Purpose: The fibre-reinforced composite space maintainer (FRCSM) has been suggested as an alternative to the band-and-loop space maintainer (BLSM). The aim of this in-vivo study was to evaluate the clinical performance and the reasons for failure of the two types of fixed space maintainers over a six-month period. Methods: Twenty patients, ranging from 4-9 years old, were selected for this study. They were randomly divided into two groups (n=10) according to the type of space maintainer that was placed. The patients were recalled on a monthly basis for clinical evaluation over a period of six months. The two-sample t-test and the non-parametric Wilcoxon rank sum test were used for statistical analysis. results: Both groups of space maintainers had a 50% failure rate. The main reason for BLSM failure was bending of the wire with impingement on the soft tissue. The FRCSM failed due to debonding and fracture of the fibre loop. There was no statistically significant difference between the failure rates (P=0.53). conclusion: The clinical performances of both space maintainers were disappointing. Only 50% of fixed space maintainers were still clinically acceptable according to the strict evaluation criteria used. Further research is recommended on the loop-design FRCSM.

Aim: The purpose of the study was to assess the marginal adaptation and discrepancy of SSC’s. Differences in adaptation and discrepancy between the four surfaces (mesial, lingual, distal, and buccal) were evaluated. Methods: The placement of stainless steel crowns were completed on a phantom head in accordance with the clinical technique. The ideal tooth preparation was made and this ‘master tooth’ duplicated to achieve a sample size of 15. The stainless steel crowns were placed, trimmed, and cemented as per the clinical technique. The cemented stainless crowns were analyzed under 100× stereomicroscope magnification. The marginal adaptation and discrepancy of each specimen was measured every 2 µm. Results: All the specimens showed marginal adaptation and discrepancy. The lingual margin had a significantly better adaptation (p < .0001) over the other surfaces. The buccal surface was the only surface that had an appropriate supra-CEJ level with a significance of p < .0001. Conclusion: The marginal discrepancies occur during the trimming procedure and assessment of the gingival approximation of the SSC margin. The inspection of stainless steel crown adaptation and discrepancy is an essential clinical step.

Objective: This retrospective survey highlighted the characteristics of children less than six years of age presenting with early childhood caries(ECC) who had two or more teeth extracted under intravenous sedation at the Tygerberg Oral Health Centre in Cape Town, South Africa. This survey was carried out in order to plan a community-appropriate intervention strategy. Methods: Records of 140 patients kept by the pediatric Dentistry Division met the inclusion criteria and were included in this survey. Most of the patients originate from economically disadvantaged areas. Results: Diet, feeding and oral hygiene habits were shown to be the most significant factors that contributed to the development of ECC in these patients. All the children were either breast- or bottle-fed past one year of age. 93.6% of the children went to sleep with the bottle or while on the breast and 90% of them were fed on demand during the night. On average, breastfeeding was stopped at 9 months of age compared to bottle-feeding that, on average, was stopped at a much later mean age of 23 months. Where oral hygiene practices were concerned, 52.6% of children brushed their own teeth without supervision. Frequency of brushing varied between subjects. Conclusion: The results of this study have demonstrated that there is a need for culturally appropriate education campaigns to inform parents (especially those in disadvantaged communities) about the importance of oral health and the prevention of oral disease.

Background Children continue to suffer from the impact of the human immunodeficiency virus‐acquired immunodeficiency syndrome (HIV/AIDS) pandemic. In Cape Town, these children receive medical care including antiretroviral therapy from facilities like Tygerberg Hospital's Paediatric Infectious Diseases Clinic. HIV‐infected children may experience an increased caries experience when compared with their healthy peers. Aim The aim of this study was to determine the oral health status of HIV‐infected children younger than 12 years receiving antiviral drugs at the Paediatric Infectious Diseases Clinic. Design A cross‐sectional survey was conducted among children aged between 2 and 12 years presenting at this clinic. Caregivers were interviewed to obtain information regarding health seeking behaviour, oral hygiene practices and dietary habits. A single clinician undertook a standardized clinical intraoral examination according to the World Health Organization guidelines, with modifications. Results Sixty‐six children were recruited. A high prevalence of dental caries (78.8%) and an unmet treatment need of 90.4% were recorded among the participants. Most children had never visited the dentist, and those who did had mainly received emergency dental care. Conclusion The high prevalence of severe dental caries in this population highlights the need for oral health awareness and the inclusion of oral health care in the comprehensive care of children with HIV. Why this paper is important to paediatric dentists The study highlights the importance of collaborating with health professions outside of dentistry. Doctors and nurses are often the first health professionals to come into contact with children with special needs. They should therefore be made aware of the early signs of decay so that these patients can be referred for dental treatment timeously. Holistic management of children with special healthcare needs is essential to improve their overall well‐being.

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Objective Investigation of the prevalence of oral mucosal lesions in human immunodeficiency virus (HIV)‐infected children undergoing highly active antiretroviral therapy (HAART). Materials and Methods Cross‐sectional study of 66 HIV seropositive children, comprised of 28 (42.4%) females and 38 (57.6%) males (average age of 6 years). Study participants all required data regarding CD4+ T‐helper cell counts and the viral load. All participants underwent an orofacial clinical examination by calibrated clinicians. Associations between the presence of oral mucosal lesions, CD4+ cell counts, and viral load were analyzed using Poisson regression. Results The prevalence of oral manifestations was detected in 21 children (31.8%). Oral lesions were detected in 16 children with viral load copies <50 cells/mm3 and 22 children with CD4+ counts >500 cells/mm3. Predominant lesions identified included angular cheilitis (36.7%), candidiasis (13.3%) and atypical oral ulcers (13.3%). The presence of one lesion was the most prevalent represented by 19 children. Oral lesions in relation to the CD4+ counts >500 resulted in; 14 children with one oral lesion, 5 with two lesions and 3 with three oral mucosal lesions. The other half of this CD4+ count patient group presented with no oral mucosal lesions. Oral lesions in relation Viral load copies <50 resulted in; 9 children with one oral lesion, 3 with two oral mucosal lesions and 4 with three oral mucosal lesions. The other half of this Viral load patient group presented with no oral mucosal lesions. No significant correlations were established between the presence of oral mucosal lesions and low CD4+ counts (p = 0.715) nor with high viral load counts (p = 0.638). Conclusion HIV‐related oral mucosal lesions still presented in the participants despite management with HAART. Based on the results, CD4+ counts and viral load does not appear to be suitable markers of orofacial involvement in children.

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