Histopathology study on pulp response to glass ionomers in human teeth

OBJECTIVE

Evaluation of the pulpal response to a resin-modified glass ionomer, a conventional glass ionomer and calcium hydroxide.

METHODS AND MATERIALS

Fifty-five deep Class V cavities were lined with Vivaglass Liner, Chembond Superior and Dycal. After seven, 30, and 60 days the teeth were extracted and a histological assessment was performed.

RESULTS

There was no statistically significant difference in pulpal response among the three groups for the same time interval (P > 0.05).

CONCLUSION

Light-cured glass ionomers have similar advantages to conventional glass ionomers.

Oral health service systems in Gauteng Province, South Africa

OBJECTIVES

To describe the provision of restorative care and dental operators' opinion about their conditions of service in a South African provincial oral health service system.

DESIGN

Assessment of oral health service over a four-month period.

SETTING

Gauteng Province, South Africa.

SUBJECTS

Dental operators in public oral health service.

INTERVENTIONS

Operator interview, collection of treatment statistics, calculation of the mean score of restoration-extraction ratio per operator.

MAIN OUTCOME MEASURES

Number and type of restorations and tooth extractions rendered, daily patient load, perceived occupational stress level and opinion about main reasons for operator stress.

RESULTS

A total of 88,705 patients had been treated. The mean number of patients treated daily was 26 (SD = 8.4). Operators extracted 39,242 teeth and placed 2992 restorations. The main type of dental treatment was extraction. The mean score of the restoration-extraction ratio per operator was 0.09 in the primary, and 0.07 in the permanent dentition. The mean level of stress was 4.9 (SD = 1.9). The majority of operators regarded patients' high dental anxiety as the main reason for stress, followed by high patient load. The mean level of stress increased with the increase in number of patients treated per day (r = 0.44, p = 0.004) and also with the increase in the number of tooth extractions performed per day (r = 0.41, p = 0.008).

CONCLUSIONS

Restorative dental care in this public oral health service is limited, tooth extraction being the predominant treatment provided. High patient load and high patient levels of dental anxiety determine this situation, according to the operators. The health authority should introduce appropriate solutions in order to address the prevailing situation adequately.

Arteriovenous malformation of the mandible: a case report

Arteriovenous malformations (AVMs) are an abnormal collection of blood vessels. They are extremely rare congenital or acquired abnormalities in the structure of blood vessels. These malformations have been associated with severe hemorrhage resulting in significant morbidity and mortality. Gingival bleeding seems to be a common symptom of most documented cases of AVM, and radiographs most often appear normal. A 12-year-old girl who was first examined by a general dentist for occasional bleeding associated with the right mandibular teeth was referred to the University of Istanbul, Faculty of Dentistry. During the suturing process to stop the leakage around the mandibular right first molar, uncontrollable hemorrhage began. Magnetic resonance imaging and angiogram revealed the AVM of the right mandibular body. After embolization with an injection of a mixture of cyanoacrylate and lipiodol, the tooth was extracted and initial periodontal therapy performed. The patient has maintained a satisfactory gingival and oral condition since the completion of dental treatment and establishment of oral hygiene. Clinicians should be aware of these lesions and the impact they can have on routine procedures. Proper recognition and therapeutic intervention can help to avoid serious complications and potentially tragic outcomes.

Dental rehabilitation of the patient with multiple endocrine neoplasia Type 2b

Multiple endocrine neoplasia 2b (MEN 2b) is characterized by medullary thyroid carcinoma, pheochromocytoma, and various neuromas throughout the body, including the oral cavity and the perioral and periocular areas. The syndrome is inherited in an autosomal dominant fashion with high penetrance. This article presents a case of MEN 2b in a 24-year-old woman and discusses the medical and surgical issues that relate to the disorder. In addition, this article describes the workup, diagnosis, and treatment, along with a discussion of the pathophysiology of MEN 2b as it relates to the dental rehabilitation of a patient with the disorder.

Extraction of first permanent molar teeth: results from three dental hospitals

OBJECTIVE

To evaluate and compare the reasons for and pattern of extraction of first permanent molars (FPMs) in three UK dental hospitals.

DESIGN

Prospective multicentre study.

SETTING

Hospital.

SUBJECTS

Three hundred children attending Manchester Dental Hospital, Liverpool Dental Hospital and Charles Clifford Dental Hospital (Sheffield) who required extraction of at least one FPM.

RESULT

The mean age in months was 129 (SD 22.7), 139 (SD 29.4), and 133 (SD 26.8) for Manchester, Liverpool and Sheffield respectively. Forty-five percent and 48% of children had four FPMs extracted at Manchester and Sheffield respectively, compared to 25% in Liverpool. The main reason for extraction was caries with poor prognosis (70%); molar incisor hypomineralisation was the reason for extraction in 11% of cases. General anaesthesia was the main anaesthetic method used in 77%, 55%, and 47% of cases in Manchester, Liverpool and Sheffield respectively. Sixty-eight percent of cases had not received previous treatment for the FPMs and 5% had fissure sealants detected. Forty percent of children had had previous extractions.

CONCLUSION

The children who are attending the hospitals for extraction of FPMs tend to be older than the recommended age for achieving spontaneous space closure. This study highlights the need for extensive prevention programs targeted at those children with high caries risk.

Oral management in a patient with fibrodysplasia ossificans progressiva

Fibrodysplasia ossificans progressiva (FOP) is an autosomal dominant disorder of connective tissue. FOP results in debilitating heterotopic ossification of the axial and appendicular skeleton. Permanent ankylosis of the temporomandibular joint (TMJ) is a common late finding, but is usually preceded by specific inciting trauma. Extreme care must be exercised when carrying out routine dental care to prevent soft tissue trauma. Oral health care for patients with FOP is usually complex. There are additional considerations when oral surgical procedures, such as extractions, are needed. Maintaining a balance between oral health and disease progression in these patients is challenging, as they frequently present with advanced oral disease. Fiber optic-assisted placement of the nasoendotracheal tube is the standard of care. Intramuscular injections including mandibular blocks must be avoided. Permanent fusion of the TMJ leads to malnutrition, inanition, and aspiration of food. In patients with complete TMJ ankylosis, dental extractions can be safely and effectively performed while accessing teeth from the buccal aspect. This approach has successfully resulted in decreased morbidity in these patients as well as others with limited oral opening.

Preformed metal crowns for decayed primary molar teeth

BACKGROUND

Preformed metal crowns (PMCs) are recommended by the British Society of Paediatric Dentistry (BSPD) for restoring badly broken down primary molar teeth. However, few dental practitioners adopt this technique in clinical practice, citing cost and clinical difficulty as reasons for this. Whilst there is a subjective impression by clinical academics that PMCs provide a more durable restoration than filling materials, there appears to be little evidence within the literature to support this.

OBJECTIVES

The primary aim of this systematic review was to compare clinical outcomes for primary molar teeth restored using PMCs compared to those restored with filling materials.

SEARCH STRATEGY

The literature was searched using: the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2005, Issue 3); MEDLINE (1966 to August 2005); EMBASE (1980 to August 2005); System for Information on Grey Literature in Europe (SIGLE) (1976 to August 2005). Relevant publications' reference lists were reviewed for relevant articles. The most recent search was carried out on 24 August 2005.

SELECTION CRITERIA

Randomised controlled trials (RCTs) that assessed the effectiveness of PMCs compared with filling materials or where there had been no treatment in children with untreated tooth decay in one or more primary molar teeth.

DATA COLLECTION AND ANALYSIS

Two review authors independently assessed the title and abstracts for each article from the search results to decide whether it was likely to be relevant. Full papers were obtained for relevant articles and all three review authors studied these.

MAIN RESULTS

Forty-seven records were retrieved by the search strategies of which some were duplicates. Of these, 14 studies were scrutinised. No studies met the inclusion criteria and six studies were excluded from the review as they were either retrospective in design or reported as prospective outcomes but not randomised. No data were available for extraction and analysis and therefore, no conclusion could be made as to whether PMCs were more successful than filling materials for restoring primary molar teeth.

AUTHORS' CONCLUSIONS

No RCTs were available for appraisal. Whilst this technique is recommended by the BSPD for use in clinical practice, the evidence to support this is not strong, consisting mainly of case reports and uncontrolled studies. It is important that the absence of evidence for PMCs is not misinterpreted as evidence for their lack of efficacy. There is a strong need for prospective RCTs comparing PMCs and fillings for managing decayed primary molar teeth. The lower levels of evidence that have been produced, however, have strength in that the clinical outcomes are consistently in favour of PMCs, despite many of the studies placing PMCs on the most damaged of the pair of teeth being analysed.

Accessing and restoring root caries: a case report

Adequate access to root caries can be problematic. The inability to view, isolate, and access the entire lesion may result in residual caries, poor adaptation of the restoration, and defective margins. Minor periodontal procedures, ranging from a mini-flap involving only one tooth, to conventional flap surgery can provide increased visibility and access to these troublesome areas. Through utilization of this technique, excellent preparations and restorations can be achieved. Restorative materials with a high potential for fluoride release as well as uptake should be highly considered in cases of root caries. The selection of a conventional or resin-modified glass ionomer provides several advantages. Most notably are the ability of these restoratives to chemically bond to tooth structure, and to provide significant fluoride release and uptake. These properties are not present in amalgam, composites, or compomers. Additionally, the material itself is relatively easy to use and provides an effective zone of caries inhibition around the margins of the restoration. Glass ionomers are not as sensitive to moisture as conventional resin composites or compomers, and, as a result, may provide a better bond to tooth structure and margination in areas where moisture control is troublesome. Finally, the polymerization shrinkage of these materials is not as great as resin composites, which should also improve marginal integrity. Clinical studies have demonstrated longevity of ten years or greater as well as success in xerostomic patients. Management of xerostomic patients should be directed toward finding satisfactory methods to relieve dryness. Some prescription medications are available, but should only be recommended after consultation with the primary care physician. Oral moisturizers are also available as are saliva substitutes. Caution should be used when recommending saliva substitutes due to the fact that some commercial products have been demonstrated to have a pH below the demineralization point of enamel. Products of this nature should be avoided. In the last few decades, the age of the patient population has increased and individuals have a greater tendency to maintain their natural dentition throughout their entire life. Gingival recession and subsequent root exposure has become more prevalent in the adult population. Additionally, the use of prescription medications that impact the flow and consistency of saliva is widespread. As a result of these phenomena, it has been predicted that root caries will become more prevalent. When preventive measures prove to be ineffective and restorations must be placed, access, visibility, and appropriate material selection are paramount. A combined minor periodontal surgery and restorative procedure is relatively simple, and when done properly, can provide excellent and affordable dentistry in these problematic areas.

The Use of CVD Diamond Burs for Ultraconservative Cavity Preparations: A Report of Two Cases

During the past decades, scientific developments in cutting instruments have changed the conventional techniques used to remove caries lesions. Ultrasound emerged as an alternative for caries removal since the 1950s. However, the conventional technology for diamond powder aggregation with nickel metallic binders could not withstand ultrasonic power. Around 5 years ago, an alternative approach using chemical vapor deposition (CVD) resulted in synthetic diamond technology. CVD diamond burs are obtained with high adherence of the diamond as a unique stone on the metallic surface with excellent abrading performance. This technology allows for diamond deposition with coalescent granulation in different formats of substrates. When connected to an ultrasonic handpiece, CVD diamond burs become an option for cavity preparation, maximizing preservation of tooth structure. Potential advantages such as reduced noise, minimal damage to the gingival tissue, extended bur durability, improved proximal cavity access, reduced risk of hitting the adjacent tooth resulting from the high inclination angles, and minimal patient's risk of metal contamination. These innovative instruments also potentially eliminate some problems regarding decreased cutting efficiency of conventional diamond burs.

CLINICAL SIGNIFICANCE

This clinical report presents the benefits of using CVD diamond burs coupled with an ultrasonic handpiece in the treatment of incipient caries. CVD diamond burs coupled with an ultrasonic device offer a promising alternative for removal of carious lesions when ultraconservative cavity preparations are required. Additionally, this system provides a less-painful technique for caries removal, with minimal noise.

Reasons for third molar teeth extraction in Jordanian adults

AIMS

To assess reasons for third molar teeth extractions in a sample of Jordanian dental patients and to evaluate the association of extractions with other independent variables.

METHODS AND MATERIALS

The study sample was comprised of dental patients in North Jordan who had third molar extractions. Data were collected from 36 dentists who were instructed to administer questionnaires to their adult patients undergoing third molar extractions and then to record the primary reason for those extractions. The data in this study was analyzed using a descriptive summary and chi square statistics.

RESULTS

Dentists performed 810 extractions for 648 patients. The reasons for the extractions were: dental caries and its consequences about 42%, eruption problems 39%, periodontal diseases about 7%, and approximately 9% of extractions were a result of the dentist's choice. The percentage of extractions due to dental caries significantly increased with increasing age. However, significant numbers of teeth were extracted due to eruption problems (51%-69%) in young adults. For 46+ year olds, 23% of extractions were caused by periodontal diseases. Extraction due to dental caries was distributed equally among the sexes. Persons with irregular tooth brushing and fewer dental visits had significantly more third molar teeth extracted due to caries and periodontal diseases compared to persons with regular tooth brushing and dental visits.

Successful use of recombinant factor VIII devoid of von Willebrand factor during multiple teeth extractions in a patient with type 3 von Willebrand disease

We report a 55-year-old patient with type 3 von Willebrand disease who underwent multiple tooth extractions with successful hemostatic management using recombinant factor VIII. The patient was previously misdiagnosed and treated incorrectly then at 53 years old, he was diagnosed with type 3 von Willebrand disease. As he had avoided dental treatments for two decades due to severe bleeding after dental extraction, multiple severe caries and marginal periodontitis were revealed. The patient refused the use of blood products in hemostatic management because he was afraid of blood-borne diseases and development of anti-von Willebrand factor alloantibodies. After close consultation, we therefore decided to use recombinant factor VIII. Four teeth extraction procedures were executed twice. Before extraction, bolus recombinant factor VIII (50 IU/kg) was administered intravenously followed by continuous infusion (5-10 IU/kg per h) for approximately 48 h. The factor VIII:C level increased from about 1 to 20-32% 30 min after bolus infusion. During continuous infusion (10 IU/kg/h), factor VIII:C was maintained at more than 10%. Little bleeding occurred during and after the multiple teeth extractions and during suture removal. On frequent examinations during a 1-year follow-up, neither von Willebrand factor nor factor VIII inhibitors were detected.

Evaluation of oral midazolam as conscious sedation for pediatric patients in oral restoration

OBJECTIVE

To evaluate the effect of midazolam alone on sedation in young children for dental restorative care.

METHODS

Forty children, aged 5 to 10 years with a mean age of 7.3 years, participated in this study. Twenty-one patients were assigned to intervention group received 0. 5 mg/kg of oral midazolam 20 minutes prior to the beginning of dental treatment, and 19 patients in control group received placebo liquid 20 minutes before treatment All patients received painless local anesthetic injection and were restrained with children's board and bands. Blood pressure (BP), heart rate (HR), oxygen saturation, treatment compliance scores of the Ramsay scale, the Briekopf and Buttner scale, Frankl scale, and the Houpt scale were recorded. Each procedure was taped and all the data were evaluated every 5 minutes by an anesthetist or experienced dentist who was unaware of the drug given to the child.

RESULTS

HR in intervention group (82.5 +/- 5.1 bpm) was much lower than that in control group (95.2 +/- 8.9 bpm; F = 31.20, P < 0.001). Intervention group had a significantly lower systolic BP level (94.8 +/- 5.6 mm Hg) than control group (98.5 +/- 5.5 mm Hg; F = 4.34, P = 0.04), but the diastolic BP (63.0 +/- 3.5 mm Hg) was not significantly lower than control group (65.5 +/- 4.8 mm Hg; F = 3.31, P = 0.07). Children in intervention group showed more compliance. The patients' scores of the Ramsay scale, Briekopf and Buttner scale, Frankl scale, and Houpt scale in intervention group (1.37 +/- 0.96, 1.37 +/- 0.83, 1.32 +/- 0.67, and 2.32 +/- 1.49, respectively) were significantly lower than those in control group (3.71 +/- 1.23, 2.71 +/- 0.96, 2.71 +/- 0.90, and 4.71 +/- 1.19; F = 44.66, 22.36, 30.39, and 31.88, respectively, all P < 0.001).

CONCLUSIONS

Oral midazolam alone is safe and produces effective sedation for the dental treatment of young children. Oral midazolam application should be generally preferred because it is more easily accepted by pediatric patients.

Chemo-mechanical dentine caries removal with Carisolv using a rotating brush

AIM

The aim of this study was to assess the efficacy of removing dentine caries using carbide burs, Carisolv with hand instruments and Carisolv in combination with a new mechanical excavation method using a rotating brush.

METHODS

36 extracted permanent teeth, with dentine caries, were assigned into 3 groups according to caries removal technique. Caries removal was monitored by checking the properties of the dentine with a dental explorer. After embedding and sectioning (400 microm), remaining caries was assessed by using a caries detector. In microscope images (7x) of the samples, the mean stain depth of the remaining carious tissue per tooth was calculated by AnalySIS computer software.

RESULTS

Four to 8 applications (mean time = 10.9 min) of Carisolv were necessary for caries removal with the new method using rotating brushes. The mean thickness of residual dentine caries by this procedure (226 microm, +/- 136) was higher than the one using Carisolv with hand instruments (57 microm, +/- 39) or carbide burs (32 microm, +/- 20). Even in areas with good access to the lesion, an unacceptable amount of residual caries was observed.

CONCLUSION

Thus, it seems that Carisolv using rotating brushes does not reach the degree of caries removal reached by additional mechanical abrasion of Carisolv using hand instruments or conventional rotating carbide burs.

Effect of high light intensity on cavity wall adaptation of a resin composite with a self-etching primer system

This study evaluated the effect of high light intensity using a plasma arc lamp on the cavity wall adaptation of photo-polymerized composite restorations. Bowl-shaped cavities were prepared on the labial surfaces of extracted bovine teeth. Each cavity was restored with a resin composite restorative system (SE Bond & Clearfil AP-X) and then polymerized using a plasma arc lamp (Arc Light II) with a series of light intensities, including 1100, 1200, 1300, 1400, 1500, and 1600 mW/cm(2), and a halogen lamp (Candilux) with 400 mW/cm(2) light intensity (n = 10). The photo-irradiation time was adjusted for each group to receive a total energy output of approximately 16,000 mJ/cm(2). The specimens were subjected to 2500 cycles of thermal fatigue and sectioned bucco-lingually through the center of the restoration. Contraction gaps on the sections were measured using a replica-SEM observation technique. The degree of gap formation was determined as the ratio of the total length of the contraction gaps to the total length of the cavity wall on each sectioned specimen. The value was converted to a percentage. The data were statistically analyzed with Kruskal-Wallis and Mann-Whitney U tests at a 0.05 level of significance. There were no significant differences (p > 0.05) in the cavity adaptation among the composites polymerized by the plasma arc lamp with high light intensities and the composite polymerized with the halogen lamp with 400 mW/cm(2) light intensity. There were no significant differences (p > 0.05) in the degree of cavity adaptation among the specimens polymerized with light intensities higher than 1100 mW/cm(2).

Reasons for permanent tooth extraction in the North of Afghanistan

OBJECTIVES

The aim of this study was to study the pattern of and reasons for permanent tooth extraction in a group of Afghan patients attending a dental clinic in the North of Afghanistan.

METHODS

A simple clinical survey was done in Afghan population sample that has undergone or planned for tooth extraction.

RESULTS

A total of 184 permanent teeth were extracted from 123 patients ranging in age from 9 to 62 years during the three-month study period. Males were 54.5% while females formed 45.5%. Overall, caries was the most frequent reason for tooth extraction (59.2%), followed by periodontal disease (35.3%), surgical indications (4.9%) and patient request (0.5%). Caries was the main reason for tooth loss up to 50 years of age. However, periodontal disease became the principal reason in 51 years old and over. Posterior teeth represented the highest percentage (84.2%) of extraction.

CONCLUSIONS

Both caries and periodontal disease were the main reasons for tooth extraction in the North of Afghanistan, so that proper oral health system including efficient programs focusing on prevention and treatment of these diseases should be created and developed.

Efficiency of the Polymer Bur SmartPrep Compared with Conventional Tungsten Carbide Bud Bur in Dentin Caries Excavation

By comparing polymer bur SmartPrep with conventional tungsten carbide bud burs in vitro, SmartPrep seems to be less effective in carious dentin excavation.

The frequency of repeat general anaesthesia for teeth extractions in children

AIM

The purpose of this study was to determine the frequency of repeat extractions under general anaesthesia (GA) in children.

METHODS

The dental hospital records of patients attending for outpatient GA extractions at Liverpool University Dental Hospital, Liverpool, UK, between January and March 2003 were examined retrospectively. A data collection form was used to record the relevant information.

RESULTS

A total of 278 patients with a mean age of 6.5 years (SD = 2.2 years) were seen for GA extractions. Of those, 33 patients (11.9%) with a mean age of 4.9 years (SD = 2 years) at the time of their initial GA had had a previous or would undergo a subsequent episode of GA extraction. The mean interval between repeat GA was 2.3 years (SD = 1.6 years). Fifteen cases (45.5%) had the repeat GA within 2 years. Radiographs were available as part of the assessment process for 84 (34.3%) of the 245 patients who had had a single episode of GA. However, of the 33 patients who had had a repeat GA, only seven (21.2%) had radiographs available at the time of the initial GA. Regarding the number of teeth extracted, a significant difference (P < 0.01) was found between the number of teeth extracted in patients who had had a single GA (mean = 4.6, SD = 2.5), compared with those extracted at the initial GA for the repeat GA group (mean = 3.2, SD = 2).

CONCLUSION

The frequency of repeat GA is relatively low, but there is a need for appropriate treatment planning incorporating the use of radiographs to reduce this even further.

Prevention of postoperative tooth sensitivity: a preliminary clinical trial

The purpose of this study was to evaluate clinically the effects of pre-treatments with a 35% hydroxyethyl metacrylate/5% glutaraldehyde dentine desensitizer (Gluma Desensitizer) and a 2% chlorexidine-based cavity disinfectant (Cav-Clean) on postoperative sensitivity. Three premolar teeth with no pain symptoms were selected from each one of 17 patients, totalling 51 teeth, for which Class II restoration using a composite was indicated. Each one of the three premolar teeth of the same patient was submitted to a different treatment. After acid etching, only a dental adhesive was applied to the first tooth, which served as the control. Gluma Desensitizer dentinal desensitizer was applied to the second premolar tooth prior to applying the dental adhesive. Cav-Clean cavity disinfectant was used on the third premolar tooth before applying the dental adhesive. Only one tooth was restored per session, and all premolar teeth were restored with a condensable composite, according to current restoration technique guidelines. Sensitivity to different stimuli (cold, heat, sweet and dental floss) was assessed on Day 1, Day 4 and Day 7 by questionnaire following restorative procedures. The results of this clinical research showed that, as far as the investigated stimuli and postoperative course are concerned, there was no statistically significant difference in the three different treatments (P>0.05). Postoperative sensitivity resulting from Class II restorations using composite resin cannot be completely eliminated with the prior use of a dentinal desensitizer or a cavity disinfectant. In day-to-day clinical treatment, postoperative sensitivity may possibly be related to the technique employed.

Pattern of dental extraction in children in a Nigerian tertiary hospital

Changes that occurred in the pattern of tooth extraction in the last 13 years among a population of children in Nigerian were studied. The result of this study was then compared to that of a past study done in the same institution 13 years earlier. Information on age, gender, and indication of tooth extraction was collected prospectively from 379 consecutive patients who visited the outpatient Pediatric Dental Clinic for the first time during the year 2002. Results showed tooth extraction due to caries decreased, while there was an increase in tooth extraction from an apparent increase in orthodontic treatment needs. Acute necrotizing ulcerative gingivitis (ANUG), a significant cause of tooth loss in the last decade, decreased significantly. The pattern of deciduous tooth loss also changed as more anterior teeth were lost for orthodontic reasons in this present study. The pattern of tooth loss in the permanent dentition remains very similar to that of the past study, though more premolars were lost in the present study. There appears to be an increasing need for tooth extractions in orthodontic treatment for this population of children. The focus of planned dental health care provisions, treatment policies, and training emphasis in child dental care may need to shift to addressing orthodontic needs.

Reasons for early loss of primary molars

PURPOSE

The aims of this study were to investigate the principal reasons for untimely loss of primary molars and to evaluate the risk factors of early primary molar loss in children aged four to nine years.

MATERIALS AND METHODS

1150 untimely lost primary molars were analyzed from 546 patients. The early loss of primary molars was analyzed in relation to age, sex, dmf (t), DMF (T) scores, toothbrushing frequency, history of treatment and maternal education. The data were converted to SPSS format. Pearson Chi-square test was used for statistical analysis.

RESULTS

Among the investigated subjects, 15.2% of children reported regular toothbrushing. Only 23.1% of subjects had a history of treatment before the tooth extraction and 33% of mothers had a low education level. Untimely loss of primary molars due to pain, caries and sepsis were 30.2%, 31% and 38.8%, respectively. The frequency of 'only one primary molar loss' was significantly higher in group 1 (p < 0.05), however the frequency of 'more than one primary molar loss' for group 2 was more than group 1 (p < 0.05). Irregular toothbrushing for the children in group 2 was found significantly high than in group 1 (p < 0.05). Irregular toothbrushing was associated with number of early primary molar loss in group 2 (p < 0.05). The level of maternal education was associated with dmf (t) scores (p < 0.05). The caries incidence was associated with number of early primary molar loss in both groups (p < 0.05). The mean number of treated teeth before extraction for group 2 was significantly higher than for group 1 (p < 0.05).

CONCLUSION

Results of this study suggested that irregular toothbrushing, high dmf (t) scores and untreatment of carious primary molars were significant risk factors in early loss of primary molars. Every effort must be taken into account in restoring rather than extracting carious teeth.

Dental laser research: selective ablation of caries, calculus, and microbial plaque: from the idea to the first in vivo investigation

One of the current dental laser research tracks is selective ablation, which is the removal of disease while not harming adjacent healthy structures. This article describes the scientific path from the first basic laboratory study of the absorption characteristics of caries to selective ablation of bacteria, microbial plaque, and calculus with a blue laser and the first in vivo safety studies in dogs. This article is an example of a typical research path for future studies of the uses of lasers in dentistry.