Dentists' Perception and Clinical Use of Preformed Metal Crowns to Restore Primary Molar Defects in Chengdu City, China: A Cross-Sectional Study.
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ABSTRACT: Background
Preformed metal crowns (PMCs), as an effective technique recommended for the enduring restoration of primary molar defects, have not been widely implemented in China as well as that in Western countries. This study is aimed at assessing the knowledge on the clinical use of the PMC technique and its effective factors among dentists in Chengdu, China. Thus, the present study is aimed at providing the best available evidence on clinical decision-making to manage dental caries in children and the overall benefits.Methods
The self-designed questionnaire in this study consisted of two main sections, including the sociodemographic characteristics of the respondents and their perception and use of PMCs. The anonymous questionnaire was distributed among 1000 dentists practicing in Chengdu via SO JUMP.Results
The response rate was 45%. Most respondents (69.6%) did not use PMCs. Academic qualification, working specialty, and professional experience were associated with dentists' use of PMCs. The lack of knowledge about the PMC technique was the main obstacle to the dental practitioners' use of PMCs (41.7%). The lack of understanding of the rationale behind PMCs was the main reason for parents' acceptance of PMC restorations (43.6%). Attending continuing education programs was the main approach to learning the PMC restorative technique (59.1%).Conclusions
The clinical use of PMCs was not very popular in Chengdu city. To promote this restorative technique, knowledge and practical training should be incorporated into routine courses of undergraduate dental education.
SUBMITTER: Jiang Q
PROVIDER: S-EPMC8355980 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:AimMolar incisor hypomineralization (MIH) is a prevalent oral health condition whose knowledge by dentists is key to the best clinical outcome. This study aimed to evaluate the knowledge, perceptions and clinical experiences of MIH among Portuguese dentists.MethodsA cross-sectional structured questionnaire was distributed nationally through a web-based survey platform. Data concerning demographic variables, years of experience, dental specialty, MIH prevalence, diagnosis, severity, training demands and clinical management of MIH were collected. We calculated a knowledge score (KS), and compared data between Pediatric Dentists (PDs), General Dental Practitioners (GDPs) and other dental specialties (ODS).ResultsOverall, 2.2% of Portuguese dentists (n = 257) answered the questionnaire. Most participants reported having identified MIH in their practice (82.5%), with PD reporting the prevalence appeared to have increased, and practically all (91.7%) considered it a public health problem. Resin composite was often the used material to restore MIH teeth (56.0%), however PDs indicated glass ionomer cements as the preferred and preformed crowns a better option. The average KS on MIH was 41.3 (± 5.7), with GDPs having a similar score than PDs. Most respondents (94.9%) reported a lack of information about MIH and were willing to receive appropriate clinical training.ConclusionsThe average knowledge on MIH was considered low among Portuguese dentists. Respondents perceived an increased incidence of MIH, despite the lack of prevalence data in Portugal. The material of choice was Glass Ionomer and performed crowns, by PDs, while GDPs and ODS reported poor confidence to manage MIH. These results may serve future programs to increase knowledge, perceptions and clinical experiences towards MIH.
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Project description:IntroductionHall's technique preformed metal crown (HTPMC) has been used widely by pediatric dentists in developed countries as a new approach for managing decayed primary molars without local anesthesia, caries removal, and tooth preparation. Currently, inadequate information is available regarding the implementation of this technique (HTPMC) in Malaysia. This study is aimed at evaluating the implementation of HTPMC by Malaysia's pediatric dentists and identify the co-occurrence frequencies of the HTPMC implementation with the respondents' demographic profile.Materials and methodsA cross-sectional questionnaire-based research was conducted among 65 pediatric dentists in Malaysia. Online questionnaires were distributed to the pediatric dentists employed at public hospitals (MOH) and universities in Malaysia.ResultIt was found that over half of the respondents (65.6%) employed HTPMC. The analysis of the co-occurrence network frequency revealed that a high frequency of female pediatric dentists who were within the age group of 31-40 years old had fulfilled their postgraduation overseas and was employed in the university mainly applied HTPMC.ConclusionThe application of HTPMC among respondent pediatric dentists in Malaysia was high. However, most respondents considered HTPMC a treatment option only to manage carious primary molar rather than a treatment of choice.
| S-EPMC8716193 | biostudies-literature
Project description:Despite the high success rates of preformed metal crowns (PMCs) in children no randomized clinical trials compare methods of placement and none describe its use in Africa. Our aim was to compare survival and cost-effectiveness of PMCs placed by conventional techniques (CT) and biological Hall techniques (HT) using a prospective randomized control trial in a general dental practice from Khartoum. One hundred and nine and 103 PMCs were placed in randomly selected children (5-8years) with 1-2 carious primary molars using HT and CT respectively and followed for 2 years. Socioeconomic status, periodontal health, occlusion, anxiety, and procedure time were compared using student t-test. Kaplan-Meier survival rates and incremental cost effectiveness ratio (ICER) were compared between CT and HT. CT and HT groups were similar for age, gender, socio-economic status. Survival rates were high (over 90%) for both study arms and not statistically different (p>0.05). Anxiety scores were significantly higher in CT arm after 12 months compared to HT (p<0.001). Clinically, gingival and plaque indices were similar between groups (p>0.05) but occlusions were raised in nearly all subjects in the HT arm (p<0.05). Periodontal health improved, and occlusions adjusted over time in both arms. There were 3 (2.7%) and 6 (5.8%) minor failures, 7 (6.4%) and 6 (5.8%) major failures in HT and CT arms respectively. Mean procedure time was lower in HT (9.1 min) than CT (33.9 min); p<0.001. Mean PMC cost was US$2.45 and US$7.81 for HT and CT respectively. The ICER was US$136.56 more for each PMC placed by CT per life year. We show that PMCs have high survival outcomes in disadvantaged populations similar to results from developed countries. As HT can be carried out by less experienced dental operators and therapists, this biological approach provides a promising cost-effective option to manage caries in developing countries with limited resources. Trial registration: The trial is registered at clinicaltrials.gov. ClinicalTrial.gov Trial Registration: NCT03640013.
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Project description:BackgroundMolar incisor hypomineralization (MIH) is a growing health problem, and its treatment is a challenge. The purpose of the present study was to evaluate and compare the perceptions, knowledge, and clinical experiences of MIH in general dental practitioners (GDPs) and paediatric dentists (PDs) in Spain.MethodsAll dentists belonging to the College of Dentists of the Region of Murcia, in the South-East of Spain, were invited to participate in a cross-sectional survey. They were asked to complete a two-part questionnaire including sociodemographic profiles and knowledge, experience, and perceptions of MIH. Data were analysed using Pearson's chi-square test, Fisher's exact test and Cramer's V test.ResultsThe overall response rate was 18.6% (214/1147). Most respondents were aged 31-40 years (44.86%), with more than 15 years of professional experience (39.72%). They worked mainly in the private sector (84.58%) and were licensed in dentistry (74.30%): 95.45% of PDs had detected an increase in the incidence of MIH in recent years (p < 0.001). Only 23.80% of GDPs claimed to have made a training course on MIH. With respect to the aetiology, chronic medical conditions (p = 0.029) and environmental pollutants (p = 0.008) were the only factors that showed significant between-group differences. Durability (p = 0.009) and remineralization potential (p = 0.018) were the factors where there was a between-group difference in the choice of the restoration material. In the case of post-eruptive fractures and opacities, the preferred material for both groups was resin-modified glass ionomer (RMGIC). However, in incisor lesions, composite was the material of choice for both groups, with significant differences (p = 0.032) in the use of glass ionomer. Most respondents expressed a need for continuing education on MIH.ConclusionSpanish dentists perceived an increase in the incidence of MIH. The material of choice was RMGIC for non-aesthetic sectors and composite for incisors. Dentists believe it is difficult or very difficult to manage MIH, since the long-term success of restorations of MIH lesions is compromised because resin adhesion is not good. Both GDPs and PDs believe they need more training on the aetiology, diagnosis, and treatment of MIH.
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Project description:To demonstrate the fatigue behavior of CAD/CAM resin composite molar crowns using a mouth-motion step-stress fatigue test. Monolithic leucite-reinforced glass-ceramic crowns were used as a reference.Fully anatomically shaped monolithic resin composite molar crowns (Lava Ultimate, n=24) and leucite reinforced glass-ceramic crowns (IPS Empress CAD, n=24) were fabricated using CAD/CAM systems. Crowns were cemented on aged dentin-like resin composite tooth replicas (Filtek Z100) with resin-based cements (RelyX Ultimate for Lava Ultimate or Multilink Automix for IPS Empress). Three step-stress profiles (aggressive, moderate and mild) were employed for the accelerated sliding-contact mouth-motion fatigue test. Twenty one crowns from each group were randomly distributed among these three profiles (1:2:4). Failure was designated as chip-off or bulk fracture. Optical and electron microscopes were used to examine the occlusal surface and subsurface damages, as well as the material microstructures.The resin composite crowns showed only minor occlusal damage during mouth-motion step-stress fatigue loading up to 1700N. Cross-sectional views revealed contact-induced cone cracks in all specimens, and flexural radial cracks in 2 crowns. Both cone and radial cracks were relatively small compared to the crown thickness. Extending these cracks to the threshold for catastrophic failure would require much higher indentation loads or more loading cycles. In contrast, all of the glass-ceramic crowns fractured, starting at loads of approximately 450N.Monolithic CAD/CAM resin composite crowns endure, with only superficial damage, fatigue loads 3-4 times higher than those causing catastrophic failure in glass-ceramic CAD crowns.
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Project description:BackgroundThe treatment of young permanent first molars with extensive carious tissue loss may often require restoration with preformed crowns. This study compared the clinical and radiographic performance of stainless-steel crowns (SSCs) and preformed zirconia crowns (ZCs).MethodsForty-eight molar incisor hypomineralisation (MIH)- or caries-affected permanent molars in 20 healthy patients between 6-13-year-old were randomly divided into ZC and SSC groups (n = 24 teeth/group) in a split-mouth design. The oral hygiene levels of patients were assessed using Greene and Vermillion simplified oral hygiene index (OHI-S). Plaque accumulation and gingival health were evaluated using the Silness&Löe plaque index (PI) and Löe&Silness gingival index (GI), respectively. Clinical retention, marginal extension level, marginal adaptation of crowns and wear of the antagonist teeth were assessed at baseline, 1, 6, 12 and 18 months. The radiological assessments for evaluating the marginal adaptation of crowns and periapical pathology of crowned teeth were performed at 6 and 12 months. The data were analyzed using Kaplan-Meier analysis, Mann-Whitney U test, and two-way ANOVA.ResultsA total of forty teeth in 17 children were evaluated for 18 months. ZCs had significantly lower gingival and plaque index values than teeth restored with SSCs during all evaluation periods (p < 0.05). Neither crown type resulted in clinically-detectable wear on opposing dentition or periapical pathology. One ZC was lost at 13 months, while all SSCs survived in function clinically. The cumulative survival rates of ZCs and SSCs were 95.2% and 100% respectively.ConclusionsBoth ZCs and SSCs showed high clinical retention rates in young permanent molars. ZCs had lower plaque accumulation and better gingival health than SSCs, which were consistently associated with mild gingival inflammation.Clinical trial registration numberNCT05049694.
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Project description:ObjectivesDentists play a major role in the diagnosis of oral potentially malignant disorders (OPMDs) that may lead to malignancy. Their knowledge on OPMDs and the risk factors associated with malignant disease needs to be sufficient. The aim of this study was to assess the level of knowledge, attitudes, and awareness of OPMDs amongst general dentists and dental specialists working in Saudi Arabia.Material and methodsQuestionnaires were distributed to dentists working in Saudi Arabia. A total of 303 dentists participated in the study. The questionnaire included 20 questions on knowledge, attitudes, and awareness of OPMDs.ResultsThe response rate was 55%. There was no significant difference between general dental practitioners and dental specialists regarding leukoplakia, which is the most common OPMD (P > .05) and in identifying tobacco and alcohol as the main risk factors for malignant transformation of OPMDs into cancer (P > .05). However, there was a significant difference (P < .05) between specialists (75.3%) and general practitioners (52.3%) in the diagnosis of OPMDs. There was a significant difference (P < .05) between specialists (63.5%) and general practitioners (28.0%) in recognising the likelihood of malignant transformation of proliferative verrucous leukoplakia. There was a significant difference between specialists (61.2%) and general practitioners (25.2%, P < .05) in recognising the erosive form or atrophic type of oral lichen planus, considering that it is more likely to undergo malignant transformation.ConclusionsDental specialists have better knowledge and awareness than general dentists regarding OPMDs. Improved continuous education programmes on the risk factors and diagnosis of OPMDs should be organised to train dentists.
| S-EPMC9275301 | biostudies-literature
Project description:The management of compromised first permanent molars (FPMs) in children presents a clinical challenge to the dental team. Hypomineralised FPMs in molar incisor hypomineralisation (MIH) conditions could undergo post-eruptive breakdown, making them susceptible to caries, leading to their subsequent loss. The planned extraction of compromised FPMs is a valid alternative to complex restorative treatment. However, establishing the presence or absence of third permanent molars, amongst other considerations, is crucial to reaching a successful outcome. Clinicians should understand the importance of an orthodontic examination around the age of 8 years old with regard to establishing a differential therapeutic decision about the ideal timing of MIH-affected FPMs' extraction in children. The aim of this article is to highlight that, with an interdisciplinary approach, a good outcome can be achieved following the extraction of poorly prognosed FPMs. The most cost-effective way of addressing MIH-affected FPMs is extraction, followed by orthodontic space closure when indicated. This obviates the need for the repeated restorative replacement and saves perfectly healthy premolars from being extracted for space creation in orthodontic treatment in several clinical scenarios.
| S-EPMC7464986 | biostudies-literature
Project description:BackgroundGuidelines in pediatric restorative dentistry recommend the use of preformed pediatric stainless steel crowns (SSCs) in cases of severe tooth decay of at least two surfaces. This clinically effective and safe restorative option is frequently refused by parents for esthetic reasons; they prefer conventional restorations using esthetic filling materials (composites, glass ionomer) if lesion severity limited to two surfaces permits. Recently, manufacturers have proposed esthetic preformed pediatric zirconia crowns (ZCs) but these have been assessed in only two randomized clinical trials (RCT) with follow-ups of 6 and 12 months. Only one of these RCTs was carried out on primary molars to test ZCs (NuSmile ZR) without a groove in its inner surface. The primary objective of this proposed RCT is to assess the effectiveness of ZCs compared with SSCs. Our hypothesis is that the effectiveness of ZCs will be equivalent to that of SSCs.MethodsIn this split-mouth, 2-year RCT, pairs of primary molars in 101 child participants will be randomized and restored with SSCs (ESPE, 3M) and ZCs (EZCrowns, Sprig Oral Health Technologies) characterized by grooves on their inner surface. Primary molars will first be allocated to SSCs, and 1 to 2 weeks later the other primary molar of the same pair will be restored by ZC. The primary outcome is the success defined by the "absence of major clinical and radiographic failure" (e.g., pain, pulp infection, dental abscess or periradicular pathology visible on radiographs). The secondary outcomes include the retention and fracture rates, the gingival condition, the wear of the antagonist of the treated teeth, as well as both parental and child satisfaction.DiscussionThis study will investigate two types of preformed pediatric crowns for the management of severe decay on primary molars. The results may help practitioners choose the better therapeutic option and to explain to parents the advantages and disadvantages of these two therapies.Trial registrationNCT03296709 . Registered on 27 September 2017.
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Project description:BACKGROUND:Despite the availability of prevention guidelines and recommendations on infection control, many dental practices lack the minimum requirements for infection control. OBJECTIVE:This study aimed to assess the level of awareness, perception, and attitude regarding the coronavirus disease (COVID-19) and infection control among Jordanian dentists. METHODS:The study population consisted of dentists who worked in private clinics, hospitals, and health centers in Jordan. An online questionnaire was sent to a sample of Jordanian dentists in March 2020. The questionnaire was comprised of a series of questions about dentists' demographic characteristics; their awareness of the incubation period, the symptoms of the disease, mode of transmission of COVID-19 and infection control measures for preventing COVID-19; and their attitude toward treating patients with COVID-19. RESULTS:This study included a total of 368 dentists aged 22-73 years (mean 32.9 years, SD 10.6 years). A total of 112 (30.4%) dentists had completed a master or residency program in dentistry, 195 (53.0%) had received training in infection control in dentistry, and 28 (7.6%) had attended training or lectures regarding COVID-19. A total of 133 (36.1%) dentists reported that the incubation period is 1-14 days. The majority of dentists were aware of COVID-19 symptoms and ways of identifying patients at risk of having COVID-19, were able to correctly report known modes of transmission, and were aware of measures for preventing COVID-19 transmission in dental clinics. A total of 275 (74.7%) believed that it was necessary to ask patients to sit far from each other, wear masks while in the waiting room, and wash hands before getting in the dental chair to decrease disease transmission. CONCLUSIONS:Jordanian dentists were aware of COVID-19 symptoms, mode of transmission, and infection controls and measures in dental clinics. However, dentists had limited comprehension of the extra precautionary measures that protect the dental staff and other patients from COVID-19. National and international guidelines should be sent by the regional and national dental associations to all registered dentists during a crisis, including the COVID-19 pandemic, to make sure that dentists are well informed and aware of best practices and recommended disease management approaches.
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