Evidence-based clinical practice guideline on restorative treatments for caries lesions: A report from the American Dental Association.

Background: An expert panel convened by the American Dental Association (ADA) Council on Scientific Affairs together with the ADA Science and Research Institute's program for Clinical and Translational Research conducted a systematic review and developed recommendations for the treatment of moderate and advanced cavitated caries lesions in patients with vital, nonendodontically treated primary and permanent teeth.

Types Of Studies Reviewed: The authors searched for systematic reviews comparing carious tissue removal (CTR) approaches in Ovid MEDLINE, Embase, Cochrane Database of Systematic Reviews, and Trip Medical Database. The authors also conducted a systematic search for randomized controlled trials comparing direct restorative materials in Ovid MEDLINE, Embase, Cochrane Central Register of Controlled Trials, ClinicalTrials.

The Modified Shields Classification and 12 Families with Defined Mutations.

Mutations in Dentin Sialophosphoprotein (DSPP) are known to cause, in order of increasing severity, dentin dysplasia type-II (DD-II), dentinogenesis imperfecta type-II (DGI-II), and dentinogenesis imperfecta type-III (DGI-III). DSPP mutations fall into two groups: a 5′-group that affects protein targeting and a 3′-group that shifts translation into the −1 reading frame. Using whole-exome sequence (WES) analyses and Single Molecule Real-Time (SMRT) sequencing, we identified disease-causing DSPP mutations in 12 families.

Fluoride Use in Caries Prevention in the Primary Care Setting.

Dental caries remains the most common chronic disease of childhood in the United States. Caries is a largely preventable condition, and fluoride has proven effectiveness in caries prevention. This clinical report aims to clarify the use of available fluoride modalities for caries prevention in the primary care setting and to assist pediatricians in using fluoride to achieve maximum protection against dental caries, while minimizing the likelihood of enamel fluorosis.

Trusting Infrastructure: The Emergence of Computer Security Incident Response, 1989-2005.

Historians have tended to analyze maintenance as an intrinsically local activity, something very unlike the development of large technological systems. This article challenges this historiographic dichotomy by examining efforts to construct a global infrastructure for maintaining computer security. In the mid-1990s, as the internet rapidly grew, commercialized, and internationalized, a small community of computer security incident responders sought to scale up their system of coordination, which had been based on interpersonal trust, by developing trusted infrastructure that could facilitate the worldwide coordination of incident response work.

Affect Dental Morphogenesis Resulting in X-linked Taurodontism, Microdontia and Dens-Invaginatus.

The etiology of dental anomalies is multifactorial; and genetic and environmental factors that affect the dental lamina have been implicated. We investigated two families of European ancestry in which males were affected by taurodontism, microdontia and dens invaginatus. In both families, males were related to each other unaffected females.

Preventive dental care use for children with special health care needs in Washington's Access to Baby and Child Dentistry program.

Background: Preschool-aged children with special health care needs (CSHCN) from low-income households are at increased risk of developing poor oral health. The study goal was to assess preventive dental care use for CSHCN enrolled in Medicaid within Washington state's Access to Baby and Child Dentistry (ABCD) program.

Methods: The authors analyzed 2012 Medicaid eligibility and claims files for children younger than 6 years in the ABCD program (N = 206,488).

Assessment of the Location of the Mandibular Lingula in Pediatric Patients Using Cone Beam Computed Tomography Images.

The purpose of this study was to determine the position of the mandibular lingula in a sample of cone beam computed tomography (CBCT) images taken on pediatric patients. A sample of 280 outpatient CBCT (i-CAT) scans (153 males and 127 females) were divided into three age groups: six to nine years (n=103), 10 to 13 years (n=103), and 14 to 18 years (n=74). The position of the lingula was determined relative to the anterior and posterior border of the ramus, mandibular notch, inferior border of the mandible, and mandibular plane.

Evidence-based clinical practice guideline on nonrestorative treatments for carious lesions: A report from the American Dental Association.

Background: An expert panel convened by the American Dental Association Council on Scientific Affairs and the Center for Evidence-Based Dentistry conducted a systematic review and formulated evidence-based clinical recommendations for the arrest or reversal of noncavitated and cavitated dental caries using nonrestorative treatments in children and adults.

Types Of Studies Reviewed: The authors conducted a systematic search of the literature in MEDLINE and Embase via Ovid, Cochrane CENTRAL, and Cochrane database of systematic reviews to identify randomized controlled trials reporting on nonrestorative treatments for noncavitated and cavitated carious lesions. The authors used the Grading of Recommendations Assessment, Development and Evaluation approach to assess the certainty in the evidence and move from the evidence to the decisions.

Consortium-based genome-wide meta-analysis for childhood dental caries traits.

Prior studies suggest dental caries traits in children and adolescents are partially heritable, but there has been no large-scale consortium genome-wide association study (GWAS) to date. We therefore performed GWAS for caries in participants aged 2.5-18.

Novel caries loci in children and adults implicated by genome-wide analysis of families.

Background: Dental caries is a common chronic disease among children and adults alike, posing a substantial health burden. Caries is affected by multiple genetic and environmental factors, and prior studies have found that a substantial proportion of caries susceptibility is genetically inherited.

Methods: To identify such genetic factors, we conducted a genome-wide linkage scan in 464 extended families with 2616 individuals from Iowa, Pennsylvania and West Virginia for three dental caries phenotypes: (1) PRIM: dichotomized as zero versus one or more affected primary teeth, (2) QTOT1: age-adjusted quantitative caries measure for both primary and permanent dentitions including pre-cavitated lesions, and (3) QTOT2: age-adjusted quantitative caries excluding pre-cavitated lesions.

Exploring the genomic basis of early childhood caries: a pilot study.

Objective: A genetic component in early childhood caries (ECC) is theorized, but no genome-wide investigations of ECC have been conducted. This pilot study is part of a long-term research program aimed to: (1) determine the proportion of ECC variance attributable to the human genome and (2) identify ECC-associated genetic loci.

Methods: The study's community-based sample comprised 212 children (mean age=39 months; range = 30-52 months; males = 55%; Hispanic/Latino = 35%, African-American = 32%; American Academy of Pediatric Dentistry definition of ECC prevalence = 38%).

Variants on chromosome 4q21 near PKD2 and SIBLINGs are associated with dental caries.

A recent genome-wide association study (GWAS) for dental caries nominated the chromosomal region 4q21 near ABCG2, PKD2 and the SIBLING (small integrin-binding ligand N-linked glycoprotein) gene family. In this investigation, we followed up and fine-mapped this region using a tag-SNP (single-nucleotide polymorphism) approach in 13 age- and race-stratified samples from 6 independent studies (N=4089). Participants were assessed for dental caries via intraoral examination and 49 tag-SNPs were genotyped capturing much of the variation in the 4q21 locus.

Development of a Core Curriculum Framework in Cariology for U.S. Dental Schools.

Maintenance of health and preservation of tooth structure through risk-based prevention and patient-centered, evidence-based disease management, reassessed at regular intervals over time, are the cornerstones of present-day caries management. Yet management of caries based on risk assessment that goes beyond restorative care has not had a strong place in curriculum development and competency assessment in U.S.

Modern Management Principles Come to the Dental School.

The University of Washington School of Dentistry may be the first dental school in the nation to apply lean process management principles as a primary tool to re-engineer its operations and curriculum to produce the dentist of the future. The efficiencies realized through re-engineering will better enable the school to remain competitive and viable as a national leader of dental education. Several task forces conducted rigorous value stream analyses in a highly collaborative environment led by the dean of the school.

Pilot Study of the Canary System Use in the Diagnosis of Approximal Carious Lesions in Primary Molars.

Purpose: This study assessed the feasibility and ease of use of the Canary System in approximal carious lesion detection in primary molars.

Methods: Forty healthy five- to 12-year-olds, who presented to the Center for Pediatric Dentistry in Seattle, Wash., U.

Clinical Decision-making for Caries Management in Children: An Update.

Dental caries continues to be one of the most common chronic diseases of childhood. Medical management of this disease has the potential to decrease the burden of disease in the most vulnerable children and delay the need for surgical intervention. Effective medical management requires early and effective risk assessment to identify individuals at risk prior to disease occurrence.

Effects of enamel matrix genes on dental caries are moderated by fluoride exposures.

Dental caries (tooth decay) is the most common chronic disease, worldwide, affecting most children and adults. Though dental caries is highly heritable, few caries-related genes have been discovered. We investigated whether 18 genetic variants in the group of non-amelogenin enamel matrix genes (AMBN, ENAM, TUFT1, and TFIP11) were associated with dental caries experience in 13 age- and race-stratified samples from six parent studies (N = 3,600).

Fluoride use in caries prevention in the primary care setting.

Dental caries remains the most common chronic disease of childhood in the United States. Caries is a largely preventable condition, and fluoride has proven effectiveness in the prevention of caries. The goals of this clinical report are to clarify the use of available fluoride modalities for caries prevention in the primary care setting and to assist pediatricians in using fluoride to achieve maximum protection against dental caries while minimizing the likelihood of enamel fluorosis.

Agreement between photographic and clinical examinations in detecting developmental defects of enamel in infants.

Objectives: This study assesses the reliability of photographic method with clinical examinations in detecting developmental defects of enamel (DDE) in the anterior primary teeth of infants.

Methods: The study sample was a part of an ongoing longitudinal study to assess risk factors for early childhood caries, and consisted of 138 and 238 infants who had scheduled follow-up visits at approximately 8 and 18-20 months corrected age, respectively. The modified DDE Index was used to record enamel defects (opacity, hypoplasia, and all types of defects) on anterior primary teeth by trained dentist examiners.

Oral health care for children with developmental disabilities.

Children with developmental disabilities often have unmet complex health care needs as well as significant physical and cognitive limitations. Children with more severe conditions and from low-income families are particularly at risk with high dental needs and poor access to care. In addition, children with developmental disabilities are living longer, requiring continued oral health care.

Macrodontia, shovel-shaped incisors, and multituberculism: probable Ekman-Westborg-Julin trait.

Multiple macrodontia is a rare finding and is defined as a condition in which a tooth is significantly larger than normal. Macrodontia may occur as an isolated finding, part of a group of dental anomalies, or as a component of a syndrome with multiple oral and systemic manifestations. The purpose of this paper was to report a case of macrodontia affecting all permanent teeth and exhibiting shovel-shaped maxillary and mandibular incisors and multituberculate molars and premolars.

Conscious sedation attitudes and perceptions: a survey of american academy of pediatric dentistry members.

Purpose: The purpose of this study was to assess the attitudes and perceptions of the American Academy of Pediatric Dentistry (AAPDM) members regarding conscious sedation.

Methods: A 22-item survey was e-mailed to 4,358 active AAPD members to identify factors that influence pediatric dentists' practice of conscious sedation in their dental offices. Bivariate and logistic regression models were used to analyze data.

Rethinking tenure in dental education.

In the midst of changes in the environment of academic dentistry over the past two decades, reform of traditional tenure is one way for dental schools to respond to these changes while maintaining scholarly, evidence-based learning environments. Challenges facing academic dentistry today and in the future include a crisis in workforce capacity, difficulty attracting recent graduates into academic positions, overburdened faculty members with limited time for scholarly activity, loss of tenured faculty members due to retirement, and a potentially diminished voice for dental schools within the parent university. The purpose of this opinion article is to suggest ways to reform the current tenure system in dental education as a means of improving recruitment and retention of new faculty members while maintaining or increasing scholarly activity within dental schools.