January 2023 Pediatric Dental Study Club Abstracts

January's Study Club highlights direct pulp capping in primary teeth, anterior crowns for primary teeth, indirect pulp capping in permanent teeth, stainless steel crowns for patients with special healthcare needs, and ethics regarding social media.

Join us on January 24th, 2023 at 7:00pm CST for our study club to discuss the following articles. We recommend reading the articles 1-2 weeks prior and taking notes on your insights to bring to the group for discussion.

#1 - Twelve-month randomized controlled trial of 38% silver diamine fluoride with or without potassium iodide in indirect pulp capping of young permanent molars

J Am Dent Assoc. 2022 Dec;153(12):1121-1133.e1.

Marwa Baraka, Magda Tekeya, Niveen S Bakry, Margherita Fontana

Abstract

Background: The clinical and radiographic effectiveness of 38% silver diamine fluoride (SDF) with and without potassium iodide (KI) was tested and compared with resin-modified glass ionomer cement (RMGIC) in indirect pulp capping of deep carious lesions in young permanent molars. Methods: One hundred eight permanent first molars with deep occlusal cavitated carious lesions in 49 children aged 6 through 9 years were randomly allocated into 3 groups (n = 36 molars per group) and treated with SDF plus KI, SDF, and RMGIC. RMGIC was used as a base and a resin-based composite restoration followed. Clinical assessments for secondary caries (primary outcome), postoperative pain, tooth vitality, and restoration success and quality rates according to Modified US Public Health Service and Ryge Criteria for Direct Clinical Evaluation of Restorations were performed after 3, 6, and 12 months. Periapical radiographs were obtained at baseline, 6 months, and 12 months. Outcomes were assessed using mixed effects multilevel logistic and linear regression analyses. Results: There were no significant differences (P = .26) among the groups at all times for secondary caries, postoperative pain, tooth vitality, clinical abscess, radiographic signs of pulpal pathology, restorations' marginal adaption, anatomic form, and surface roughness. There was a significant difference (P = .03) in restoration color, marginal staining, and luster. The RMGIC group outperformed the 2 SDF groups in color and luster. Conclusions: The authors did not find differences among the groups in preventing secondary caries or pain or in maintaining pulpal health. The RMGIC group had better restoration color and luster than both SDF groups and better marginal staining than the SDF group. Practical implications: The results of this study can help guide treatment decision making regarding use of SDF and SDF plus KI as indirect pulp capping materials in deep cavitated lesions. This clinical trial was registered at ClinicalTrials.gov. The registration number is NCT04236830.

Keywords: Silver diamine fluoride; and secondary caries; indirect pulp capping; marginal staining; permanent molars; potassium iodide; resin-modified glass ionomer cement.

#2 - Calcium Hydroxide Paste, Mineral Trioxide Aggregate, and Formocresol as Direct Pulp Capping Agents in Primary Molars: A Randomized Controlled Clinical Trial

Abstract coming soon...

#3 - Clinical Comparison of Preformed Zirconia and Composite Strip Crowns in Primary Maxillary Incisors: 18-Month Results of a Prospective, Randomized Trial

Abstract coming soon...

#4 - Stainless steel crowns as a restoration for permanent posterior teeth in people with special needs: A retrospective study

J Am Dent Assoc. 2020 Feb;151(2):136-144

Alison V Sigal, Michael J Sigal, Keith C Titley, Paul B Andrews

Abstract

Background: Limited information exists regarding the use of stainless steel crowns (SSCs) in permanent teeth. The objective of this retrospective cohort study was to present the long-term clinical outcomes of the SSC compared with those of amalgam and composite resin restorations and the SSC radiographic outcomes in a special-needs population. Methods: This study included 271 patients with at least 1 SSC restoration from the Mount Sinai Hospital Dentistry Clinic for Persons with Special Needs in Toronto, Ontario, Canada. A total of 2,621 posterior permanent tooth restorations were documented: 766 SSCs, 1,651 amalgam restorations, and 204 composite resin restorations. Clinical analysis included patient demographics, treatment parameters, and outcome assessments for each restoration recorded. Radiographic analysis of SSC restorations included 127 bite-wing radiographs and 118 periapical radiographs, measurement of interproximal bone loss, and assessment of periapical status using the Periapical Index Scale. Results: The 10-year survival rates for new SSC and amalgam restorations were 79.2% and 63.5%, respectively. The 91 SSC failures included 2 recementations, 33 replacements, and 56 extractions. Primary diagnoses at the time of failure included chronic periodontal disease (25) and loose or lost SSCs (24). Of the 528 failed conventional restorations that were replaced, 60% were replaced with SSCs. The mean alveolar bone loss from mesial and distal sites was 1.36 millimeters and 1.40 mm, respectively. Therefore, 93% of the sites recorded were less than 2 mm and classified as healthy. All pre-SCC and post-SSC periapical radiographs had healthy Periapical Index Scale scores (1 or 2) recorded over an average duration of 8.4 years (1-29.1 years). Conclusions: SSCs are a durable treatment option for the restoration of the posterior permanent dentition. Practical implications: Posterior permanent teeth restored with stainless steel crowns can be expected to last for 10 years and represent a viable treatment choice for severely carious or fractured posterior permanent teeth.

Keywords: Stainless steel crowns; operative dentistry; posterior permanent teeth; restorations.

#5 - What are the ethical considerations of using video social media platforms such as TikTok in your dental practice?

J Am Dent Assoc. 2022 Dec;153(12):1191-1192

Kathleen Nichols

Some of my colleagues are using social media platforms like TikTok to create

short videos to appeal to a larger patient population, to build their practice bases,

and to educate patients. Some of these videos can be shared in the form of duets

whereby other dentists can opine on the post. So, if 1 dentist posts a video of their

treatments, a second dentist can repost the video and comment if this feature is

enabled by the content creator, giving their “professional” opinion, without the

full knowledge of the patient’s dental history, consent, or specific case details.

These “TikTok Dentists” are providing generalized treatment recommendations

and have no specifics of the patient in question. I do not want to be left behind,

but I wonder what the ethical considerations of this social media platform are in

the world of modern dentistry.

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