Lesion sterilization and tissue repair (LSTR) method in irreversible dental pulp changes of primary teeth

Background/Aim: Deep carious lesions on primary teeth usually have been causing infectious dental pulp changes. If indicated, traditional endodontic root canal treatment for these kinds of pulpal infections in primary teeth usually should involve the performing of pulpectomy methods, but often with questionable prognosis. The lesion sterilization and tissue repair (LSTR) approach is one of the good endodontic therapeutic alternatives for affected primary teeth with a poor prognosis, which could otherwise be condemned to premature extraction. Aim was to evaluate the medium-term clinical success in everyday practice of the LSTR method applied in affected primary teeth with irreversible pulpal tissue infections by observation of reduction/absence of their clinical symptoms. Material and methods: The study sample included child patients who had one or more of their affected primary molars with irreversible pulpal tissue changes of poor prognosis treated with the LSTR method. For each patient whose primary molar tooth was endodontically treated with the LSTR method a clinical evaluation of treated tooth was performed at intervals of 1 and 12 months afterwards. Results: Study sample was consisted of 40 child patients aged 4 to 9 years, with 45 primary molars included in total. It was obvious that the symptoms related to affected sample teeth have already been decreased almost immediately after initial action of triple antibiotic paste. Final outcome after 12-months follow-up period was success of applied LSTR method in 43 (95.6%) affected sample teeth in a way that initial clinical symptoms completely decreased and disappeared. Conclusions: LSTR method has been shown as successful pulpotomy technique for noninstrumental endodontic approach in non-vital pulp treatment of primary molar teeth in a 12-months follow-up period

Attitude, knowledge and practice of pediatricians in the prevention of early childhood caries

Background/Aim: The aim of the research was to examine the general attitude, knoweledge and practice of pediatricians about caries in children of preschool age. Material and Methods: The research was conducted from November 2019 to the end of January 2020. The research consisted of a survey of pediatricians. The questionnaire consisted of 4 modules and 37 questions, which related to the attitude, knowledge and practice of pediatricians on the prevention of early childhood caries. Results: The majority of pediatricians (84.9%) stated that they assess the nutrition of their patients, while 32.1% of them always do oral health assessment, and half of them in the second month of the child's life; and 39.6% assess oral health only if there is a problem. The majority of pediatricians (86.8%) recommended the first dental examination, most often in the first year of the child's life (79.5%), and then every 6 months (43.5%). The majority of respondents did not required information about the dental health of their patients' mothers, fluoride toothpastes and topical application of fluoride as well (62.3-75.5%). The majority of pediatricians (79.2%) have never provided or sometimes provided educational material on caries prevention and control to the parents of their patients. The most accurate answers and the highest percentage of correct answers that the pediatricians had were about attitudes (Z=8.98, 66.63%), while the fewest correct answers and the lowest percentage of correct answers regarding the practices on the prevention of early childhood caries (Z=11.91, 58.90%). Conclusions: The research showed that pediatricians have the good attitudes and knowledge, but do not implement prevention of early childhood caries in practice. The basic deficiency of attitude, knowledge and perception of the importance of prevention is a consequence of insufficient education of pediatricians

Karijes u djece u javnim vrtićima u Sarajevu, Bosna i Hercegovina

Objectives: Dental caries first occurs within primary dentition in toddlers and preschool children, in a form of early childhood caries (ECC). In every day’s busy and employment burdened parenting, caretakers and institutions have become important even more nowadays, not only for forming child general behavior and character, but also for maintenance of their general and oral health as well. Aims: To evaluate the presence and severity of ECC in children who attended public kindergartens in Sarajevo, and to offer basic information for the maintenance and improvement of child oral health to their parents and kindergarten teachers. Methods: The study included 1722 preschool children aged 3-6 years who attended kindergartens within Sarajevo public kindergarten institution, together with their parents and kindergarten teachers. Dental team members gradually visited all kindergartens situated in four Sarajevo city municipalities and examined kindergarten children according to the WHO Oral Health Survey Manual. Oral health promotion material for parents and kindergarten teachers was also distributed simultaneously during sequential visits. Results: ECC was present in preschool kindergarten children in Sarajevo, with its high prevalence (67.71%), dmft-value (3.97) and severity (SiC index 8.79). There was also a significant lack of dental healthcare to examined children mostly related to lack of visiting dental offices by children’s parents (CI=10.55%, RI=10.80%, TI=12.98%). Conclusion: Parental role in preserving and improving of their children oral health should be systematically and profoundly improved. Kindergarten officials and staff should recognize the importance of anticariogenic diet menus and oral hygiene maintenance within their institutions.Uvod: Prva pojava zubnog karijesa događa se u mliječnoj denticiji male i predškolske djece i to u obliku karijesa ranog djetinjstva (KRD). U današnjem užurbanom i opterećenom roditeljstvu, osobe i institucije koje čuvaju djecu postale su još važnije, ne samo zato što oblikuju opće ponašanje i karakter djeteta, nego i zato što održavaju njegovo opće i oralno zdravlje. Cilj: Željela se procijeniti prisutnost i težina KRD-a kod djece koja su pohađala javne vrtiće u Sarajevu te roditeljima i odgajateljima ponuditi osnovne informacije o održavanju i poboljšanju oralnoga zdravlja njihove djece. Metode: Istraživanjem su bila obuhvaćena 1722 djeteta predškolske dobi od 3 do 6 godina koja su pohađala vrtiće u sklopu javnih vrtićkih ustanova u Sarajevu zajedno sa svojim roditeljima i odgajateljima. Članovi stomatološkog tima postupno su posjećivali sve vrtiće u četirima gradskim općinama i pregledali djecu prema Priručniku za pregled oralnoga zdravlja Svjetske zdravstvene organizacije. Tijekom tih posjeta također su roditeljima i odgajateljima podijeljeni materijali za promicanje oralnoga zdravlja. Rezultati: KRD je pronađen kod djece u sarajevskim predškolskim ustanovama – prevalencija je bila visoka, čak 67,71%, kep-vrijednost iznosila je 3,97, a težina je imala SiC indeks od 8,79. Kod pregledane djece uočen je i znatan nedostatak dentalne zdravstvene zaštite, a uglavnom je bio povezan s neodlaskom roditelja s djecom u stomatološke ordinacije (CI = 10,55 %, RI = 10,80 %, TI = 12,98 %). Zaključak: Skrb roditelja za očuvanje i poboljšanje oralnoga zdravlja njihove djece potrebno je sustavno i temeljito unaprjeđivati. Službenici i osoblje vrtića trebali bi u svojim ustanovama prepoznati važnost antikariogenih dijetetskih jelovnika i održavanja oralne higijene

A Large Dentigerous Cyst in a Child as a Complication of Deciduous Molar Endodontic Treatment: An Interesting Case Report with Short Literature Review

This study presents a case report of an inflammatory dentigerous cyst of tooth #35, associated with its previously endodontically treated deciduous predecessor. Cystic lesion growth caused impaction of the second premolar, displacing it closer to the lower border of the mandible. The lesion represents a typical dentigerous cyst that possibly arises in association with periapical inflammation of a deciduous molar involving the follicle of the premolars. This report highlights the inflammatory etiology of dentigerous cysts, which mainly occur in mixed dentition. A 12-year-old patient was referred to Oral Surgery Department regarding a sizeable radiolucent lesion in the unerupted mandibular second premolar region, detected on an Orthopantomagram (OPG) X-ray. A non-vital primary predecessor had been endodontically treated at least one year before an examination, with a control OPG X-ray showing no signs of pathology at the time. The patient did not report any symptoms. Clinical examination revealed an egg-like tumefaction of the alveolar bone in the left premolar region of the mandible. Cone-beam computed tomography analysis showed a sizeable translucent lesion surrounding the crown of the impacted tooth. The lesion was enucleated in its entirety, along with the impacted premolar, under local anesthesia. Clinical findings combined with radiographic and microscopic examinations confirmed the diagnosis of an inflammatory dentigerous cyst. The seventeen month follow-up revealed good bone healing. This case presented a rare complication of endodontic treatment of deciduous teeth and informed on possible complications of endodontic therapy in deciduous teeth, emphasizing the importance of early diagnosis of cysts in preventing extraction of permanent teeth

Dental Caries Experience in Children in Public Kindergartens of Sarajevo, Bosnia and Herzegovina

Objectives: Dental caries first occurs within primary dentition in toddlers and preschool children, in a form of early childhood caries (ECC). In every day’s busy and employment burdened parenting, caretakers and institutions have become important even more nowadays, not only for forming child general behavior and character, but also for maintenance of their general and oral health as well. Aims: To evaluate the presence and severity of ECC in children who attended public kindergartens in Sarajevo, and to offer basic information for the maintenance and improvement of child oral health to their parents and kindergarten teachers. Methods: The study included 1722 preschool children aged 3-6 years who attended kindergartens within Sarajevo public kindergarten institution, together with their parents and kindergarten teachers. Dental team members gradually visited all kindergartens situated in four Sarajevo city municipalities and examined kindergarten children according to the WHO Oral Health Survey Manual. Oral health promotion material for parents and kindergarten teachers was also distributed simultaneously during sequential visits. Results: ECC was present in preschool kindergarten children in Sarajevo, with its high prevalence (67.71%), dmft-value (3.97) and severity (SiC index 8.79). There was also a significant lack of dental healthcare to examined children mostly related to lack of visiting dental offices by children’s parents (CI=10.55%, RI=10.80%, TI=12.98%). Conclusion: Parental role in preserving and improving of their children oral health should be systematically and profoundly improved. Kindergarten officials and staff should recognize the importance of anticariogenic diet menus and oral hygiene maintenance within their institutions