The annual 3M Oral Care Graduate Student Research Presentations and Awards are a result of the partnership formed between 3M Oral Care and CAPD/ACDP.
3M Oral Care generously sponsors the attendance of Canadian pediatric dentistry graduate students presenting original research at the CAPD/ACDP Annual Conference. All presenters will receive 3M Oral Care product samples and, through a formal judging process, the top graduate student presenter will also receive $1000.00.
Full details at http://capd-acdp.org/Grads-and-Undergrads
The 2018 Graduate Student Presenters will take place on Saturday, September 15 from 8:00 am to 9:30 am with the winner announced Saturday evening at the President’s Dinner
The 2018 Presenters, in alphabetical order (photos will be added shortly):
Dr. Edwin Chan, University of Toronto
Survival of class III amalgam and composite restorations in primary cuspid teeth
Edwin Ka Meng Chan1, Paul Andrews1, Amir Azarpazhooh1, Michael Sigal1, Keith Titley1, 1Graduate Department of Dentistry, Faculty of Dentistry, University of Toronto, Toronto, ON
Background: There is minimal literature available on the longevity of intra-coronal direct restorations in primary cuspid teeth, limiting the ability of clinicians and patients to make evidence-based treatment decisions.
Objectives: The aim of this retrospective cohort study was to determine the survival of class III amalgam and composite restorations in primary canines.
Methods: A retrospective chart review was performed at the pediatric dental clinic at the University of Toronto, Ontario, Canada. A total of 403 amalgam and 698 composite restorations placed in 603 patients between 1999 and 2017 were included in this study. Demographic and clinical information were collected from the charts for analysis.
Results: The median survival time of amalgam and composite was approximately 4.5 years and 3.8 years respectively. There was no statistically significant difference between the clinical survival of amalgam and composite (log-rank test: p=0.09, Wilcoxon: p=0.31). Amalgam was significantly less likely to fail due to recurrent caries versus composite with a relative risk of 0.35 (95% CI: 0.19, 0.65; p<0.01).
Conclusions: In this study, amalgam and composite restorations both demonstrate acceptable survival to be used as class III restorations in primary canines. Patients who are at high risk for caries may be candidates for amalgam restorations to increase the chance of survival and reduce the likelihood of recurrent decay. Long-term controlled prospective studies are recommended for further investigation.
Tricalcium silicate-based cement (BiodentineTM) pulpotomies in permanent traumatised teeth with complicated fractures
Objectives: The aim of this multicentric prospective study was to evaluate the clinical and radiographic outcomes of BiodentineTM (BD) pulpotomies on permanent traumatised teeth with pulp exposure.
Methods: This study was carried out in two hospital-based dental departments in Canada. Children seeking emergency care following trauma to anterior permanent teeth were invited to participate in this study. Medically compromised children and teeth with concomitant avulsion were excluded. Data collected included: patient demographics, time since pulp exposure, size of exposure, color of pulp tissue, associated trauma and radiographic root maturation stage. A standardized vital pulpotomy technique using BD was followed in both centers. The treatment outcome was assessed clinically and radiographically at 1 week, 1, 3, 6 and 12 months after treatment. Clinical success was determined when a tooth remained asymptomatic and when it responded positively to vitality testing. Radiographic success was determined as follow: formation of dentinal bridge, continuation of root maturation (apexogenesis) in immature teeth and normal appearance of periradicular tissues.
Results: Thirty-four patients between the age of 8 to 16 years old (mean 10.86 ± 2.2) were included in this study. There were 26 males and 13 females. A total of 39 teeth were treated with a BD vital pulpotomy. Average time since pulp exposure was 8.3 hours and average size of exposure was 1.6 millimeters. Thirteen teeth (33%) had an immature apex. Preliminary results at six-month follow-up showed a survival rate of 100% and a success rate of 97%. One failure was noted one month post-treatment and the tooth was subsequently treated with root canal therapy. As per clinical outcomes, 94% of teeth responded positively to vitality testing at one month and 100% at six-month follow-up. Thirty three percent of teeth presented tooth sensitivity at one month and 15% at six-month follow-up. Five teeth showed slight discoloration, however the results remained esthetically satisfying. Radiographic outcomes showed dentinal bridge formation in 78% of cases. Nine (69%) immature teeth showed continued root formation.
Conclusions: BD is a suitable material for pulpotomies on anterior permanent traumatised teethith a pulp exposure. It may be a good alternative to Mineral Trioxide Aggregate vital pulpotomies as it does not cause significant discoloration, and to root canal treatment as it can allow root maturation.
The Association of Body Mass Index and Severe Early Childhood Caries in Young Children
Authors: T. Kennedy, C. Rodd, C. Daymont, ME. Moffatt, B. Mittermuller, S. Signh, C. Grant, A. Pierce, A. Letellier, M. Gusmini, RJ. Schroth.
Objective: To evaluate the relationship between body mass index (BMI) and severe early childhood caries (S-ECC) in children undergoing general anesthesia (GA) for dental surgery in Winnipeg, Manitoba.
Methods: Children included in this study were recruited into a larger prospective investigation evaluating the variations in nutritional status and well-being following dental rehabilitation of S-ECC under GA. Parents provided written informed consent. Pre-operative height and weight measurements were obtained using a digital Detecto Pro-Doc scale and stadiometer. BMI Z-scores were calculated using the Canadian Pediatric Endocrine Group anthropometric calculators for World Health Organization (WHO) growth references. Operative reports were reviewed to calculate decayed, missing, filled, teeth/surfaces (dmft/dmfs) scores based on treatment rendered and to document numbers of pulpotomies and extractions. Approval was obtained from the University of Manitoba’s Health Research Ethics Board. Funding was provided by the Children’s Hospital Research Institute of Manitoba, grant number: 317939,326300,2000. Statistical analysis included descriptive statistics, bivariate tests, and correlation analysis to evaluate the association of BMI Z-score and severity of dental caries as defined by dmfs.
Results: Overall, 150 children with S-ECC were recruited; 52% female, with a mean age of 47.7±14.2(mean±SD) months. The average dmfs was 40.2±17.5, with significantly higher dmfs found in males(45.5±17.1) than females (35.2±16.4) (p<0.001). A total of 42% participants were classified as at risk of overweight (18.7%), overweight (16.7%), or obese (6.6%) based on WHO growth charts (mean BMI Zscore=0.9±1.3, range:-2.2 – 4.2). Correlation analysis showed a significant positive relationship between BMI Z-score and dmfs (r =0.2 p=0.04) as well as number of anterior extractions (r=0.2; p<0.01). A negative relationship was found between posterior extractions and BMI z-score (r=-0.2; p=0.02).
Registered First Nations children had significantly higher BMI Z-scores (1.2±1.2 versus 0.4±1.3; p<0.001) and dmfs (43.8±17.5 versus 35.5±16.4; p<0.01) compared to all other children in the study.
Conclusions: Over 40% of children in this study are considered to be at risk for overweight, overweight, or obese; a finding previously reported in Manitoba. In this population, an increased BMI z-score was found to be associated with higher dmfs scores and greater need for anterior extractions. Further analysis is ongoing and will include multiple linear regression models to control for many of the confounding variables that are associated with both obesity and S-ECC.
Effectiveness of Silver Diamine Fluoride (SDF) to Arrest Early Childhood Caries (ECC)
Authors: R Sihra, M Bertone, H Martin, B Patterson, B Mittermuller, V Lee, ME Moffatt, J Edwards, P Dahl, G ‘tJong, L Dufour, K Hai-Santiago, M Fontana, L Robertson, RJ Schroth.
Objectives: To determine the effectiveness of SDF to arrest ECC and to determine the association with oral health-related quality of life (OHRQoL).
Methods: Children with active caries lesions in primary teeth were recruited from community clinics in Winnipeg, Manitoba. Following informed consent, parents completed a questionnaire. At baseline, soft cavitated lesions involving dentin (ICDAS 5 or 6) were treated with 38% SDF. Colour, size and hardness of lesions were recorded at each visit. Four months after the first visit, treated lesions were assessed to determine if they had arrested (black in colour and very hard dentin) and a second application of 38% SDF was provided. The early childhood oral health impact scale (ECOHIS) was completed at the second visit. Nine months following the baseline visit, children return for the third and final visit to assess whether treated lesions have arrested and to complete a follow-up questionnaire including a follow-up ECOHIS. All assessments were conducted by one examiner. Statistical analyses included descriptive statistics (frequencies, means, arrest rates) and bivariate statistics (t tests).
Results: Forty-one children (mean age 41.7 ± 15.9 months) had a total of 241 caries lesions treated. To date, 37 children (48.7% male) with 216 lesions (109 posterior, 107 anterior) completed the second visit. Overall, 156 (72.2%) lesions were arrested after the first application of SDF (74 (67.9%) posterior, 82 (76.6%) anterior lesions). Difficulty in providing treatment due to compliance of the child was reported for 8 participants for whom the overall arrest rate was 47.9% versus 81.9% when no difficulty was reported (p=0.0025). The mean ECOHIS score at second visit was 4.1 ± 4.6 (range 0 to 20) out of a maximum score of 52, with higher scores indicating poorer OHRQoL. A total of 78.4% of parents reported that their child has never or hardly ever had pain in the mouth, teeth, or jaws. Data collection is ongoing and the final arrest rate will be determined once all third visits are completed.
Conclusions: Preliminary results suggest that SDF may be effective in arresting caries in children with ECC, but behavior may influence the success of SDF.
Operating funds were provided by the University of Manitoba and from Dr. Schroth’s CIHR Embedded Clinician Research award.
Waiting Room Time: An Opportunity for Caregiver Oral Health Education
Graduate Student: Randa Soussou; Research Advisor: Dr. Jolanta Aleksejūnienė Research Committee: Dr. Rosamund Harrison and Dr. Komkham Pattanaporn Department of Oral Health Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, Canada
Objectives: For several decades, senior UBC dental students have provided free dental treatment for low income children in the UBC Children’s Dental Program (CDP). However, dental students have limited time to provide oral health education and counselling to accompanying caregivers during care visits. Therefore, the present work aimed to develop a ʺwaiting-room basedʺ dental health education program (DHEP) and assess its short-term effectiveness in changing parents’ dental health-related behaviours (“dental behaviours”).
Methods: The PRECEDE-PROCEED theoretical model was used to develop and evaluate the program. Overall, the project had three distinct phases: preparation, intervention and evaluation. Preparation (Phase 1) involved a situational analysis (SA) which informed the DHEP design. Structured interviews were conducted with caregivers and various stakeholders of the CDP, including Health Authority Staff, UBC Pediatric Dentistry instructors and participating dental students.
Information gathered from the SA was used to design the Intervention (Phase 2) which was delivered by one individual in the waiting rooms at UBC’s two children’s dental clinics. During the intervention, each caregiver set personalized goals for changing their child’s “dental behaviours”. For Evaluation (Phase 3), caregivers were contacted by telephone, 2 to 3 months after counselling, to follow-up on their personalized goals and document their self-reported children’s “dental behaviours”. Comparisons were made using Chi-square tests; significance was set at P<0.05.
Results: For Phase 1; 97 caregivers, 42 dental students, 5 HA staff and 8 instructors were interviewed. The majority of caregivers were new immigrants to Canada, had language barriers and limited dental awareness. Their preference was for one-on-one counselling supported by visuals. Input of our other informants supported such an approach. Of the Phase 2 cohort of 80 caregivers who received DHEP, the follow-up rate for Phase 3 was 81% (67/80). Significant increases in proportions (12% to 79%) of caregivers reported that they were brushing their children’s teeth and brushing before bed (54% to 85%). Improvement in child’s snacking habits was also reported. Further, most caregivers reported providing a sweet treat as “dessert” with the meal, rather than an “in-between meal” snack. Decreases (from 93% to 69%) in giving children sugar-containing beverages and in consuming sugar-containing foods as snacks (from 94% to 31%) were also noted. All changes were significant at P < 0.05
Conclusion: Waiting-room based counselling, developed with the input of caregivers and other stakeholders, demonstrated measurable short-term success promoting change in oral health behaviours like home care and snacking habits. Caregivers participated enthusiastically.
First-time event at the CAPD/ACDP Conference. More information will be available in the weeks ahead but in the meantime, if you are interested in participating as an attendee or as a potential employer, please email steve@ capd-acdp.org by July 1st