of Pedodontics of Iwate Medical University, the patterns of ectopic eruptions of permanent incisors and first molars (restricted to these teeth in this study) were classified into 4 groups (I-IV) to investigate the conditions of its incidence, size of the teeth and dental arch, and conditions at the stage of the mixed and permanent dentitions. RESULTS: 1. The total frequency of ectopic eruptions was 5.6%. No difference based on sex was found. 2. By classification, ectopic eruptions of the upper and lower permanent central incisors (Group I) amounted to more than half of the total frequency. The incidence of ectopic eruptions of the upper and lower permanent first molars (Group III) was very low and amounted to only 4.6% of the total frequency. 3. In Groups I and III, the incidence was higher in the maxilla than in the mandible. 4. Based on sex, the incidence was higher in boys in Group III and in girls in group II. 5. Ectopia of the permanent central incisors was frequently bilateral and those of the lower permanent lateral incisors and upper permanent first molars were frequently unilateral. 6. The mesiodistal width of the ectopically erupted permanent teeth tended to be somewhat enlarged, but showed no significant differences from Ono's mean value. 7. In ectopic eruptions at the area of the incisors, the C-C distance was narrowed with an increase in the ectopically erupted permanent teeth. 8. In patients in whom the permanent dentition was formed without occlusal guidance, the basal arch length and dental arch length were large and basal arch width and dental arch width were small. 9. In cases which were followed from the deciduous dentitions to permanent dentitions, the anterior tooth area at the stage of the mixed dentition was frequently crowded. Occlusal guidance was carried out in more than half of these cases.

Humans↗

[Local anesthesia for children: a critical step].

To realise a good child's dentistry, an excellent analgesia is primordial. Local anaesthesia is most useful for reliable and complete dental care on one tooth during one single appointment. But the young patient is afraid by the "ting", making an association with disagreeable or sore souvenirs as a vaccination. First contact with the dentist is the very important; from psychological point of view, situation has to be dedramatized; from technical point of view, anaesthesia has to be not painful and efficacious. In pedodontics, the best technical procedure is an infiltration anaesthesia.

Anesthesia, Dental↗

[A case of a so-called congenital tooth appeared in maxilla].

The congenital teeth are not only classified by Massler et al. as a natal tooth that has erupted at birth and a neonatal tooth that erupts at neonatal period, but also divided into a normal deciduous tooth and a supernumerary tooth. The congenital teeth are mostly found in the mandibular anterior region, but extremely rare in other regions. The authors met a rare case, that had a so-called congenital tooth in the maxillary anterior region, which was a supernumerary and fused tooth. The case was a boy patient, 4 months of age, who visited the pedodontic clinic, of Ohu University Dental Hospital, with the complaint of ruber and swelling of the maxillary anterior gum pad, October 17th in 1986. By oral inspection of the dental radiogram and his past history, the authors found a odontoid material in the swelled gum pad and diagnosed it as a so-called congenital and supernumerary tooth. The tooth was extracted. The extracted tooth was investigated histopathologically. It had the v-shaped incisula at the middle of its edge, and seemed as if two teeth had coalesced. The serial preparations by the labio-lingual section showed no partition, such cementum as to divide the enamel, the dentin and the pulp near the incisula. Therefore it was diagnosed as fused tooth correctly. In the labial surface of the root formed about a third root length, the thickness of the cellular cementum was observed. It was considered as a physiological reaction to no support of the alveolar bone and to the excess mobility of the tooth. The prognosis after its extraction was good, and all normal deciduous incisors appeared in his mouth, 7 month later.

Fused Teeth↗

[Resin and glass-ionomer sealants. Indications, mechanism of action, and application technics].

The usefulness and indications to treatment with sealants in pedodontics are examined. Sealants are classified and the action mechanism of sealant resins and the application techniques needed for correct positioning of the material are described. The use of the new glass-ionomer cement sealants, with their advantages and disadvantages, are then discussed and the preventive and economic value of occlusive seals evaluated.

Adolescent↗

The efficacy of rubber dam isolation in reducing atmospheric bacterial contamination.

A study was made to ascertain the efficacy of rubber dam isolation in controlling atmospheric bacterial contamination, when conservative pedodontic procedures are performed. There was a highly significant (p less than 0.001) reduction in bacterial contamination of the atmosphere, perioperatively, when rubber dam isolation was used. As the reduction in bacterial aerosols was greatest at 1 m from the headrest, the use of rubber dam would minimize significantly the inhalation of infective aerosols by dental personnel.

Adolescent↗

Esthetic principles; concepts, and practices in pediatric and adolescent dentistry.

The foundation of all dental esthetics is health. A beautiful dentition only occurs in supporting structures free of disease and inflammatory responses. Beyond health, the desire for manipulation of the oral cavity for esthetics in pedodontics is guided by the expectations of the dentist and the parents. When treatment planning for young children and adolescents, it is imperative that the dentist helps to distinguish procedures performed for the health and functional needs of the child from techniques performed to meet cultural standards of esthetics.

Adolescent↗

Oral histology and embryology: an integrated educational program.

Since 1976 dental students in The University of Western Australia have undertaken a revised course in oral histology and embryology taught within the framework of an oral biology program. The new course includes clinic sessions, which are presented prior to scheduled lecture and laboratory instruction on a particular tissue, and are intended to familiarize students with the clinical appearance of that tissue. Participating staff include members from the divisions of oral biology, oral pathology, periodontics, pedodontics, and preventive dentistry, Examination of histologic slides during laboratory sessions is supplemented by use of dental radiographs in order to achieve a close correlation between histologic structure and radiographic appearance. The use of the dental clinic environment to teach basic and applied microanatomy, and inclusion of clinical data such as radiographs, has strengthened the link between basic biological science and clinical dentistry.

Curriculum↗

[Changes in dentistry].

Although collective and individual prophylactic measures have been shown to drastically reduce or totally prevent dental caries and periodontal disease, a recent survey of over a thousand twenty-year olds from all areas in Switzerland revealed an average DMFT value of 14.5, including 8.6 teeth already filled. Alarmingly, more than two thirds of all the proximal fillings examined radiographically were inadequate and therefore sources of marginal irritation. Dentistry in the future must accordingly concentrate on increased primary prevention and, where restorations are necessary, on placing restorations that will not lead to secondary caries and destructive marginal periodontitis. These goals can be most economically achieved through a team approach where the dentist delegates to his (or her) dental hygienist and specially trained chairside assistant the tasks of radiological and clinical diagnosis of caries and of marginal irritants in order to interfere with the progress of periodontal disease. The dentist, in addition, freed from administrative tasks by electronic data processing, will direct the team, and his practice will, in the future, fall into one of two large areas: preventive dentistry and/or pedodontics of curative gnathology.

Adult↗

Pretreatment modeling. A technique for reducing children's fear in the dental operatory.

Research on modeling indicates that this technique offers dentists a means of reducing fear in child patients of all ages. As a preventive measure used with children who have had no prior exposure to dental treatment, it can be particularly efficacious. Based on the assumption that much of adult dental avoidance is based on dental fears acquired in childhood treatment, the reduction of children's dental fear would have a positive effect on the individual's tendency to seek out dental health care throughout his or her lifespan. For the dentist, there are also short- and long-term benefits. Dental management of the child is prerequisite to providing good dental care. Pedodontics as a specialty recognizes behavioral management of the child cannot be separated from the quality of the dentist's work. Fear has been identified as an important factor in disruptive behavior of school age children in the dental office. Practicing dentists consider the fearful, disruptive child to be among the most troublesome of problems in their clinical work. The child must cooperate or at least passively comply with the dentist's procedures in order to have the technical work completed. By reducing disruptive patient behavior (crying, screaming children whose peripheral and gross motor movements often make direct contact with the dentist or his equipment) the most unpalatable aspect of pediatric dentistry is minimized. Further, the actual time for treatment becomes shorter rather than longer. Although modeling is not restricted to videotape media, the emergence of current videotape technology provides the practitioner with the means for incorporating patient viewing of prerecorded modeling tapes as part of the usual waiting period. Such a procedure would mean that in the long run, the dentist will spend more time doing dentistry and less in behavioral management tasks.

Anxiety↗

Treatment of unilateral posterior crossbite: comparison of the quad-helix and removable plate.

The aim of this retrospective study was to compare the quad-helix and removable plate with respect to effect and cost of treatment in the mixed dentition with unilateral forced crossbite. In the quad-helix group (25 children), expansion was accomplished with a prefabricated .036'' quad-helix soldered to bands on the maxillary molars. In the plate group (25 children), the removable plates had a midline screw and four Adams clasps. The screw was opened by one quarter-turn each week. The crossbite was eliminated in all cases in the two groups. The respective results in the quad-helix group and in the plate group (in brackets) were: intermolar arch width increased 3.6 mm (3.7 mm); the total period of appliance therapy averaged 3.8 months (21.6 months), ranging from 2 to 6 months (12-30 months); the number of visits averaged 4.6 (16.0), ranging from 3 to 6 (11-22); number of appliances needed averaged 1 (1.7), and the costs of the appliances averaged $58 ($174). In the plate group, the average values of the laboratory costs were 3-fold, the number of visits 3.5-fold, and the expansion and retention time 5.7-fold more than the quad-helix group. The present treatment rationale with the quad-helix appliance is easy, effective, cost-efficient, and can be learned by every pedodontitis for correction of unilateral crossbites in the mixed dentition.

Child↗