The existence of accessory canals in the furcation region of primary molars has been the subject of extensive research. The objective of this study was to use a micro-computed tomography scanner to analyze accessory canals in the furcation region of extracted primary molars. Sixty-five primary molars which were extracted for purposes not including this study were collected and scanned at a resolution of 9.0 μm using a Skyscan 1176 Micro-CT scanner. For each extracted molar collected, the patients age at the time of extraction was recorded, as well as whether the tooth came from the maxillary or mandibular arch and if the tooth was a first or second molar. DataViewer v1.5.1 software was used to analyze each scanned primary molar for the presence or absence of canals, canal patency and number of canals present. Collected data was analyzed using SPSS 20.0 for Windows. Fisher’s exact and Kruskal-Wallis tests were used to identify association between variables. Canals were observed in the furcation area of 83% of molars scanned, and patent canals were found in the furcation area of 8% of the molars. The mean number of canals per tooth was found to be 2.6. The majority of these canals were found adjacent to the periodontal ligament on the outer surface of the furcation. Second molars were observed to have a higher number of canals than first molars (p<0.05), with maxillary second molars having a mean number of canals of 3.3, mandibular second molars having a mean number of canals of 3.5, maxillary first molars having a mean of 1.8, and mandibular first molars having a mean of 2.1 canals. No significant association was found between patient age and the number of canals present. Micro-Computed Tomography was an effective method to quantify accessory canals in the furcation region of extracted primary molars. / October 2016

Indiana University-Purdue University Indianapolis (IUPUI) / Molar Hypomineralization (MH) of the first permanent molars (FPMs) and the second primary molars (SPMs) is a common developmental defect of enamel, with global prevalence of 14% and 5% respectively. Children with MH represent a special pediatric population because their affected molars have extreme susceptibility to enamel breakdown, decay and tooth sensitivity. Although the problem of MH has been described almost twenty years ago mainly through reports from Europe, there is very little information about the problem from the USA. In this dissertation, MH was explored both from the perspectives of pediatric dentists’ (PDs) and at population level. The majority of the survey respondents perceived MH prevalence to be <10% in their clinical practice (62%). The most cited clinical challenge in managing MH teeth was “long-term success of restorations” (79%). When analyzed individually, responses differed significantly for different demographics and educational characteristics of the respondents (p<0.05). At population level, MH of the FPMs (Molar Incisor Hypomineralization (MIH) cohort: 337 schoolchildren, average age 9 years) and of the SPMs (Hypomineralized Second Primary Molar (HSPM) cohort: 423 schoolchildren, average age 7 years) had prevalence estimates of 13% and 6% respectively. In the MIH cohort, water fluoridation or non-Hispanic Black race/ethnicity was significantly associated with higher collective prevalence of enamel defect (EDs) (P<0.05), but not with the prevalence of MH of the FPMs. In the HSPM cohort, race/ethnicity was significantly associated with higher overall prevalence of EDs of SPMs, but not with the HSPM prevalence. Older age group (>10 years), living in central Indiana, and water fluoridation were significantly associated with higher overall prevalence of EDs (P<0.01), but not with the HSPM prevalence. Caries experience was significantly higher in children with MH of FPMs and/or SPMs than in the group without MH. We concluded that USA pediatric dentists’ respondents were well aware of the MH problem, but demonstrated discrepancies in different aspects of the MH problem. At population level, MIH and HSPM were common presentation with prevalence estimates similar to the global figures. Certain demographic characteristics were significantly associated with the overall prevalence of the enamel defects of the examined teeth.

Objectif : La dentisterie pédiatrique évolue vers des approches minimalement invasives pour la gestion des caries, transition accentuée par l'impact de la pandémie de la COVID-19. Parmi les procédures préconisées en dentition primaire, la technique de Hall s'est montrée efficace pour relever des défis tels que la coopération limitée des jeunes patients et l'accès restreint aux blocs opératoires. Malgré son efficacité avérée de 98%, son adoption demeure limitée parmi les dentistes pédiatriques. Le but de cette étude était d'évaluer l'enseignement de la technique de Hall dans les programmes de spécialité en dentisterie pédiatrique, d'analyser son utilisation, sa connaissance, et sa perception parmi les spécialistes américains et canadiens, ainsi que d'explorer les obstacles limitant son adoption. Méthodologie : Les dentistes pédiatriques du Canada et des États-Unis ont été sollicités à travers la liste de diffusion de l'American Academy of Pediatric Dentistry. Un questionnaire composé de 32 énoncés et d’une section spécifique destinée aux directeurs de programme a été distribué électroniquement en septembre (États-Unis) et en octobre (Canada) 2023, via la plateforme LimeSurvey. Des rappels ont été faits après 4 à 6 semaines. Résultats : Au sein de l'échantillon de 364 participants, l'analyse statistique a révélé des différences significatives dans l'utilisation de la technique en fonction de la région d'exercice (p=0,009), du type de pratique (p<0,001), de l'âge du professionnel (p<0,001), du nombre d'années d'expérience (p<0,001), des sources de remboursement (p=0,003) et si la technique leur avait été enseignée ou non (p<0,001). Conclusion : Les résultats indiquent une augmentation de l'utilisation de la technique de Hall parmi les dentistes pédiatriques, tout en soulignant la persistance d'obstacles. Ils proposent aussi des pistes d'intervention pour encourager davantage son adoption, en cohérence avec l'évolution vers des approches minimalement invasives de gestion de la carie. / Introduction: Pediatric dentistry increasingly favors minimally invasive approaches, discouraging extensive treatments such as complete caries removal. The COVID-19 pandemic hastened this shift, highlighting relevance of procedures like the Hall technique (HT) for managing carious lesions in primary dentition while addressing challenges such as patient cooperation and restricted access to operating rooms. Despite being recognized for its 98% efficacy, this technique continues to encounter limited adoption among pediatric dentists. Purpose: To assess the integration and teaching methods of the HT in graduate pediatric dentistry programs, evaluate its utilization, comprehension, and perception among American and Canadian specialists, and explore obstacles to its adoption. Methods: Pediatric dentists in Canada and United States (U.S.) were surveyed via the American Academy of Pediatric Dentistry mailing list, featuring a dedicated section for program directors. Using the LimeSurvey platform, a questionnaire of 32 potential inquiries was electronically available in early September (U.S.) and early October (Canada) of 2023, with reminders issued 4-6 weeks later. Results: Of 364 participants, statistical analysis indicated significant differences in HT use according to practice regions (p=0.009), settings (p<0.001), age (p<0.001), years of experience (p<0.001), reimbursement sources (p=0.003), and education exposure (p<0.001). This offers a comprehensive understanding of the nuanced landscape surrounding the HT among pediatric dentists in Canada and the U.S. Conclusion: This investigation reveals a growing acceptance of the HT, despite persistent challenges faced by pediatric dentists in Canada and the U.S. These findings provide actionable insights for improving the adoption of the HT in contemporary pediatric dentistry practices, aligning with today's emphasis on minimally invasive approaches.