Browsing by Author "Dean, Jeffrey"

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    Demarcated Primary Second Molar Hypomineralization: Prevalence Data and Associated Sociodemographic Determinants from Indiana
    (American Academy of Pediatric Dentistry, 2021) Ahmed, Azza Tagelsir; Soto-Rojas, Armando; Dean, Jeffrey; Eckert, George J.; Martinez-Mier, Esperanza Angeles; Cariology, Operative Dentistry and Dental Public Health, School of Dentistry
    Purpose: Demarcated primary second molar hypomineralization (DMH-Es) is a common developmental defect of enamel, with prevalence estimates between five percent and 20 percent. From the Americas, studies exploring the problem of DMH-Es and explicitly using the European Academy of Pediatric Dentistry diagnostic criteria were limited to some South American countries, but no similar studies were available from any of the North American countries including the United States. The purpose of this study was to investigate the prevalence and sociodemographic determinants of DMH-Es among schoolchildren in Indiana, USA. Methods: Four hundred twenty-three schoolchildren (average age equals 7.6 [±2.2 standard deviation] years) were examined by a calibrated pediatric dentist. Sociodemographic data were collected from patients' questionnaires and electronic dental records. Results: DMH-Es had a prevalence estimate of six percent versus 40 percent overall of any enamel defect (AED) of the primary second molars (PSMs) and/or the permanent first molars (PFMs). Race/ethnicity was significantly associated with a higher overall prevalence of AED of PSMs but not with the prevalence estimate of DMH-Es. Older age group (10 years or older), living in central Indiana, and water fluoridation were significantly associated with a higher overall prevalence of AEDs (P<0.01) but not with the prevalence of DMH-Es. Caries experience was significantly higher in children with demarcated molar hypomineralization (DMH) of PFMs and/or PSMs than in the group without. Conclusions: DMH-Es prevalence estimate was similar to the global figures. Certain demographic characteristics were significantly associated with the overall prevalence of the enamel defects of the examined teeth.
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    Prevalence, Clinical Presentation, and Associated Sociodemographic Characteristics of Molar Hypomineralization in Indiana, USA
    (2020-05) Ahmed, Azza Tagelsir Mohamed; Martinez Mier, E. Angeles; Dean, Jeffrey; Soto, Amanda; Lippert, Frank; Mohammed, Aghareed; Miller, James
    Molar Hypomineralization (MH) of the first permanent molars (FPMs) and the second primary molars (SPMs) is a common developmental defect of enamel, with global prevalence of 14% and 5% respectively. Children with MH represent a special pediatric population because their affected molars have extreme susceptibility to enamel breakdown, decay and tooth sensitivity. Although the problem of MH has been described almost twenty years ago mainly through reports from Europe, there is very little information about the problem from the USA. In this dissertation, MH was explored both from the perspectives of pediatric dentists’ (PDs) and at population level. The majority of the survey respondents perceived MH prevalence to be <10% in their clinical practice (62%). The most cited clinical challenge in managing MH teeth was “long-term success of restorations” (79%). When analyzed individually, responses differed significantly for different demographics and educational characteristics of the respondents (p<0.05). At population level, MH of the FPMs (Molar Incisor Hypomineralization (MIH) cohort: 337 schoolchildren, average age 9 years) and of the SPMs (Hypomineralized Second Primary Molar (HSPM) cohort: 423 schoolchildren, average age 7 years) had prevalence estimates of 13% and 6% respectively. In the MIH cohort, water fluoridation or non-Hispanic Black race/ethnicity was significantly associated with higher collective prevalence of enamel defect (EDs) (P<0.05), but not with the prevalence of MH of the FPMs. In the HSPM cohort, race/ethnicity was significantly associated with higher overall prevalence of EDs of SPMs, but not with the HSPM prevalence. Older age group (>10 years), living in central Indiana, and water fluoridation were significantly associated with higher overall prevalence of EDs (P<0.01), but not with the HSPM prevalence. Caries experience was significantly higher in children with MH of FPMs and/or SPMs than in the group without MH. We concluded that USA pediatric dentists’ respondents were well aware of the MH problem, but demonstrated discrepancies in different aspects of the MH problem. At population level, MIH and HSPM were common presentation with prevalence estimates similar to the global figures. Certain demographic characteristics were significantly associated with the overall prevalence of the enamel defects of the examined teeth.
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    Stainless Steel Crown Success Using the Hall Technique: A Retrospective Study
    (Elsevier, 2014-12) Ludwig, Kevin; Fontana, Margherita; Vinson, LaQuia; Platt, Jeffrey; Dean, Jeffrey; Department of Pediatric Dentistry, IU School of Dentistry
    Background In this retrospective study, the authors evaluated the clinical and radiographic success of stainless steel crowns (SSCs) used to restore primary molars with caries lesions, placed by means of both the traditional technique (involving complete caries removal and tooth reduction before placement of the SSC) and the Hall technique (involving no caries removal, no crown preparation and no use of local anesthetic before placement of the SSC). Methods The authors conducted a retrospective chart review by using the patient records at a private pediatric dental practice at which the Hall technique had been introduced in June 2010 as an alternative treatment to traditional SSC placement. The inclusion criteria were caries lesions on a primary molar with no clinical or radiographic evidence of pulpitis, necrosis or abscess, as well as follow-up of at least six months or until failure, whichever came first. They graded restoration success by using a four-point scale based on presence or loss of the SSC, and whether or not the patient needed further treatment associated with pulpal pathology or secondary caries. They collected and summarized patient demographic information. They used a Kaplan-Meier survival curve along with 95 percent confidence intervals to evaluate clinical success. Results The authors found that 65 (97 percent) of 67 SSCs placed with the Hall technique (mean observation time, 15 months; range, four-37 months) and 110 (94 percent) of 117 SSCs placed with the traditional technique (mean observation time, 53 months; range, four-119 months) were successful. Conclusion Findings of this study show a similar success rate for SSCs placed with the traditional technique or the Hall technique.