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Permanent Molars (permanent + molar)
Kinds of Permanent Molars Selected AbstractsFour-Year Cost-Utility Analyses of Sealed and Nonsealed First Permanent Molars in Iowa Medicaid-Enrolled ChildrenJOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 4 2007Patita Bhuridej DDS Abstract Objectives: Dental sealants, by their ability to prevent caries and maintain teeth in better health, have some inherent utility to individuals, programs, or society. This study assessed the 4-year incremental cost utility of sealing first permanent molars of 6-year-old Iowa Medicaid enrollees from a societal perspective and identified the group of teeth or children in whom sealants are most cost effective. Methods: Dental services for first permanent molars were assessed using claims and encounter data for a group of continuously enrolled Medicaid enrollees who turned 6 between 1996 and 1999. Previously published utilities were used to weight the different health states. The weighted sum of outcomes [Quality-Adjusted Tooth-Years (QATYs)] was the measure of effectiveness. Costs and QATYs were discounted to the time of the child's sixth birthday. Results: For all first molars, the cost of treatment associated with sealed teeth was higher but the utility was also slightly higher over the 4-year period. The relative incremental cost per 0.19 QATY ratio [changing the health state from a restored tooth (utility=0.81) to a nonrestored tooth (utility =1)] by sealing the molar ranged from $36.7 to $83.5 per 0.19 QATY. The incremental cost/QATY ratio was lower for sealing lower utilizers and for mandibular versus maxillary molars. Conclusions: Sealants improved overall utility of first permanent molars after 4 years. The 4-year cost/QATY ratio of sealing the first permanent molar varied by arch and type of utilizers. Sealing first permanent molars in lower dental utilizers is the most cost-effective approach for prioritizing limited resources. [source] Leukaemic infiltration of the mandible in a young girlINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 2 2007RACHAEL E. BENSON Background., This report presents a case of leukaemic infiltration of the mandible in a 10-year-old female of Sudanese extraction. Case report., The patient was in remission from acute lymphoblastic leukaemia when she presented with pain localized to the alveolar ridge overlying the unerupted lower right second permanent molar. Two days later, she developed right inferior alveolar nerve paraesthesia. Radiographic imaging demonstrated cortical line absence around the developing lower right second and third permanent molars, and distal displacement of the lower right third molar. In addition, the cortical outline of the right inferior dental canal lacked clarity. Biopsy confirmed leukaemia recurrence demonstrating the Philadelphia chromosome. Tailored chemotherapy was commenced, and a bone marrow transplant was carried out 12 weeks later. At 6-month dental review, the patient remained exceptionally well with no bone pain and normal sensation in the right lower lip. Conclusion., The importance of regular and long-term dental examination of patients with leukaemia is discussed. [source] Four-Year Cost-Utility Analyses of Sealed and Nonsealed First Permanent Molars in Iowa Medicaid-Enrolled ChildrenJOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 4 2007Patita Bhuridej DDS Abstract Objectives: Dental sealants, by their ability to prevent caries and maintain teeth in better health, have some inherent utility to individuals, programs, or society. This study assessed the 4-year incremental cost utility of sealing first permanent molars of 6-year-old Iowa Medicaid enrollees from a societal perspective and identified the group of teeth or children in whom sealants are most cost effective. Methods: Dental services for first permanent molars were assessed using claims and encounter data for a group of continuously enrolled Medicaid enrollees who turned 6 between 1996 and 1999. Previously published utilities were used to weight the different health states. The weighted sum of outcomes [Quality-Adjusted Tooth-Years (QATYs)] was the measure of effectiveness. Costs and QATYs were discounted to the time of the child's sixth birthday. Results: For all first molars, the cost of treatment associated with sealed teeth was higher but the utility was also slightly higher over the 4-year period. The relative incremental cost per 0.19 QATY ratio [changing the health state from a restored tooth (utility=0.81) to a nonrestored tooth (utility =1)] by sealing the molar ranged from $36.7 to $83.5 per 0.19 QATY. The incremental cost/QATY ratio was lower for sealing lower utilizers and for mandibular versus maxillary molars. Conclusions: Sealants improved overall utility of first permanent molars after 4 years. The 4-year cost/QATY ratio of sealing the first permanent molar varied by arch and type of utilizers. Sealing first permanent molars in lower dental utilizers is the most cost-effective approach for prioritizing limited resources. [source] Replacement versus repair of defective restorations in adults: resin compositeAUSTRALIAN DENTAL JOURNAL, Issue 3 2010MO Sharif Background:, Composite filling materials have been increasingly used for the restoration of posterior teeth in recent years as a tooth coloured alternative to amalgam. As with any filling material composites have a finite life-span. Traditionally, replacement was the ideal approach to treat defective composite restorations, however, repairing composites offers an alternative more conservative approach where restorations are partly still serviceable. Repairing the restoration has the potential of taking less time and may sometimes be performed without the use of local anaesthesia hence it may be less distressing for a patient when compared with replacement. Objectives:, To evaluate the effectiveness of replacement (with resin composite) versus repair (with resin composite) in the management of defective resin composite dental restorations in permanent molar and premolar teeth. Search strategy:, For the identification of studies relevant to this review we searched the Cochrane Oral Health Group Trials Register (to 23rd September 2009); CENTRAL (The Cochrane Library 2009, Issue 4); MEDLINE (1950 to 23rd September 2009); EMBASE (1980 to 23rd September 2009); ISI Web of Science (SCIE, SSCI) (1981 to 22nd December 2009); ISI Web of Science Conference Proceedings (1990 to 22nd December 2009); BIOSIS (1985 to 22nd December 2009); and OpenSIGLE (1980 to 2005). Researchers, experts and organizations known to be involved in this field were contacted in order to trace unpublished or ongoing studies. There were no language limitations. Selection criteria:, Trials were selected if they met the following criteria: randomized or quasi-randomized controlled trial, involving replacement and repair of resin composite restorations. Data collection and analysis:, Two review authors independently assessed titles and abstracts for each article identified by the searches in order to decide whether the article was likely to be relevant. Full papers were obtained for relevant articles and both review authors studied these. The Cochrane Collaboration statistical guidelines were to be followed for data synthesis. Main results:, The search strategy retrieved 279 potentially eligible studies, after de-duplication and examination of the titles and abstracts all but four studies were deemed irrelevant. After further analysis of the full texts of the four studies identified, none of the retrieved studies met the inclusion criteria and all were excluded from this review. Authors' conclusions:, There are no published randomised controlled clinical trials relevant to this review question. There is therefore a need for methodologically sound randomised controlled clinical trials that are reported according to the Consolidated Standards of Reporting Trials (CONSORT) statement (http://www.consort-statement.org/). Further research also needs to explore qualitatively the views of patients on repairing versus replacement and investigate themes around pain, anxiety and distress, time and costs. [source] Root canal morphology of mandibular permanent molars at different agesINTERNATIONAL ENDODONTIC JOURNAL, Issue 10 2008H. R. D. Peiris Abstract Aim, To investigate differences in the root canal morphology of permanent mandibular molar teeth at various ages. Methodology, Four hundred and eighty permanent mandibular first and second molars were examined. First and second molars were divided into six and five groups, respectively, according to the age of the patient at the time of extraction. Root canal morphology was studied using a clearing technique. The canal morphology of the mesial root was classified into three stages depending on its developmental pattern. When the root canal system was completely differentiated, the canal classification and the number of lateral canals and inter-canal communications were recorded. Vertucci's classification was taken as the main reference. Canal morphology was compared amongst age groups. Results, In both first and second molars, developmental stages of canal morphology amongst age groups were significantly different (P < 0.0001). The prevalence of inter-canal communications was highly significantly different in the first (P < 0.0001) and less significant in the second molar (P < 0.05). After completion of the canal differentiation, the mesial roots of first molars had type IV and II canal forms. The majority of the mesial roots of second molars had type I and III canals. C-shaped canals were found in 3% of second molars. Conclusions, Mesial roots of first and second molars mostly had one large canal until 11 and 15 years of age, respectively. In both molars, the canal system was completely defined at 30,40 years. The prevalence of inter-canal communications was low at young and old ages but high at intermediate ages. [source] Root and canal morphology of permanent mandibular molars in a Sudanese populationINTERNATIONAL ENDODONTIC JOURNAL, Issue 10 2007H. A. Ahmed Abstract Aim, To investigate variations in the root canal systems of first and second permanent mandibular molar teeth in a Sudanese population using a clearing technique. Methodology, Two hundred extracted first and second permanent mandibular molars from three cities in the state of Khartoum were studied. Access cavities were prepared and pulp tissue was removed by immersion in 5% sodium hypochlorite under ultrasonication; Indian ink was then injected into the root canal systems assisted by a vacuum applied apically. The teeth were rendered clear by demineralization and immersion in methyl salicylate before evaluation. The following observations were made (i) number of roots and their morphology; (ii) number of root canals per tooth; (iii) number of root canals per root and (iv) root canal configuration. Results, Overall 59% of mandibular first molars had four canals with 3% having a third distolingual root. Seventy-eight per cent of second mandibular molars had two separate flat roots, whilst 10% were C-shaped. The most common canal system configurations were type IV (73%) and type II (14%). Inter-canal communications were more common in the mesial roots. The prevalence of inter-canal communications was 65% in first molars and 49% in second molars. Conclusions, In this sample of Sudanese teeth, 59% of the mandibular first permanent molars had four root canals whilst 10% of the mandibular second molars had C-shaped roots/canals. [source] Frequency and type of canal isthmuses in first molars detected by endoscopic inspection during periradicular surgeryINTERNATIONAL ENDODONTIC JOURNAL, Issue 3 2005T. Von Arx Abstract Aim, To analyse the occurrence of canal isthmuses in molars following root-end resection. Methodology, The material consisted of 56 mandibular and 32 maxillary first molars subjected to periradicular surgery. Based on radiographic, clinical, as well as intraoperative status, only roots with associated pathological lesions were treated. In total, 124 roots were resected (80 mandibular and 44 maxillary molar roots). The cut root faces were inspected with a rigid endoscope following apical root-end resection. The number of canals as well as the presence and type of canal isthmuses were recorded. Results, In maxillary first molars, 76% of resected mesio-buccal roots had two canals and an isthmus, 10% had two canals but no isthmus, and 14% had a single canal. All disto-buccal and palatal roots had one canal. In mandibular first molars, 83% of mesial roots had two canals with an isthmus. In 11%, two canals but no isthmus were present, and 6% demonstrated a single canal. Sixty-four per cent of distal roots had a single canal and 36% had two canals with an isthmus. Conclusions, This clinical study during periradicular surgery and intraoperative endoscopic examination of first permanent molars found a high frequency of canal isthmuses at the resection level. Endoscopic inspection also demonstrated that none of the isthmuses were filled, emphasizing the difficulty of orthograde instrumentation and root filling of canal isthmuses. [source] Estimating age by tooth wear of prehistoric human remains in Brazilian archaeological sitesINTERNATIONAL JOURNAL OF OSTEOARCHAEOLOGY, Issue 5 2006R. N. Oliveira Abstract The occlusal surfaces of 298 permanent maxillary and mandibular molar teeth of prehistoric shellfish-gatherer subjects from the Piaçaguera and Tenorio sites (4930 to 1875 BP), near the central-northern coastline of São Paulo, Brazil, were examined for classification of macro-wear stages. Molar tooth wear is an indication of masticatory activity and can be used in the estimation of age at death. The examination of visual and schematic aspects of occlusal macro-wear used a visual chart proposed by Brothwell, which includes the three superior and inferior, left and right, permanent molars. Three examiners performed the macroscopic observations twice under the same conditions. The resulting age estimates were compared with previous information of age estimated by skeletal examination. A reduced intra- and inter-observer variation was observed; all re-examinations indicated discrepancies of less than two years for the upper and lower limit of the age range estimates. The procedure was also considered consistent with the skeletal method used for age estimation of human remains excavated in Brazilian archaeological shell mounds, with a discrepancy of less than 8.22 years between the upper and lower limits of estimates by both methods. Age classification by the occlusal molar wear may be a useful tool for the classification of archaeological findings, mainly when only fragmentary skeletal remains are excavated. The current results indicate that the application of the Brothwell chart for Brazilian archaeological series presented satisfactory results of consistency, and its expanded use may represent a relevant adjunct for research. Copyright © 2006 John Wiley & Sons, Ltd. [source] Oral features and dental health in Hurler Syndrome following hematopoietic stem cell transplantationINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 5 2010ELEANOR McGOVERN International Journal of Paediatric Dentistry 2010; 20: 322,329 Background., Hurler Syndrome is associated with a deficiency of a specific lysosomal enzyme involved in the degradation of glycosaminoglycans. Hematopoietic stem cell transplantation (HSCT) in early infancy is undertaken to help prevent the accumulation of glycosaminoglycans and improve organ function. Aim., To investigate the oral features and dental health of patients with Hurler Syndrome who have undergone successful HSCT. Materials and methods., Twenty-five patients (median age 8.6 years) post-HSCT (mean age 9.4 months) underwent oral assessment (mean of 7.5 years post-HSCT). Results., Dental development was delayed. Numerous occlusal anomalies were noted including: open-bite, class III skeletal base, dental spacing, primary molar infra-occlusion and ectopic tooth eruption. Dental anomalies included hypodontia, microdontia, enamel defects, thin tapering canine crowns, pointed molar cusps, bulbous molar crowns and molar taurodontism. Tooth roots were usually short/blunted/spindle-like in permanent molars. The prevalence of dental caries was low in the permanent dentition (mean DMFT 0.7) but high in the primary dentition (mean dmft 2.4). Oral hygiene instruction with plaque and or calculus removal was indicated in 71% of those that were dentate. Conclusion., Patients with Hurler Syndrome post-HSCT are likely to have delayed dental development, a malocclusion, and dental anomalies, particularly hypodontia and microdontia. [source] Bacterial invasion of dentinal tubules beneath apparently intact but hypomineralized enamel in molar teeth with molar incisor hypomineralizationINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 5 2008TOBIAS G. FAGRELL Background., The most common problems for a patient with molar incisor hypomineralization (MIH) are the collapse of enamel and cavitations, loss of fillings, and secondary caries, but most of all, severe hypersensitivity. Objective., The aim of this paper was therefore to histologically study possible bacterial invasion of dentinal tubules beneath apparently intact, but hypomineralized enamel in permanent molars with MIH. Material and methods., Five extracted permanent first molars diagnosed with MIH were fixated, demineralized, and sagittally serially sectioned in a bucco-lingual direction in a microtome with a thickness of 4,5 µm. Sections were stained with a modified Brown and Benn staining for bacteria, unstained sections were analysed in field emission SEM. Results., Stained sections from the cuspal areas, below the hypomineralized enamel, the staining indicated the presence of bacteria in the dentinal tubules. The HTX staining showed that the pulp in sections without any findings was normal and free from bacteria or infiltrates from inflammatory cells. In sections where bacteria were found in the cuspal areas or deeper in the dentin, a zone of reparative dentin was found, and in sections from one tooth, the coronal pulp showed an inflammatory reaction with inflammatory cells. In sections adjacent to those without any bacterial staining, the SEM analyses revealed empty dentinal tubules without any odontoblast processes or signs of bacteria. When odontoblast processes were found, the dentinal tubules were filled with bacteria located on the surface of the odontoblast processes. In some areas, a large number of tubules were found with bacteria. No bacteria were found close to the pulp. The odontoblast processes appeared larger in areas where bacteria were found. Conclusions., The presence of bacteria in the dentinal tubules and inflammatory reactions in the pulp indicate that oral bacteria may penetrate through the hypomineralized enamel into the dentin, thus possibly contribute to hypersensitivity of teeth with MIH. [source] Leukaemic infiltration of the mandible in a young girlINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 2 2007RACHAEL E. BENSON Background., This report presents a case of leukaemic infiltration of the mandible in a 10-year-old female of Sudanese extraction. Case report., The patient was in remission from acute lymphoblastic leukaemia when she presented with pain localized to the alveolar ridge overlying the unerupted lower right second permanent molar. Two days later, she developed right inferior alveolar nerve paraesthesia. Radiographic imaging demonstrated cortical line absence around the developing lower right second and third permanent molars, and distal displacement of the lower right third molar. In addition, the cortical outline of the right inferior dental canal lacked clarity. Biopsy confirmed leukaemia recurrence demonstrating the Philadelphia chromosome. Tailored chemotherapy was commenced, and a bone marrow transplant was carried out 12 weeks later. At 6-month dental review, the patient remained exceptionally well with no bone pain and normal sensation in the right lower lip. Conclusion., The importance of regular and long-term dental examination of patients with leukaemia is discussed. [source] R2 The pattern of extraction of first permanent molars: results from three dental hospitalsINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 2006S. S. ALBADRI Objective:, To determine and compare the reasons and pattern of extraction of first permanent molars (FPM) in 3 UK dental hospitals. Design:, Data were collected prospectively from 300 children attending Manchester Dental Hospital (MDH), Liverpool Dental Hospital (LDH) and Charles Clifford Dental Hospital, Sheffield (CCDH) who required extractions of at least one FPM. Information recorded included age, FPM extracted, reason for extractions, previous treatment, method of extraction, and whether patients had previous extractions. Result:, The mean age in months was 129 (Std 22.7), 139 (Std 29.4), and 133 (Std 26.8) for MDH, LDH, CCDH respectively. 45% and 48% of children had four FPM extracted at MDH & CCDH, respectively, compared to 25% in LDH. The main reason for extraction (70%) was caries with poor prognosis, followed by caries and compensating extraction (14%). Molar Incisal Hypoplasia was the reason for extraction in 11% of cases. General anaesthesia was the main anaesthetic method used with 77%, 55%, and 47% in MDH, LDH and CCDH, respectively. Local anaesthesia was used in 43% of cases in LDH in comparison to 12% and 22% in MDH and CCDH, respectively. 68% of children had received no previous treatment to the FPM and only 5% had fissure sealants placed. 40% of children had previous extractions. Conclusion:, The children who are attending our hospitals for extractions of FPM tend to be older than the recommended age for achieving maximum space closure. This study highlights the need for extensive prevention programs targeted at those children with high caries risk. [source] Immunocytochemical investigation of immune cells within human primary and permanent tooth pulpINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 1 2006H. D. RODD Summary. Aim., The aim of this study was to determine whether there are any differences in the number and distribution of immune cells within human primary and permanent tooth pulp, both in health and disease. Design., The research took the form of a quantitative immunocytochemical study. One hundred and twenty-four mandibular first permanent molars and second primary molars were obtained from children requiring dental extractions under general anaesthesia. Following exodontia, 10-µm-thick frozen pulp sections were processed for indirect immunofluorescence. Triple-labelling regimes were employed using combinations of the following: (1) protein gene product 9·5, a general neuronal marker; (2) leucocyte common antigen (LCA); and (3) Ulex europaeus I lectin, a marker of vascular endothelium. Image analysis was then used to determine the percentage area of immunostaining for LCA. Results., Leucocytes were significantly more abundant in the pulp horn and mid-coronal region of intact and carious primary teeth, as compared to permanent teeth (P < 0·05, anova). Both dentitions demonstrated the presence of well-localized inflammatory cell infiltrates and marked aborization of pulpal nerves in areas of dense leucocyte accumulation. Conclusions., Primary and permanent tooth pulps appear to have a similar potential to mount inflammatory responses to gross caries The management of the compromised primary tooth pulp needs to be reappraised in the light of these findings. [source] Four-Year Cost-Utility Analyses of Sealed and Nonsealed First Permanent Molars in Iowa Medicaid-Enrolled ChildrenJOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 4 2007Patita Bhuridej DDS Abstract Objectives: Dental sealants, by their ability to prevent caries and maintain teeth in better health, have some inherent utility to individuals, programs, or society. This study assessed the 4-year incremental cost utility of sealing first permanent molars of 6-year-old Iowa Medicaid enrollees from a societal perspective and identified the group of teeth or children in whom sealants are most cost effective. Methods: Dental services for first permanent molars were assessed using claims and encounter data for a group of continuously enrolled Medicaid enrollees who turned 6 between 1996 and 1999. Previously published utilities were used to weight the different health states. The weighted sum of outcomes [Quality-Adjusted Tooth-Years (QATYs)] was the measure of effectiveness. Costs and QATYs were discounted to the time of the child's sixth birthday. Results: For all first molars, the cost of treatment associated with sealed teeth was higher but the utility was also slightly higher over the 4-year period. The relative incremental cost per 0.19 QATY ratio [changing the health state from a restored tooth (utility=0.81) to a nonrestored tooth (utility =1)] by sealing the molar ranged from $36.7 to $83.5 per 0.19 QATY. The incremental cost/QATY ratio was lower for sealing lower utilizers and for mandibular versus maxillary molars. Conclusions: Sealants improved overall utility of first permanent molars after 4 years. The 4-year cost/QATY ratio of sealing the first permanent molar varied by arch and type of utilizers. Sealing first permanent molars in lower dental utilizers is the most cost-effective approach for prioritizing limited resources. [source] Assessing Cost-Effectiveness of Sealant Placement in ChildrenJOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 2 2005Rocio B. Quiñonez DMD Abstract Objective: The lack of cost-effectiveness information regarding sealant placement strategies is thought to have influenced reimbursement policies and subsequent sealant utilization in dental practice. This study compared three strategies for managing the occlusal surfaces of first permanent molars: seal all (SA), risk-based (RBS), and seal none (SN). Methods: A decision tree was developed for various possible outcomes following each of the above strategies. Due to the complexity of the decision tree, a Markov model was used to allow for the construction of a chain of events representing the natural history of sealant retention, caries formation, and their associated health states. The outcome measures were the incremental cost per month gained in a cavity-free state over a ten-year period. Results: Our theoretical model showed that RBS strategy improved clinical outcomes, in the form of cavity-free months, and saved money over SN. The strategy of sealing both high and low risk teeth (SA) further improved outcomes but at an additional cost compared to RBS. However, the cost was small, $08 for each additional cavity-free month gained per tooth. Further, minor changes in the baseline assumptions resulted in the SA strategy being the dominant strategy. Conclusion: This study provides evidence that sealing children's first permanent molars can improve outcomes and save money by delaying or avoiding invasive treatment and the destructive cycle of caries. In a time of limited funds for dental services, these results can assist payers in establishing more rational sealant reimbursement policies. [source] Compromised first permanent molars: an orthodontic perspectiveAUSTRALIAN DENTAL JOURNAL, Issue 1 2010DC-V Ong Abstract The first permanent molar (FPM) is commonly subject to significant compromise which may arise due to caries or endodontic complication, or from developmental anomalies such as hypoplasia. Compromised teeth with questionable prognosis may result in short and long-term clinical dilemmas. This review article highlights the factors that require careful consideration when a compromised FPM is detected and the importance of timely FPM extraction. Several clinical cases are described in detail to discuss possible treatment options from the orthodontic perspective. [source] Continuing professional development self-assessment quiz: Compromised first permanent molars: an orthodontic perspectiveAUSTRALIAN DENTAL JOURNAL, Issue 1 2010Article first published online: 5 MAR 2010 No abstract is available for this article. [source] Is orthodontic treatment without premolar extractions always non-extraction treatment?AUSTRALIAN DENTAL JOURNAL, Issue 3 2005S. Kandasamy Abstract While it is common in contemporary orthodontic and orthopaedic treatment to commence treatment for many growing patients during the mixed-dentition, the creation of anterior space, often involving the attempted distalization or holding-back of the upper and lower permanent molar teeth has been shown to commonly result in posterior space deficiencies. Although the extractions of permanent premolar teeth may have been avoided, the developing second and third permanent molars are often affected, so that third molar impaction results in many cases. This is not to say that orthodontic treatment carried-out without premolar extractions is not ideal in many cases, but on the available evidence, so-called absolute ,non-extraction' protocols should be questioned, so that both the dental profession and the public at large are not misled. [source] Clinicians choices of restorative materials for childrenAUSTRALIAN DENTAL JOURNAL, Issue 4 2003LA Tran Abstract Background: Recently, there has been an expansion in the range of tooth-coloured restorative materials available. In 1999, the National Health and Medical Research Council recommended clinicians use alternatives to amalgam in children ,where appropriate'. Methods: A three-part 29-item questionnaire was developed, tested in a focus group, and distributed to members of the Australasian Academy of Paediatric Dentistry (AA; paediatric dentists and paediatric dentistry postgraduate students; n=55), and the Australian and New Zealand Society of Paediatric Dentistry, Victorian Branch (SPD; general dentists and dental therapists; n=50). Participant information, material choices, and six hypothetical clinical scenarios were addressed. Results: The overall response rate was 74 per cent. For both groups, the first ranked factor influencing choice of restorative material for vital primary teeth was child age, and caries experience for vital first permanent molars. For moderate-sized Class I and II restorations in primary molars, a tooth-coloured material was chosen by 92 and 84 per cent respondents respectively. For restoring two separate proximal lesions in a primary molar, 65 per cent chose a tooth-coloured material followed by a stainless steel crown (27 per cent; all AA members), then amalgam (8 per cent). The SPD respondents were significantly more likely to choose glass ionomer cement for Class I and II restorations and for restoring two proximal lesions (all p=0.000) in primary molars than AA respondents, who were more likely to choose composite resins/compomers or amalgam/stainless steel crowns for these restorations. Younger respondents (21,40 years) were significantly more likely to choose composite resins/compomers or amalgam/stainless steel crowns (p=0.048) than older respondents (41,65 years), who were likely to choose glass ionomer cement. Conclusions: For Class I and II restorations in primary molars, glass ionomer cement was the material chosen most frequently (SPD respondents); preference for amalgam or stainless steel crowns was low (both SPD and AA groups). The wide range of materials chosen for the hypothetical clinical scenarios suggests the need for guidelines on selection of restorative materials, and the need for longitudinal studies to follow actual clinical outcomes of the materials chosen. [source] MTA pulpotomy of human permanent molars with irreversible pulpitisAUSTRALIAN ENDODONTIC JOURNAL, Issue 1 2009Mohammad Jafar Eghbal dds Abstract The histological success of mineral trioxide aggregate (MTA) pulpotomy for treatment of irreversible pulpitis in human teeth as an alternative treatment was investigated in this study. Fourteen molars which had to be extracted were selected from patients 16,28 years old. The selection criteria include carious pulp exposure with a history of lingering pain. After isolation, caries removal and pulp exposure, MTA was used in pulpotomy treatment. Patients were evaluated for pain after 24 h. Two patients were lost from this study. Twelve teeth were extracted after 2 months and were assessed histologically. Recall examinations confirmed that none of the patients experienced pain after pulpotomy. Histological observation revealed that all samples had dentin bridge formation completely and that the pulps were vital and free of inflammation. Although the results favour the use of MTA as a pulpotomy material, more studies with larger samples and a longer recall period are suggested to justify the use of MTA for treatment of irreversible pulpitis in human permanent teeth. [source] Caries incidence in permanent first molars after discontinuation of a school-based chlorhexidine-thymol varnish programCOMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 3 2003Pilar Baca Abstract , Objectives: To determine whether the cessation for 3 years of a 24-month program of chlorhexidine-thymol varnish applications would affect caries incidence in the first permanent molars of a population of schoolchildren of middle and lower-middle socioeconomic level. Methods: Two groups of 6,7-year-old schoolchildren, randomized by school-class, were followed up in a clinical trial. One group received applications of chlorhexidine-thymol varnish every 3 months and the other group acted as controls. The program ended after 24 months and its effects were evaluated. Three years later, 55.5% of the schoolchildren were re-examined and the caries increments were documented. Results: At the end of the 24-month program, the treated children had significantly fewer decayed and filled surfaces in permanent molars (lower DFS index) versus the controls. At 3 years after the discontinuation of the program, this difference had disappeared; there were no differences in the incidence of decayed, missing and filled surfaces (DMFS) index in permanent molars between the treated children and the controls. Conclusion: The cessation for 3 years of a 3-month program of chlorhexidine-thymol varnish applications resulted in a nonsignificant increase in the prevalence of dental caries in the permanent first molar. [source] | ||||||||||||||||||||||