Thesis (doctoral)--Münster, 1934. / Includes bibliographical references (p. 19).

Magister Scientiae Dentium - MSc(Dent) / The aim of the study was to determine the oral and debntal health status of pediatric cardiac patients, 12 years of age and younger, and compare them with non-cardiac patients. A total of 150 children, 75 with known cardiac condition (study group) and 75 no-cardiac (control group) were examined. No statistically significant differences were established in the study between the caries experience score for the cardiac and control groups. The study concludes that the cardiac group generally has a higher decay component and a lower missing component which may be an indication of the lack of dental intervention. The gingival inflammation was significantly higher in the cardiac group although the plaque scores were similar in the two groups. / South Africa

Indiana University-Purdue University Indianapolis (IUPUI) / The purpose of this study was to determine the rate of plaque formation in children and its relationship to their periodontal and caries indices and to evaluate a television area measurement instrument. Plaque formation at 6-, 24-, 48-, and 96-hour intervals was observed in 56 children aged 8 through 12 to establish the rapidity of its reformation after a thorough dental prophylaxis. The plaque was recorded with disclosing agents and oriented Polaroid photographs and measured by newly developed television and electronic area measurement instrumentation which proved to be highly reliable. The presence of caries and periodontal disease was then correlated with the amount of plaque recorded at each observation period. A high correlation was found between the Anterior P-M-A and the Periodontal Index. No significant correlations were found between the periodontal indices and the DMFs scores or with the amount of plaque present and the DMFs scores. Seventy-seven per cent of the children displayed measurable amounts of plaque just 6 hours after a thorough dental prophylaxis. In comparing the amount of plaque formed by these children with results reported from similar studies conducted on adults, it is apparent that children in this age group form more plaque in less time than adults. A significant correlation was found between the amount of plaque present and the periodontal indices at the 48-hour examination.

Indiana University-Purdue University Indianapolis (IUPUI) / The need for a safe but effective agent to sedate dental patients who are severe behavior management problems prompted this investigation of ketamine HCl. Ketamine HCl is a general anesthetic agent with the unique property of selectively depressing the higher centers of the brain without adversely affecting respiration or cardiac output. Sixty behavior problem pedodontic patients were selected at random and placed in one of three groups to receive the following treatments: Treatment I - ketamine HCl and scopolamine; Treatment II - ketamine, scopolamine, and droperidol, and Treatment III - ketamine, scopolamine, and nitrous oxide-oxygen analgesia. Each treatment group received ketamine HCl 2 mg/lb and 0.1 - 0.3 mg scopolamine. The second two treatment groups were supplemented with droperidol .025 mg/lb or nitrous oxide-oxygen (20-50%) to maintain anesthesia. The patients were given a series of pre and post-treatment mental and physical tests and were considered completely recovered when they could equal their pre treatment test scores. Routine dental restorative procedures limited to one and one-half hours were carried out with the use of the ruber dam. Onset of anesthesia was five minutes for all three treatment groups. Treatment III showed a significantly longer working time but recovery times were not significantly different between groups. Ketamine HCl was determined to be a safe, effective agent for use in pedodontic outpatients provided prescribed techniques are followed. Complications were infrequent and minor and parental response was considered satisfactory.

Indiana University-Purdue University Indianapolis (IUPUI) / This investigation served as a follow-up of the unilateral and bilateral cleft lip and palate patients who underwent primary alveolar bone grafting at James Whitcomb Riley Hospital of the Indiana University Medical Center. The sample consisted of 18 patients, 15 males and three females, who received primary alveolar grafts between September 7, 1983 and March 5, 1985. Thirteen had complete unilateral clefts, and five had complete bilateral clefts of the lip and palate. The mean age of the group was 8 years, and none had received orthodontic treatment. The statistical analysis of the lateral cephalometric radiographs revealed significant differences in maxillofacial growth between the Riley sample population and the non-cleft, age-matched patients in the University of Michigan Growth Study. The Riley data were, overall, statistically and proportionately smaller than the normal population. These findings are due to the smaller skeletal size of the Riley group. Arch symmetry measurements indicated that at 8 years of age there were significant differences from ideal or perfect symmetry. Due to existent dental development and scarring from the palatal procedure, these findings were expected. Ideal symmetry may not be a realistic achievement for the cleft patients. Palatal surface area values were visually analyzed through graphs. The growth patterns of the Riley population were similar to those of the normal and non-grafted cleft groups in a study from the University of Miami. The data supports the theory that primary alveolar bone grafting, as performed at James Whitcomb Riley Hospital, does not result in growth attenuation.

Indiana University-Purdue University Indianapolis (IUPUI) / Malpractice litigation is on the increase and a lack of informed consent is more frequently becoming primary and secondary causes of action. A study was designed to compare and analyze the viewpoints of Indiana pediatric dentists and trial attorneys concerning the doctrine of informed consent. The ultimate goal was to share the information with both groups and raise the level of awareness of the doctrine among pediatric dentists. A three-page questionnaire dealing with the doctrine of informed consent was mailed to 85 pediatric dentists and 350 trial attorneys practicing in Indiana. The response rate for pediatric dentists was 70.6 percent and the response rate for trial attorneys was 61.4 percent. Overall, most pediatric dentists and trial attorneys were moderately familiar with the doctrine of informed consent. However, trial attorneys do not feel that pediatric dentists conform to the doctrine, while pediatric dentists perceive that they do conform. Pediatric dentists and trial attorneys recommend that informed consent be obtained orally and then documented on an informed consent form. Both professional groups agree that obtaining informed consent is necessary in the practice of pediatric dentistry. Unfortunately, pediatric dentists and trial attorneys do not f eel that predoctoral dental school education or specialty training prepares the pediatric dentist to obtain an informed consent. Not surprisingly, both groups feel that pediatric dentists are more concerned with obtaining informed consent today than they were in the past. Most pediatric dentists are obtaining informed consent in less than five minutes. However, pediatric dentists feel that the time spent obtaining informed consent has either remained the same (55.9 percent) or increased (44.1 percent); trial attorneys feel that this trend has increased (81.5 percent). Overall, pediatric dentists and trial attorneys disagree on whether parental consent is required for specific patient types. Moreover, the two groups agree on the type of consent necessary. For 20 dental procedures (54 percent) and disagree on 17 dental procedures (46 percent). Finally, most trial attorneys and pediatric dentists feel that conforming to the doctrine of informed consent reduces or eliminates future malpractice litigation.

To examine the pediatric dentists’ perspective on level of care to children 0-3 years old by general dentists, an electronic survey was sent out to 5185 AAPD members and 769 responded (response rate: 14.8%). Forty-six percent agreed with a general dentist providing a dental home to children 0-3 years old. Only 24% agreed that general dentists could perform complex restorative and behavior management procedures for 0-3 years old. Younger respondents, pediatric dentists who practice in rural areas or teaching pediatric dentistry, and those who perceived adequate exposure during dental school were more likely to agree on general dentists proving a dental home (p values ranged from <0.0001 to 0.022). This study finding can help guide what level of care general dentists may provide and when a referral to a pediatric dentist is recommended and the appropriate competency level of entry-level general dentists to care for 0-3 years old.

Purpose: Compare the efficacy of two benzodiazepines (diazepam or midazolam) in combination with meperidine and hydroxyzine for pediatric dental sedation. Methods: A randomized, double blind observation study of behaviors and outcomes related to two sedation groups. Frankl and Houpt behavior scores were recorded at three time points: injection time, initiation of treatment and at the end of treatment. Postoperative phone call surveys were conducted within eight hours of discharge to assess sleep, activity, and behavior. Results: A total of 40 sedation subjects were included in the study, of which 20 were treated with diazepam triple Combination (Di+M+H) and 20 with midazolam triple regime (Mi+M+H). Treatment was successful for 45% of cases with midazolam and 70% with diazepam (P value=.20). Houpt sleep scores were significantly higher for diazepam than midazolam at injection (P-value=.0043) and during treatment (P-value=.0152). Although Frankl scores, Houpt move and Houpt cry scores tended to favor diazepam, none were statistically significantly different. More abnormal behavior was reported with midazolam, though not statistically significant (35% vs 6%, P-value=.0854). Postoperative sleep time was longer for midazolam, but not significantly different (median sleep time: 61 vs 45 minutes, P-value=.2071). Conclusion: The diazepam, meperidine, hydroxyzine triple combination sedation regimen shows promising results as a successful alternative to midazolam triple combination. Longer postoperative monitoring may be required with diazepam, but this study has shown postoperative sleep times to be less than previously reported. Larger sample size is needed to determine if the current trend will be maintained.

No description available.

Due to the early onset of caries in many children general anesthesia is often required in order to treat the dental disease. Unfortunately following dental treatment under GA, many children have caries relapse, which often requires a repeat GA in order to accomplish the new dental treatment. The objective of this study was to determine if recall frequency following treatment under general anesthesia affects the likelihood that children will require new dental treatment under a repeat GA. 674 charts were reviewed from a private Pediatric dental practice located in Winnipeg Manitoba Canada where patients who underwent a GA for dental treatment were investigated. It was found that those patients, who required new treatment following an initial treatment under GA, were less likely to receive a repeat GA for new dental treatment if they attended more frequently for a recall examination. / October 2016