Clara Sandibel Garcete Delvalle

Background : To the best of our knowledge, no multicentre study has evaluated the age and reasons for the first dental visit (FDV) among children in Spain. In response, we conducted this multicentre…

Background: Dental caries is currently the most common chronic disease affecting the Spanish pediatric population. Therefore, the main objective of this study was to assess Caries Management by Risk Assessment (CAMBRA) in children attending a university dental clinic between the ages of 6 and 12 and establish the DMFT (decayed, missing, and filled teeth index for permanent teeth) of the sample. In addition, the study calculated the plaque index, salivary pH level, buffering capacity, and the quantity and quality of saliva in the sample and determined if there were statistical differences between sexes and between subgroups with DMFT = 0 (control) and DMFT > 0 (cases). Methods: A case–control study was conducted with 89 patients aged 6 to 12 years. Clinical and salivary indicators were measured. Caries risk was also assessed using the CAMBRA protocol, and the sample was also divided into control and case groups for further analysis. Results: The CAMBRA questionnaire showed that 65.2% of participants presented a high risk of caries. The sample showed an average DMFT of 0.65 with a plaque index of 57.2%. The mean salivary pH was 7.35 (±0.30). The average volume of stimulated saliva was 6.83 mL (±3.68), and the buffering capacity was classified as normal in 57% of cases. No statistically significant differences were found between sexes or in the evaluated risk factors. In the control group, the mean salivary pH value was 7.35, and the amount of stimulated saliva was 6.5 mL. The buffering capacity was classified as normal in 67% of cases. In contrast, the case group presented a mean pH value of 7.15 and a salivary volume of 5 mL, with a normal buffer capacity in 50% of cases. Conclusions: The CAMBRA protocol indicated that more than half of the participants presented a high risk of caries, indicating the need to customize treatment plans for each patient. The salivary pH showed statistic differences between the control and case groups, indicating the importance of incorporating salivary biomarkers into routine clinical practice.

Purpose To determine the root resorption pattern and calculate the root resorption length of mandibular primary molars in children. Methods A cross-sectional and descriptive study was conducted of 367 panoramic radiographs of healthy nonorthodontic children, 169 girls with a mean age of 9.39 years and 198 boys with a mean age of 9.02 years. The length of the mesial and distal roots of the primary molar was calculated using a computer program (PixelStick®) that measures the pixels indicated in the image. Student’s t test, the Mann‒Whitney U test and the Kruskal‒Wallis test were used for comparisons, and p < 0.05 indicated statistical significance. Results A 0.84 mm delay in root resorption of the first mandibular primary molar (74) in boys was described. There was also a delay in the resorption of the mesial root of 0.89 mm and 1.12 mm from the distal root of the second mandibular primary molar (75) in boys and a significant increase in root resorption in girls (p < 0.05). The mesial and distal roots of the first mandibular primary molar were resorbed equally; however, the mesial root of the second mandibular primary molar was resorbed before the distal root. Conclusions Delays in root resorption were detected in boys, whereas advances in root resorption were detected in girls. The root resorption pattern of the first mandibular primary molar was symmetrical; however, the resorption pattern of the second mandibular primary molar was asymmetric, with the mesial root being resorbed first. Clinical and radiographic monitoring of mandibular primary molars with unevenly resorbed roots is recommended to avoid the complications associated with over retained molars.

Osteogenesis imperfecta (OI) is a hereditary disorder characterized by bone fragility and skeletal abnormalities. The administration of bisphosphonates (BPs) in children with OI increases bone density. This antiresorptive inhibits osteoclast action, thus altering physiological processes, in which osteoclasts play important roles, such as the eruptive process. The aim of this investigation was to study the eruptive process (dental development of permanent dentition, resorption of temporary dentition, and alveolar eruption of the first permanent molar) in children with OI medicated with BPs and to compare the results with those of a control group. In total, 34 panoramic radiographs of children with OI [mean chronological age of 8.43 (± 1.77)] who were medicated with BPs for a period of one year or more were studied and 367 panoramic radiographs of healthy children [mean chronological age of 9.19 (± 1.62)] were used as controls. The Demirjian method was used to study the dental development of the seven permanent teeth in the third quadrant. Alveolar eruption of the first permanent molar was considered when perforation of the alveolar bone was produced. The Haavikko method was used to study the root resorption of the five primary teeth in the third quadrant, and software (PixelStick®) was used to measure the lengths of the mesial and distal roots of the primary molars. The cumulative dose of BPs was obtained by mathematically calculating the total dosage received (mg)/weight (kg) and multiplying the relative potency of the medication. The Mann‒Whitney U test was used for comparisons, and p < 0.05 indicated statistical significance. A delay of 0.95 points in dental development and delayed exfoliation of primary dentition between 1.31 and 1.66 years were described in the study group. A root resorption delay of 11.8% was described among the 5 primary teeth of 23.3% among the single-rooted teeth and of 5.6% among the two-rooted teeth in children with OI medicated with BFs ( p < 0.05). Delayed alveolar eruption of the first permanent molar at 0.31 years of age was found in children with OI medicated with BFs. We detected delayed tooth development at one stage of maturation in the study group, which was clinically imperceptible. The dental age (≤ 0.55 years) was greater than the chronological age in both groups. We also reported delayed exfoliation of the primary dentition (from 1.31 to 1.66 years), delayed root resorption of the primary dentition (11.8%), and delayed (from 1 mm to 1.25 mm) root resorption of the primary molars in the study group. Although the degree of dental development of the first permanent molar was similar between the two groups, we found delayed (0.31 years) alveolar eruption in the study group and a greater delay (0.44 years) in children whose cumulative dose of bisphosphonates exceeded 2000.

Objective: The purpose of this literature review is to gather updated information on diagnostic and therapeutic guidelines for early childhood caries. Material and methods: PubMed, Embase, Ovid, Cochrane Central and Google Scholar were searched for appropriate articles up to 5 years old (up to January 2018 inclusive). 229 studies were identified, including 13 clinical trials that discussed different treatment modalities for teeth affected by this disease. Conclusion: Early childhood caries is an increasingly common disease and is a condition that presents a unique set of clinical challenges for dental health professionals. This updated information recommends starting treatment as early as possible to eliminate the risk of increased cavitations because of early childhood dental caries and its consequences in these patients.

Background: Osteogenesis imperfecta (OI) is an inherited disorder characterized by bone fragility and skeletal alterations. The administration of bisphosphonates (BPs) to patients with OI reduces pain, thereby improving their quality of life. The main mechanism of action of BPs is the inhibition of osteoclast action. In the oral cavity of children with OI during growth and development, physiological processes that require the function of osteoclasts occur. The aim of this investigation was to study the dental development of premolars and the root resorption of primary molars in children with OI medicated with BPs according to age and sex. Methods: An observational and analytical study was designed. The study sample consisted of 26 6- to 12-year-old children with a confirmed diagnosis of OI treated with BPs with available panoramic radiographs. The control group consisted of 395 children with available panoramic radiographs. Both groups were divided into subgroups according to sex and age. The third quadrant was studied, focusing on the first left temporary molar (7.4), the second left temporary molar (7.5), the first left permanent premolar (3.4) and the second left permanent premolar (3.5). The Demirjian method was used to study the dental development of 3.4 and 3.5, and the Haavikko method was used to study the root resorption of 7.4 and 7.5. The Mann‒Whitney U test was used for comparisons, and p < 0.05 indicated statistical significance. Results: The mean chronological age of the 421 patients was 9.21 years (95% CI 9.05–9.37). The sample was reasonably balanced by sex, with 52.5% (221 patients) boys versus 47.5% (200 patients) girls. Delayed exfoliation and tooth development were described in children with OI (p = 0.05). According to sex, the root resorption of primary molars and tooth development were significantly lower in boys in both groups and in girls in the OI group, but the differences between the age groups were not significant. Conclusions: Children with OI treated with BPs exhibit delayed dental development of the premolars and delayed root resorption of the primary molars. Boys exhibited delays in both variables, but the differences by age subgroup were not significant. These clinical findings support the importance of clinically and radiographically monitoring the dental development and root resorption of primary teeth in children with OI treated with BPs to avoid alterations of the eruptive process.