Malocclusion in the primary dentition

In this paper we analyze the type and frequency of malocclusions in a group of 100 health children with complete primary dentition. Bjork's method for epidemiological registration was taken as a basis. Of the examined children, 78% had some malocclusion type. The most frequent was the increased horizontal overbite. In vertical overbite relation we find anterior open bite, increased overbite, anterior open bite, increased overbite.     

Fluoride,beverages and dental caries in the primary dentition

Knowledge concerning risk factors for primary dentition caries in young children is incomplete. Models are presented for caries development using longitudinally gathered fluoride exposure and dietary intake data in the Iowa Fluoride Study. Primary tooth caries examinations were conducted at age 5. Dietary (beverage) and fluoride exposure data were gathered longitudinally from age 6 weeks through 4 years (n = 291); 23% had decayed or filled surfaces. Logistic regression revealed that beverage components and toothbrushing made unique contributions to caries experience. Water consumption (36-48 months), milk consumption (24-36 months), and fluoridated toothpaste brushings (36-48 months) were negatively associated with caries; sugared beverages and milk (6 weeks to 12 months) were positively associated. Although fluoride exposure is important, sugared beverages contribute substantially to caries risk, while water and milk consumption and frequent toothbrushing early can have protective effects.     

Traumatic injuries in the primary dentition

Abstract  – As a support for the guidelines published in 2001, a review of the literature was carried out using the evidence-based approach in order to update the state of the art regarding epidemiology and treatment of traumatic dental injuries in the primary dentition. An online search in Medline, and a review of expert literature, lead to the conclusion that most luxation injuries heal spontaneously, and unless more conclusive evidence is available, conservative treatment of acute dental trauma for preschool children is suggested. Pain control, the dentist's ability to cope with the child's anxiety, and follow-up instructions in oral hygiene techniques will allow many primary teeth that are currently lost at the time of injury to be saved.     

Endodontic treatment in the primary dentition

A number of factors are involved in the development of pulp and periapical disease in primary and permanent teeth, with dental caries being the main factor. Although these factors are similar, the clinical management of a primary or permanent tooth with pulp or periapical disease may be quite different. This is based mainly on the differences between the two types of teeth, with primary tooth longevity, coronal structural integrity, root canal morphology, and root anatomy being important features to be taken into account when treatment planning. This paper reviews some aspects of primary teeth and the various treatment options for the management of pulp and periapical disease.     

Aplasia, supernumerary teeth and fused teeth in the primary dentition

abstract – Numerical variations and fusions in the primary dentition were studied among 4,564 children from 3 to 31/2 years of age. The results of the examination showed that aplasia occurs in 0.5%, hyperodontia in 0.5%, and fusions in 0.9%. Patients with aplasia in the primary dentition nearly always showed aplasia of the successors. In patients with unilateral aplasia in the primary dentition, aplasia of the contralateral permanent tooth was often found also. Most cases of hyperodontia occurred in the maxilla. Half the supernumerary teeth were maxillary lateral incisors, and they were often followed by hyperodontia in the permanent dentition, whereas cases with supernumerary central incisors were less often followed by hyperodontia in the permanent dentition. Where a mandibular lateral incisor and canine were fused, aplasia of the permanent lateral incisor was always found, whilst cases with fused incisors only rarely involved changes in the permanent dentition. Cases with gemination in the primary dentition were as a rule followed by normal conditions in the permanent dentition.     

Trauma to the primary dentition

The guiding principle in managing trauma to the primary dentition is potential sequelae to the permanent tooth. If the risk to the permanent tooth is great, the primary tooth should be removed. If esthetics are a concern to the parent, a number of appliances can be fabricated to temporarily manage this issue. It is important that parents realize that the desire to maintain optimum esthetics by maintaining a significantly injured primary tooth can, in many cases, cause more damage to the permanent tooth. Where avulsions have occurred, the old adage "when in doubt, leave it out" is still perhaps the most reliable advice.     

Interdental spacing and caries in the primary dentition

PURPOSE: This study assessed the relationship between interdental spacing patterns and caries experience in the primary dentition. METHODS: Caries examinations were conducted amoung 356 children 4 to 6 years of age. At the time of the examinations, alginate impressions were obtained and poured in yellow stone. From the stone casts, each interdental area was categorized as: (1) space > 1 mm, (2) space < 1 mm, (3) no space, teeth in contact, or (4) no space, teeth overlapped. These categories were collapsed into presence or absence of space for each interdental site, and counted for each individual. Analyses assessed the relationships between interdental spacing and caries experience with separate analyses for anterior spacing, posterior spacing and total spacing. RESULTS: Children with more total interdental spaces had less decay experience and less untreated decay than children with fewer interdental spaces, and children with more molar spacing had less molar decay experience; however, these relationships were weak. Correlation analyses demonstrated significant relationships between number of decayed surfaces and total number of interdental spaces (r=-0.11, P=.04) and number of molar sites with interdental spaces (r=-0.13, P=.02). Multivariate analyses revealed the total number of interproximal spaces to be weakly associated with interproximal caries experience, but that fluoride exposure was a much stronger predictor. CONCLUSIONS: Absence of interdental spaces is weakly associated with greater decay experience in the primary dentition.     

Oral leukocytes and gingivitis in the primary dentition

A survey was performed to evaluate the relationships among orogranulocytic migratory rale, gingival index and plaque index in a group of systematically healthy preschool children.
The fifty children selected for study had only primary teeth, no pharyngeal or extragingival inflammation and were taking no medication. Each child was subjectively scored for the amount of bacterial plaque and gingival inflammation present. The rate of migration of leukocytes into the oral cavity per 30 second period was determined from the last three of ten 30 second consecutive oral saliva rinses as an objective measure of gingival inflammation.
A minimal amount of localized mild marginal gingivitis was observed in the presence of a rather large plaque accumulation. No significant correlation was observed between rates of oral leukocyte migration and the degree of gingival inflammation. However, the leukocyte migratory rates in this group were quite low as compared to those found in adults by other investigators.     

Aetiology, diagnosis and treatment of posterior cross-bites in the primary dentition

INTRODUCTION: Children who present with a posterior cross-bite in the primary dentition may be predisposed to long-term detrimental consequences if the condition is left untreated. Controversy exists in the literature as to the most appropriate time to treat this condition. OBJECTIVES: The aim of this review is to evaluate the need for correcting posterior cross-bites in the primary dentition based on the current understanding of the aetiology, likelihood of self-correction, and consequences of various forms of this malocclusion persisting into the mixed and permanent dentitions. A review of the reported treatment options for management of this condition is also presented. METHODS: Literature pertaining to the epidemiology and management of posterior cross-bites in the primary dentition are reviewed. CONCLUSION: Posterior cross-bites in the primary dentition are relatively common and their causes are numerous. Because a significant proportion of posterior cross-bites self-correct beyond the primary dentition, routine correction in the primary dentition phase cannot be advocated. A unilateral posterior cross-bite as a result of a functional displacement of the mandible is one of the few malocclusions which should be considered for correction in the primary dentition. Further research is needed in the management of this condition.     

Pulp therapy in the primary dentition.

Pulp therapy in the primary dentition is an area undergoing continual changes. Treatment involves numerous methods and the use of a variety of dental materials. This article discusses various techniques and materials used in pulp therapy in the primary dentition. It includes a summary of the morphology, indications, contraindications, techniques for pulpotomies and pulpectomies, and contemporary treatment modalities used in the primary dentition.     

Talon cusp in primary dentition

Six cases of talon cusp in the primary dentition are reported, bringing to ten the total cases described in the literature. The dental anomaly affected only maxillary primary central incisors, and no succedaneous teeth were affected. None of the ten cases were associated with any abnormal development syndrome. Clinical observations suggest that the incidence of talon cusps in the primary dentition may be not lower than that in the permanent dentition in Chinese children.     

Pulp therapy in the primary dentition.

Several treatment options for pulp therapy in primary teeth are reviewed. Conservative treatments are recommended for primary teeth whose pulps have the potential to recover once the irritation has been removed. The role of dentin permeability and microleakage is emphasized when protective basis and indirect pulp treatment are discussed. Alternative dressings for formocresol pulpotomies such as 6.25% glutaraldehyde solution, antigen-extracted allogeneic dentin matrix, and crude bone morphogenetic protein are reported with promising results. Pulpectomy is recommended for teeth with evidence of chronic inflammation involving radicular pulp or pulp necrosis with and without periapical involvement. The main disadvantage of zinc oxide-eugenol paste, widely used for primary root fillings in the United States, is its slow resorption rate, frequently much slower than that of the root. Other root canal pastes containing iodoform, or a modification of this with the addition of calcium hydroxide, are being utilized in South America, Japan, and Europe.     

Marginal bone loss in the primary dentition

Abstract. The present study was designed to determine the prevalence of bone loss in the primary dentition of children. Radiographs from children aged 7–9 were collected from 25 out of a total of 26 Public Dental Clinics in the County of Örebro, Sweden. These radiographs, representing 36.0%, 50.3% and 48.7% of all 7-, 8- and 9-year-old children ( n = 8666) living in the districts of the participating clinics, constituted a primary sample. In addition, the 9-year-olds were subjected to a more comprehensive sampling procedure to obtain a more complete sample (sample of 9-year-olds), resulting in a group of 2017 children (71.9%). The radiographs were evaluated with respect to presence of marginal bone loss (CEJ-MBL: distance between the cemento-enamel junction and the marginal bone level >2 mm), proximal calculus and number of decayed and filled proximal surfaces (dfs_p) in the posterior areas of the primary dentition. In the primary sample, the prevalence of bone loss for 1 proximal surfaces of the primary dentition in the 7-, 8- and 9-year-old children was 2.0%, 3.1% and 4.5%, respectively. The corresponding figures for proximal calculus were 2.5%, 3.1% and 4.2%. Mean number of dfs_p amounted to 2.3, 2.5 and 3.0. The prevalences of bone loss and proximal calculus as well as the mean number of dfs_p in the sample of 9-year-olds corresponded to the findings for the 9-year-old children in the primary sample. The analyses of the sample of 9-year-olds showed that most of the children with bone loss had 1 affected surface only. The largest CEJ-MBL distance for each individual with bone loss ranged from 2.5 to 6.0 mm. Children with bone loss displayed calculus more often than children without bone loss. The children with bone loss also showed higher mean dfs_p compared to children without bone loss.     

Caries in the primary dentition,after discontinuation of water fluoridation

J Evid Base Dent Pract 2001;1:10-1