Department of Pediatric Dentistry Works

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    A retrospective clinical study of resin-modified glass ionomer restorations in the primary posterior dentition
    (2023-06-01) Dean, Jeffrey A.; Peterson, Hans; Moawad, Amal N. A.; Sanders, Brian J.; Al-Hosainy, Ashraf
    The study's objective was to evaluate the survival rate of resin-modified glass ionomer (RMGI) when used in a capsule form for restoring primary molars. The study was performed in a private pediatric dental practice in Indianapolis, Indiana. Patients included in this retrospective study had at least one RMGI restoration that had been in place at least 12 months previous to the restoration exam and chart review., The material used was Fuji II LC in capsules (GC., Alsip, IL). The cavity preparations were similar to that of amalgam restorations except that there was less extension for prevention, they were more conservative and with rounded line angles. The restorations were placed per the manufacturer’s instructions. The restorations were evaluated using a grading system that is a modification of the one used by Gunner Ryge. The results were as follows: 114 restorations were evaluated in 48 patients with a mean age of restorations of 35.42 months (12 to 76 months). The restorations received Alpha and Bravo grades for Marginal Integrity and for Wear at a rate of 96.0 and 95.6%, respectively, and 95.0% had no Recurrent Caries. The study showed a 93% success rate for restorations. This result supports previous research in that RMGI may be the material of choice when attempting to intracoronally restore primary molars. Also, the use of the capsule form which is mixed through trituration eliminated possible hand mixing errors, and the use of application tips and bulk filling the cavity might improve the overall strength of the restorations.
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    Blood levels of lead and dental caries in permanent teeth
    (Wiley, 2020) Yepes, Juan F.; McCormick-Norris, Jayme; Vinson, LaQuia A.; Eckert, George J.; Hu, Howard; Wu, Yue; Jansen, Erica C.; Peterson, Karen E.; Téllez-Rojo, Martha M.; Martinez Mier, Esperanza Angeles; Pediatric Dentistry, School of Dentistry
    Objectives: The purpose of this study was to determine whether there is an association between lead exposure within the ages of 1-4 years and dental caries in the permanent dentition between ages 9-17 among Mexican youth. Methods: Data were collected for the Early Life Exposures in Mexico to Environmental Toxicants (ELEMENT) cohort from a group of 490 children born and reared in Mexico City. Among ages 1-4 years, blood lead levels were measured in micrograms of lead per deciliter of blood (μg/dL) and the presence of caries in adolescence was determined using the International Caries and Detection and Assessment System (ICDAS). The relationship between blood levels of lead and decayed, missing, or filled surfaces (DMFS) was examined using negative binomial regression. Covariates were selected based on previous studies and included age, gender, socioeconomic status, oral hygiene, body mass index, and diet. The nonlinear relationship between lead and DMFS was examined using smoothing splines. Results: The mean overall blood lead level (BLL) was 4.83 μg/dL (S.D. of 2.2). The mean overall caries level (DMFS) was 4.1. No statistically significant association was found between early childhood blood lead levels and dental caries in adolescence. Conclusion: This study shows a lack of association between exposure to lead between the ages of 1-4 years of age and dental caries in permanent dentition later in life. Other covariates, such as age and sugar consumption, appeared to play a more prominent role in caries development.
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    Contemporary predoctoral paediatric behaviour guidance education in the United States and Canada
    (Wiley, 2022) Weishuhn, David; Scully, Allison; Amini, Homa; Salzmann, Larry; Boynton, James R.; Pediatric Dentistry, School of Dentistry
    Purpose: To determine the contemporary educational experiences of predoctoral dental students in the United States and Canada regarding behaviour guidance (BG) of the child patient and assess trends from a previous study in 2004. Methods: Data were collected from 32 predoctoral paediatric dentistry programme directors in the United States and Canada via a web-based survey. Results: The didactic curriculum hours devoted to the teaching of BG techniques in 2019 are similar to 2004. A majority (60.7%) of programmes do not have a formal assessment of competency with BG techniques. Lectures (n = 28), clinical experience (n = 28) and observation (n = 26) were the most common techniques implemented to teach BG techniques, and tell-show-do (100%), non-verbal communication (82.1%), positive reinforcement (89.3%) and distraction (82.1%) were the techniques that more than 75% of dental students most commonly have hands-on experience with during their dental education. In 2019, students tended to have more hands-on experience with nitrous oxide/oxygen inhalation and less hands-on experience with aversive techniques and sedation. Conclusions: The majority of dental schools do not have a formal competency in BG of the child patient. Compared with 2004, nitrous oxide/oxygen is used more by dental students and there is less predoctoral education in aversive BG techniques.
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    Dental Manifestations of Pediatric Bone Disorders
    (Springer, 2017-12) Yepes, Juan F.; Pediatric Dentistry, School of Dentistry
    Purpose of Review Several bone disorders affecting the skeleton often are manifest in the maxillofacial region. This review presents the most common bone disorders in children and their dental–oral manifestations: fibrous dysplasia, Paget’s disease, osteogenesis imperfecta, renal osteodystrophy, hypophosphatasia, and osteoporosis. The specific intraoral characteristics will reviewed in detail. Recent Findings Recent studies confirmed the close relationship between the mandible and the maxilla with the most prevalent systemic bone disorders in children. Summary This review will help practitioners to integrate the oral health into the systemic health and improve the multidisciplinary approach of pediatric patients between medicine and dentistry.
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    Dental maturity of Caucasian children in the Indianapolis area
    (American Academy of Pediatric Dentistry, 2011-05) Weddell, Lauren S.; Hartsfield, James K.; Department of Pediatric Dentistry, School of Dentistry
    PURPOSE: The purpose of this study was to compare chronologic and dental age using Demirjian's method. METHODS: Two hundred and fifty-seven panoramic radiographs of healthy 5- to 17.5-year-old Caucasian children in the Indianapolis area were evaluated using Demirjian's 7 tooth method. RESULTS: The intraclass correlation coefficient (ICC) for agreement with Demirjian was 0.94 (95% confidence interval [CI]: 0.87, 0.97). The ICC for repeatability of the investigator was 0.97 (95% CI=0.95, 0.99). Calculated dental age was significantly greater than chronologic age by 0.59 years (P<.001). There was no significant difference in the mean difference in ages between sexes (P=.73). Medicaid subjects had a significantly higher (P<.001) mean difference (0.82 years) than private insurance subjects (0.32 years). There was a significant negative correlation between the chronologic age and the difference in ages (r=-0.29, P<.001). Overweight (P<.001) and obese (P=.004) subjects were significantly more dentally advanced than normal (P=.35) and underweight (P=.42) subjects. CONCLUSIONS: Demirjian's method has high inter- and intraexaminer repeatability. Caucasian children in the Indianapolis area are more advanced dentally than the French-Canadian children studied by Demirjian. Difference between dental age and chronologic age varies depending on the age of the child, socioeconomic status, and body mass index.
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    Dental X-Ray Exposure The Past has become the Future
    (California Dental Association, 2019) Miles, Dale A.; Yepes, Juan F.; Pediatric Dentistry, School of Dentistry
    Most dental X-ray procedures are delegated to office staff and some recommendations and techniques, such as selection criteria and rectangular collimation for intraoral imaging, have been ignored or forgotten by some dentists. Some of the X-ray exposure recommendations, updated by the American Dental Associtation’s Science Institute in June 2018, and the need to adopt guidelines proposed by the public campaign Image Gently are discussed to help the reader develop safe X-ray protocols, from intraorals to CBCT.
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    The effect of dynaCleft[R] on presurgical orthopedics in bilateral cleft lip and palate patients
    (Wolters Kluwer, 2019) Carlson, Lauren N.; Vinson, LaQuia A.; Sanders, Brian J.; Jones, James E.; Pediatric Dentistry, School of Dentistry
    Aims: The aim of this study was to determine the effects DynaCleft® has on patients with bilateral cleft lip and palate. Subjects and Methods: Comparative data were collected from a total of 46 infants diagnosed with bilateral cleft lip and palate between 1981 and 2017. Twenty-three infants were treated with DynaCleft® and an obturator and 23 infants received an obturator only. Maxillary impressions were taken at each infant's initial clinic visit and again on the day of his/her surgical cleft lip repair. Differences in maxillary retraction, sagittal repositioning, and cleft widths were compared between the two groups. Statistical Analysis Used: Paired t-tests were used to determine if there was significant change before and after DynaCleft® therapy, and two-sample t-tests were used to compare the data between the two study groups. Results: Clinically, DynaCleft® averaged more maxillary retraction and cleft size reduction on both the right and left sides compared to the control group. Within the DynaCleft® group, a statistically significant difference was found for premaxillary retraction on both the right and left sides. However, all the other comparisons between the two groups were not found to be statistically significant. Conclusions: DynaCleft® as a presurgical orthopedic therapy may help to limit uncontrolled physiological changes and reposition the premaxillary segment, while reducing cleft widths prior to definitive lip surgery.
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    The Effect of DynaCleft® on Cleft Width in Unilateral Cleft Lip and Palate Patients
    (2017) Vinson, LaQuia A.; Pediatric Dentistry, School of Dentistry
    Objective: The specific aim of this retrospective cross-sectional study was to assess the efficacy of DynaCleft® as a method of presurgical orthopedics with infants with a unilateral cleft lip and cleft palate who used an oral obturator. Study design: Data was collected from 25 infants all of comparable age diagnosed with a unilateral complete cleft lip and palate. Eight patients used DynaCleft ® and an obturator (Group Alpha) and seventeen patients only had an obturator (Group Beta). Maxillary impression casts were obtained from each patient at the initial clinic visit and at the time of cleft lip repair. Differences in alveolar cleft width were compared between the two groups. Casts were measured twice by one observer using a digital caliper. Results: Group Alpha began treatment on an average age of 24.25 days and Group Beta an average of 15.35 days of age. The average cleft width of Group Alpha was 8.13 mm and after treatment it was 4.59 mm. The average cleft width of Group Beta was 8.09 mm and 6.92 mm after treatment. Results of paired t-tests and two-sample t-test showed that cleft width changes between the two groups were significant (P = .03). Conclusions: DynaCleft ® significantly decreased the size of the alveolar cleft width compared to infants who did not use it. Providers should consider using DynaCleft® for patients who may not have access to infant maxillary orthopedics.
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    Effect of human milk and its components on Streptococcus mutans biofilm formation
    (2015) Allison, Lesa M.; Walker, LaQuia A.; Sanders, Brian J.; Yang, Ziyi; Eckert, George; Gregory, Richard L.; Department of Pediatric Dentistry, IU School of Dentistry
    Objective: This study investigated the effects of human breast milk and its components on the nutritional aspect of the caries process due to Streptococcus mutans UA159 biofilm formation. Study design: Human breast milk was collected from 11 mothers during 3-9 months postpartum. To test for the effect on biofilm formation, a 16-hour culture of S. mutans was treated with dilutions of human breast milk and several major components of human breast milk, lactose, lactoferrin, IgA, and bovine casein in sterile 96-well flat bottom microtiter plates for 24 hours. The biofilms were fixed, washed, stained with crystal violet, and extracted. Absorbance was measured to evaluate biofilm growth mass. Results: Dilutions 1:10-1:2,560 of the human breast milk samples increased biofilm formation by 1.5-3.8 fold compared to the control. Lactoferrin decreased biofilm formation significantly in all dilutions (average milk concentration of 3 mg/ml). Lactose had no effect at average breast milk concentrations (60 mg/ml) except at its lowest concentration (15 mg/ml) where it was increased. IgA significantly decreased biofilm formation at its highest concentration of 2,400 μg/ml (average milk concentration 600 μg/ml). Casein caused significantly increased biofilm formation at all concentrations tested above the average milk content (2.3 mg/ml). Conclusions: The results of this study demonstrate an increase in S. mutans biofilm formation by human breast milk 3-9 months post partum. Among its major components, only casein significantly increased biofilm formation among the concentrations analyzed. Lactose had no effect except at 15 mg/ml. Lactoferrin and IgA significantly decreased S. mutans biofilm formation at their highest concentrations. This information expands the current knowledge regarding the nutritional influence of breastfeeding and validates the necessity to begin an oral hygiene regimen once the first tooth erupts.
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    The effect of intraoral suction on oxygen-enriched surgical environments: a mechanism for reducing the risk of surgical fires
    (American Dental Society of Anethesiology, 2014) VanCleave, Andrea M.; Jones, James E.; McGlothlin, James D.; Saxen, Mark A.; Sanders, Brian J.; Vinson, LaQuia A.; Department of Pediatric Dentistry, IU School of Dentistry
    In this study, a mechanical model was applied in order to replicate potential surgical fire conditions in an oxygen-enriched environment with and without high-volume suction typical for dental surgical applications. During 41 trials, 3 combustion events were measured: an audible pop, a visible flash of light, and full ignition. In at least 11 of 21 trials without suction, all 3 conditions were observed, sometimes with an extent of fire that required early termination of the experimental trial. By contrast, in 18 of 20 with-suction trials, ignition did not occur at all, and in the 2 cases where ignition did occur, the fire was qualitatively a much smaller, candle-like flame. Statistically comparing these 3 combustion events in the no-suction versus with-suction trials, ignition (P = .0005), audible pop (P = .0211), and flash (P = .0092) were all significantly more likely in the no-suction condition. These results suggest a possible significant and new element to be added to existing surgical fire safety protocols toward making surgical fires the "never-events" they should be.