The application of rotary instrumentation is successful in removing the smear layer and significantly decreasing the root canal microflora, along with superior and consistent obturation in primary teeth. The obturating materials are effective against resistant root canal microflora due to their antimicrobial properties. Aim: To evaluate and compare the combined effect of the type of instrumentation and obturating material on the outcome of pulpectomized primary molars.
A total of 288 selected primary molars were randomly divided into three treatment groups (Group KS, HS and MF), according to the type of instrumentation used for cleaning and shaping of the root canals. Each group consisted of 96 teeth. In the groups KS, HS and MF, root canal instrumentation was carried-out with Kedo-SG Blue pediatric rotary files, HERO Shaper rotary files, and manual NiTi K-files, respectively. Following instrumentation, these three groups were further subdivided into 3 subgroups consisting of 32 teeth each and obturated using zinc oxide eugenol, Endoflas®, and DiaPex Plus®. The quality of the root filling was assessed immediately and evaluated both clinically and radiographically over a two-year period.
The quality of obturation was superior in the root canals instrumented with rotary file systems compared to manual files. The success rate was not statistically significant on the combination of different types of instrumentation file systems and obturating materials at the end of follow-up period.
The outcome of pulpectomized teeth is not significantly influenced by the advanced physical characteristics of rotary files and the chemical and biological qualities of the obturating materials.
This study aims to assess the correlation between parents' knowledge of primary teeth and early childhood caries (ECC).
A study questionnaire consisting of 27 statements was presented to the parents of 500 children aged 0–6 years to obtain their responses. The dmft (decayed, missed, and filled teeth) index values of the children were also recorded.
The average number of correct answers was 16.41. There was a statistically significant difference in the relationship between parents' knowledge levels and their children's ECC diagnoses. The knowledge levels of parents whose children did not have caries were found to be higher (p < 0.001). There was a statistically significant relationship between the parents' knowledge level and their gender, educational status, occupation, income status, and child's age (p < 0.05).
Increased parental knowledge of the importance of primary teeth has a positive relationship with a child's oral health, which can be influenced by sociodemographic characteristics.
Pastes for professional mechanical tooth cleaning (PMTC) that contain abrasive ingredients can damage the surface of a tooth. A PMTC paste containing silica was recently developed as an adsorption material.
We assessed the effectiveness with regard to on stain deposition of a novel PMTC paste containing high-performance silica (HPS) comprising porous ultra-fine particles. We also compared the pigment adsorption capability of HPS with that of ordinary silica.
When PMTC solutions were added to hydrated lime stained with coffee or rooibos tea, a PMTC solution containing HPS was more effective with regard to stain removal than other PMTC solutions without HPS. In addition, stain-preventive effect of the PMTC paste containing HPS was also higher than that of the PMTC paste without HPS. When HPS and ordinary silica were immersed in food-coloring additives, HPS was more adasorptive than ordinary silica, especially with regard to high-molecular-weight pigments. Furthermore, HPS was significantly more adsorptive than ordinary silica 5 min after exposure to coffee and 24 h after exposure to rooibos tea (P < 0.05).
Our results suggest that PMTC paste containing HPS effectively adsorbs pigments and can remove staining and prevent stain deposition without polishing teeth.
Periodontal status and oral hygiene practices are found to be deficient in autistic children. This is attributed to challenges in oral health practices at home and the ability to provide dental treatment in the clinic.
The aim of this research was to identify and understand parental challenges regarding oral health practices of autistic children at home and to identify the barriers related to dental treatment.
This cross-sectional study included 54 parents of Autism Spectrum Disorder (ASD) children attending autism support group centres in the Western Cape. Data collection was completed through a structured online questionnaire. The questionnaire was comprised of socio-demographics, pharmacotherapeutic treatment of the child, oral health challenges faced by parents at home, and oral health challenges in the dental clinic.
Parental assistance of children during daily tooth brushing was reported by 59% of participants and the absence of flossing was particularly evident (90.7%). In the dental clinic, 58% of the parents described the child's behaviour as uncooperative. The majority of parents reported irregular visits to the dentist with extractions being the most commonly performed procedure. Options for treatment under sedation or general anaesthesia were more readily acceptable among parents of autistic children.
Findings suggest that children with ASD require long-term assistance with daily oral hygiene practices. The clinical environment represents an anxiety-provoking space and the uncooperative behaviour of children with ASD is the main barrier to dental treatment.
Vital pulp therapy (VPT) is a contemporary approach for managing deep caries in permanent teeth. However, there is limited information about postoperative pain, especially in pediatric patients.
This comprehensive review examines English-language articles on postoperative pain after VPT, focusing on patient-reported discomfort from procedure completion to 7 days afterward. It aims to concisely summarize pain incidence, intensity, duration, analgesic usage, and associated factors.
Diverse studies with different study designs, age groups, pulpal diagnoses, patient populations, VPT techniques, treatment protocols, and outcome measurements have examined postoperative pain after VPT. Significant heterogeneity exists among studies in the pain rating scale, timing of pain assessment, and reporting of pain incidence and intensity. None of the studies have examined postoperative pain after VPT as the primary outcome. The peak incidence of postoperative pain after VPT occurred on the first day, ranging from 26.8% to 79.1%. Patients commonly reported the pain as mild. This pain typically resolved within 7 days. Factors such as preoperative pain intensity, percussion pain, periapical lesions, and pulp dressing materials were identified as potential predictors for postoperative pain after VPT.
Understanding postoperative pain enhances clinicians’ proficiency, encouraging a more comprehensive, patient-centric VPT approach. This review fills a knowledge gap, offering valuable insights for practitioners. Recognizing the nuanced nature of pain dynamics allows clinicians to elevate their proficiency and provide optimal patient care with VPT. Future well-designed studies, focusing particularly on postoperative pain in children, will advance our understanding in this area.
von Willebrand disease (VWD) is a bleeding disorder caused by an abnormality of the von Willebrand factor protein.
Two brothers diagnosed with VWD came to our clinic, the older for caries treatment and the younger for extraction of primary teeth. To control intraoperative bleeding and postoperative hemostasis, the older brother received plasma-derived/factor VIII concentrate intravenously the day before dental treatment, while the younger brother received desmopressin preoperatively, as that was found to be effective.
For invasive dental treatment of patients with VWD, it is important to choose a plan according to patient symptoms.
Down syndrome (DS) can cause irregular dental eruption patterns and hypodontia. However, data on permanent tooth eruption in DS patients in Japan are insufficient. This study aimed to predict the dental characteristics of DS by conducting a nationwide survey in Japan.
Questionnaires were used to collect information about the age, sex, number of present teeth, and dental formula with DS from facilities providing dental care for the disabled. The findings were compared with the Survey of Dental Diseases and used as control survey.
Data were collected from 3348 patients aged 5–69 years. The mean number of permanent teeth was highest (N = 25.2) at 19, 20–24, and 25–29 years. At 5–19 years, the increase in the eruption rates was slower with DS compared to that in the control survey. At 25–29 years, the difference in eruption rates between the two surveys exceeded 20 % in the mandibular lateral incisors and maxillary second molars, except for third molars. Most of the second premolars were unerupted when the primary second molars were retained. Noneruption of the permanent canines and some adjacent teeth was observed when the maxillary primary canines were retained.
This study demonstrates the eruption status of permanent teeth with DS. The eruption of permanent teeth is delayed, the number of permanent teeth is low, and early tooth loss may be seen with DS. Thus, it is important to determine the overall eruption status and provide adequate support based on their age.
The success of root canal treatment is influenced by several factors including the type and technique of root canal preparation, the type of irrigants used, the quality of obturation, and post-endodontic restoration. Recent systematic reviews have concluded that there is no substantial evidence to establish the superiority of rotary file systems over hand files in terms of clinical and radiographic success in pulpectomized teeth.
To determine the correlation between quality of obturation and long-term outcome of pulpectomized primary molars following root canal instrumentation with pediatric rotary file systems and a hand file system.
The study involved 100 primary molars from children aged 4–7 years that required pulpectomy. The teeth were divided into four groups, each consisting of 25 teeth. In the first, second, third, and fourth groups, root canal instrumentation was carried out with Pedo-Flex pediatric rotary files (Group PF), Kedo-SG pediatric rotary files (Group KS), Pro-AF Baby Gold pediatric rotary files (Group BG), and hand nickel titanium K files (Group HF), respectively. Obturation was performed with zinc oxide eugenol cement using an engine-driven Lentulo-spiral. The quality of the root filling was assessed immediately after obturation through radiographic examination. The pulpectomized teeth were then evaluated both clinically and radiographically over a two-year period.
The quality of obturation was superior in the root canals instrumented with pediatric rotary file systems compared to hand files. At the end of follow-up period, the clinical success rate was 100% and the radiological success rates were 88%, 92%, 92%, and 80% in Groups PF, KS, BG, and HF, respectively. The optimally filled pulpectomized primary molars resulted in a superior success rate than compared to underfilled or overfilled teeth.
The quality of obturation significantly influences the success rate of pulpectomized teeth. Therefore, the use of pediatric rotary files is recommended as rotary files contribute to a greater number of optimally filled canals.

