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The 12-month space changes in the maxillary dental arch after premature loss of a primary maxillary first molar consist mainly of distal drift of the primary canine toward the extraction site. Mesial movement of permanent molars or tilting of the primary molars did not occur. An increased arch dimension was found especially in the anterior segment (intercanine width and length). There is no need for the use of space maintainers from the results in this study in cases of premature loss of a primary first molar.

Most of the natal or neonatal teeth were in the mandibular primary incisor position and not all of them were supernumerary. No gender differences were found in tooth morphology, positive family history, and treatment methods. The tooth morphology was not significantly related to a positive family history, premature delivery, or the mother's physical condition before delivery.

Background/purpose The consequence of premature loss of primary teeth resulting in the need for space maintainers has been controversial for many years. There is no longitudinal long-term report in literature regarding the premature loss of a primary maxillary first molar. The aim of this study was to continue observing the long-term space changes of 19 cases following premature loss of a primary maxillary first molar during the transition from primary to permanent dentition. Materials and methods Ten of the 19 original participants were excluded because of extensive decay or loss to follow-up. Nine children (mean age at time of tooth extraction, 6.0 ± 0.42 years) with unilateral premature loss of a primary maxillary first molar were examined. Maxillary dental study casts were obtained 2 days or 3 days after tooth removal and, on average, 81 months later. The contralateral intact primary molars in each participant served as controls. The arch width, arch length, intercanine width, intercanine length, and arch perimeter of each study cast from the initial and follow-up examinations were measured and compared using paired t -tests. Results Eight of nine cases (88.9%) did not show crowded permanent successors or canine block-out at the extraction site. Interestingly, the permanent dentition was more crowded at the control site (2/9) than at the extraction site (1/9). The arch width, arch length, intercanine width, and intercanine length significantly increased at 81 months (P < 0.05), whereas the arch perimeter increases approached significance (P = 0.071). Conclusion The anterior and posterior arch dimensions significantly increased 81 months after premature loss of a primary maxillary first molar, which suggested that space maintainers were not needed in these cases.

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Background/purpose: General anesthesia provides optimal conditions for treating uncooperative children. The purpose of this retrospective study was to assess all restorative outcomes and evaluate the efficacy of comprehensive dental rehabilitation under general anesthesia in children. Materials and methods: Sixty-eight complete records of children who underwent comprehensive dental rehabilitation under general anesthesia in the Kaohsiung Chang Gung Hospital, Kaohsiung, Taiwan between 2012 and 2013 were selected for this study. The clinical and radiographic assessments included determination of the outcomes of anterior versus posterior composite restorations, posterior composite restorations versus stainless steel crown restorations, and vital pulpotomies versus indirect pulp cappings. Results: Posterior composite restoration had a significantly higher success rate (90.3%) than anterior composite restoration (71.7%, P < 0.001). Full-coverage stainless steel crowns had a significantly higher success rate (99.0%) than posterior composite restorations (P < 0.001). In addition, indirect pulp capping had a 100% success rate, which was higher than that of vital pulpotomy (94.9%). However, the difference was not significant (P > 0.05). Conclusion: Although general anesthesia provides an optimal condition for treating children with high caries risk, high failure rates of composite restorations were noted. Indirect pulp capping and ferric sulfate pulpotomy followed by stainless steel crown restorations are successful techniques and can be used to treat deep carious lesions.

Background/purpose There is no long-term study on the comparison of indirect pulp therapy with ferric sulfate pulpotomy in primary molars. This retrospective study aimed to compare the success rates of ferric sulfate pulpotomy with those of indirect pulp therapy in primary molars during a 4-year follow-up. Material and methods A total of 114 primary molars from 38 children (16 females and 22 males) with deep carious lesions were selected. Among these molars, 71 indicated for ferric sulfate pulpotomy and 43 indicated for indirect pulp therapy were treated under general anesthesia according to a standard protocol by two senior pediatric dentists. Clinical and radiographic assessments for determining success rates were performed using established criteria at initial, post-operatively, and at 24 and 48 months. Data were analyzed using Fisher's exact test to compare success rates of ferric sulfate pulpotomy and indirect pulp therapy at the 24- and 48-month follow-ups. Results The overall success rates for indirect pulp therapy and ferric sulfate pulpotomy were 100% (43/43) and 91.5% (65/71), respectively, at the 24-month follow-up; the difference was not significant (P = 0.08). However, the success rate for indirect pulp therapy (93.0%, 40/43) at the 48-month follow-up was significantly higher than that for ferric sulfate pulpotomy (70.4%, 50/71) (P = 0.008). Conclusion Indirect pulp therapy showed a significantly higher success rate at the 4-year follow-up than did ferric sulfate pulpotomy for treating deep carious lesions in primary molars. Earlier exfoliation was observed after treatment with ferric sulfate pulpotomy compared to indirect pulp therapy.

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