Saudi Cultural Missions Theses & Dissertations
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Item Restricted A service evaluation on the treatment of first permanent molars under inhalation sedation(Saudi Digital Library, 2022-10-01) Alireza, Maryam; Hosey, Marie-Thereasa; Ivanova, MonikaBackground: Compromised first permanent molar (cFPM) affect 25% UK. The more severely affected the FPM the more challenging and complicated treatment becomes. A dilemma on whether to extract or restore these molars. Treatment of these molars have not been consistent due to lack of guidance on how to determine prognosis. Aim: • To report on the management of first permanent molars (FPM) in children under inhalation sedation and to assess treatment according to severity. • To identify the profiles of children treated under IS and other non-FPM treatments Methods and design: A retrospective service evaluation based on dental records of children who had dental treatment under inhalation sedation between January 2016 and December 2020 in the paediatric dentistry department in St Thomas’s Hospital. Result: Case notes for 1514 children have been analyzed. The mean age of the children who were treated under inhalation sedation was approximately seven and nine months (7.9) years. The ratio of male (51%) and female (46%) was similar. Four hundred children had treatment on FPM. FPM restorative treatment was (86%) FPMs were restored whereas extraction (14%). Almost 71 (47%) FPMs of all those extracted were restorable since the caries was in the outer one third of the dentine at worst. Conclusion: 3 In a cohort of UK patients’ treatment of first permanent molars under inhalation is mostly restorative, however, almost half of the extracted teeth were restorable.19 0Item Restricted Spontaneous Space Closure and Developing Permanent Dentition After Timed Extraction of First Permanent Molars(Saudi Digital Library, 2022-06-01) Albedaiwi, Lamees; Neves, Aline A; Bister, DirkBackground: Management of compromised First Permanent Molars (FPM’s) in young patients is challenging for dentists. However, timed extraction in the UK is a common and acceptable practice. Most children are discharged post extraction, because extraction at an ‘ideal time’ is thought to result in spontaneous space closure. Objectives: 1) To assess spontaneous space closure in a cohort of non-discharged or re- referred patients after extraction of a compromised FPM and the clinical condition of the developing dentition. 2) To report space closure based on radiographic prognostic factors associated with spontaneous space closure. Methods: A retrospective service evaluation was conducted based on case records of children under the age of 16 years-old who had extraction of FPMs under general anaesthesia from January 2017 to December 2019. Dental Panoramic Tomogram (DPT) radiographs were used to assess the developmental stage of the second permanent molar (SPM), angulation of both SPM and second premolar (SPP), presence of bone over the crown of the SPM and presence of the third molar before extraction. Patient’s dental records used to assess space closure and condition of SPP and SPM. Statistics results were analysed using SPSS 26. Results: Two hundred and seventeen quadrants with extracted FPM’s from 81 patients were assessed retrospectively. Spontaneous space closure occurred in 94.8% of the maxillary and 52% of the mandibular quadrants and this difference was statistically significant (p<0.01). The developmental stage of the SPM, presence of bone over the crown of the SPM and presence of the third molar were not statistically significantly correlated with space closure (p>0.01). As with the angulation of SPP and SPM, the maxilla showed an overall high success rate regardless of the angulation; whereas, for the mandible the percentage of space closure ranged from 49- 60%. Conclusion: Timed extraction of cFPM’s is a treatment option for the young patients. In the maxilla, the majority of FPM’s resulted in spontaneous space closure; whereas, about half the mandibular cases showed unfavourable outcomes. Results of this service evaluation indicate that consideration must be given when planning timed extraction of a compromised FPM, appropriate pre-extraction planning must take place to ensure the benefits outweigh the potential disadvantages and unfavourable outcomes.33 0