The timing of tooth eruption in preterm children: A systematic review

BackgroundPreterm birth has been reported to affect normal physiological growth and development of preterm-delivered children. Whether preterm birth affects primary and permanent tooth eruption, is not yet determined.AimsTo identify whether preterm birth affects tooth eruption by reviewing scientific literature.Methods MEDLINE, EMBASE, Cochrane library and reference lists of included studies were screened from January 1980 to November 2020. The study designs included both interventional and observational studies analysing peculiarities of tooth eruption in premature infants with no congenital syndromes. Risk of bias was assessed using NIH Quality Assessment tool for cohort, cross-sectional studies.Results Twelve articles were selected for data extraction after exclusion of 1709 irrelevant studies. Primary teeth eruption time in preterm children was delayed up to two months taking account of chronological age only. In most studies, after changing the age from chronological to corrected, the eruption of primary teeth was still delayed, but the difference was negligible. Catch-up growth occurs in 18 months and the difference in primary teeth eruption time remains insignificant. Very low birth weight and non-breastfeeding were associated with delayed primary teeth eruption. One study found earlier eruption of first permanent molars and incisors, while other two stated lagging maturation of permanent teeth up to the age of nine years. The quality of evidence provided by the studies was low.ConclusionConsidering chronological age, primary teeth eruption time in preterm children was delayed and related to very low birth weight and non-breastfeeding. Data on eruption of permanent teeth were inconsistent; more detailed research is need

Changes in management preference of deep carious lesions and exposed pulps: questionnaire studies with a 10-year interval among dentists in Lithuania

We aimed to investigate changes in management preferences for deep carious lesions and pulps exposed during carious tissue removal that occurred during the last 10 years and identify associated dentists’ background factors. The data were collected among dentists registered with the Lithuanian Dental Chamber at two time points using a similar questionnaire. In 2011, 400 randomly selected dentists received a questionnaire by mail, and 153 (38.3%) responded. In 2021, an electronic invitation to an online questionnaire was sent to all members of the Lithuanian Dental Chamber, and 213 (8.9%) dentists responded. The questionnaire included the definitions of management options, a radiograph, and a clinical picture of a deep carious lesion reaching to the inner fourth of dentine in a mature permanent tooth, asked management preferences in four different scenarios, as well as participants’ background characteristics, reasons for management, and procedural preferences. Data were analyzed using bivariate and multivariable analyses. Compared to 2011, participants in 2021 had 60% lower odds of preferring nonselective versus selective caries removal (OR 0.4, 95% CI 0.2–0.7) and endodontic treatment versus nonselective and selective caries removal (OR 0.4, 95% CI 0.2–0.6) in the scenario of asymptomatic and symptomatic (indicating reversible pulpitis at most) deep lesions, respectively. For exposed pulp, participants in 2021 had lower odds than in 2011 of preferring endodontic treatment versus vital pulp therapy (direct pulp capping and pulpotomies) for both scenarios without symptoms (OR 0.4, 95% CI 0.2–0.7) and with symptoms (OR 0.2, 95% CI 0.1–0.4). A higher proportion of respondents in 2021 reported using rubber dam (44% vs. 17% in 2011, p < 0.001) and hydraulic calcium silicate cements as a capping material (68% vs. 40% in 2011, p < 0.001). The management preferences were associated with the university of graduation and the number of years in dental practice, indicating “recommended in textbooks” and “recommended in scientific publications” as reasons for management preferences. To conclude, a change toward less invasive management options was observed. To a certain extent, dentists have implemented evidence-based recommendations in dental practice. To ensure further adoption of scientific evidence, dentists should be encouraged to update themselves on the newest evidence-based practices