Webinar course on pediatric dentistry: Pediatric Dentistry Evolution

- Principles of treatment of tooth avulsion 
- Research enhancing predictability of treatment protocols
- Immediate and long-term complications of avulsion
- Splinting recommendations, treatment of pulp necrosis especially in teeth with immature roots, periapical pathologies, future orthodontic treatment, and prosthodontic rehabilitation

Traumatic dental injuries in children, adolescents and adulthood have been established to cause several immediate and long-term complications. They have a prevalence of 11-30% in different parts of the world, with a high predilection for adolescents (teen ages). Tooth Avulsion or exarticulation is one of the most severe forms of traumatic dental injuries leading to complete disjunction of tooth from its supporting structures. Avulsion is itself an emergency and is often accompanied by pan-facial trauma or injuries to other parts of the body.

Tooth avulsion in primary and permanent teeth warrants adequate emergency management which must be done by caregivers, parents, sports coaches, teachers and even the healthcare workers at the site of trauma. A low level of awareness in public often leads to a delayed reporting of these cases; affecting the prognosis adversely. Avulsion of young permanent teeth is complex and require a practical and evidence based protocol for management. The attending pediatric dentist needs to have a clear understanding regarding follow up assessments, splinting recommendations, treatment of pulp necrosis especially in teeth with immature roots, periapical pathologies, future orthodontic treatment, and prosthodontic rehabilitation. Additionally, the avulsion of primary teeth must be followed up for long duration due to chances of developmental deformities in succedaneous teeth.

With increase in understanding of regenerative medicine, efforts are underway to develop methods for improving the prognosis of avulsed teeth reporting after a delay and inadequate storage. This lecture aims to provide an insight of recent evidence based guidelines for immediate and long term management of avulsed teeth and to highlight the futuristic researches which can improve the predictability of management protocols.

- Etiopathogenesis of root resorption due to tooth trauma- Protocols for treating tooth resorption due to tooth trauma- Complications treatment protocols: discoloration, loss of vitality, mobility, periradicular pathology, root resorption and ankylosis

Even after effective initial care, the injured teeth are prone to certain secondary changes like discolorations, loss of vitality, mobility, peri-radicular pathologies, root resorption and ankylosis. Effective treatment protocols have been formulated as per the evidence-based guidelines for many of these conditions, however, the trauma induced root resorptions lack proper understanding. This lecture aims to highlight the etiopathogenesis, molecular basis and clinical paradigms of dental trauma induced root resorptions along-with highlighting the key protocols for their management.

- Dental caries: a behavioral disease- Caries detection. Сaries diagnosis- Caries risk assessment: is there a place in daily practice?- Clinical management of initial carious lesions- Non-invasive x micro-invasive interventions

In the past, dental caries was defined as an infectious transmissible disease, which is nowadays a concept considerate outdated and incorrect. Currently, dental caries is being described as a disbiose of the biofilm, mediated by behavioral components. This understanding had a direct impact on how the signs of the disease (carious lesions) are diagnosed and managed. Therefore, this course aims to introduce these new concepts, and, by means of scientific evidence and clinical cases, to demonstrate how they can be applied in daily practice.

- Recommendations on terminology
- Recommendations on carious tissue removal
- Selective x non-selective carious removal
- Methods of carious dentine excavation
- Clinical management of dentine carious lesions

Historically, the management of dental caries was based on the belief that caries was a progressive disease that eventually destroys the tooth unless there was restoration.

Among the objectives of the treatment, the restorer is in the repair or damage by caries, protect and preserve the tooth structure, and maintain pulp vitality whenever possible.

Today, restoration there is no synonym for caries.

The restorations have a useful life, so you have to be very careful in choosing each case. Today we have an arrangement, materials with excellent properties of bioactivity, adhesion, aesthetics and functionality.

The current pediatric dentistry faces different aspects of them as interdisciplinary treatment. There are numerous cases in which we intervene in a timely, but which will later require a prosthetic treatment of greater durability and in different conditions of emotional, intellectual and occlusion maturation.

We need to adapt to that change and think about the future in what is convenient for our patient, fulfilling their needs

The assessment of evidence for each topic was based on a modification of the American Dental Association’s grading of recommendations: strong evidence (based on well-executed randomized control trials, meta-analyses, or systematic reviews); evidence in favor (based on weaker evidence from clinical trials); and expert opinion (based on retrospective trials, case reports, in vitro studies, and opinions from clinical researchers).

The contemporary pediatric dentist has a greater interest in the intervention of malocclusion, this is due to the precious interaction with patients in growth stages, so that some dental schools in the training of specialists in pediatric dentistry are including in their programs the topics of orthopedics for the proper management of dentofacial disorders.

The American Academy of Pediatric Dentistry reports that the Guidance of eruption and development of the primary, mixed, and permanent dentitions is an integral component of comprehensive oral health care for all pediatric dental patients.

Such guidance should contribute to the development of a permanent dentition that is in a stable, functional, and esthetically acceptable occlusion and normal subsequent dentofacial development. Early diagnosis and successful treatment of developing malocclusions can have both short-term and longterm benefits while achieving the goals of occlusal harmony, function and dentofacial esthetics.

To do a correct diagnosis, prognosis and evolution of the patient and its legal implications, case documentation is indispensable

An adequate documentation will have auxiliaries that provide us with information for treatment, therefore the importance of the elements that constitute it.

The intervention of the pediatric dentist in malocclusion is to establish a priority of treatments. What most frequently works is in dental alterations of number, form and structure; posterior and anterior cross bites; intervention of non-functional habits, identification of problems in airways.

The assesment of evidence for each topic was based on the reference manual of pediatric dentistry approved by American Academy Pediatric Dentistry.

- History and characteristics of Nitrous Oxide Sedation- The definitions of minimal and moderate sedation - The advantages, drawbacks and risks of nitrous oxide sedation - The basic respiratory physiology, including the uptake and distribution of gases - Distinguish the states of anesthesia and phases of State I Anesthesia- The pharmacology, and physiology of Nitrous Oxide - The indications, contraindications, complications of inhalation analgesia and how to minimize them - The characteristics of the Nitrous Oxide/Oxygen delivery system and checklists used in nitrous oxide sedation - Clinical protocol for the use of Nitrous Oxide/Oxygen Sedation- Safety and occupational exposure considerations - Patient/population selection for maximum success- Patient, family education and Documentation - Practical tips for maximizing positive patient outcomes

Nitrous oxide has been used by dentists to provide comfort for their patients for over a hundred years. Distress and pain experienced by a child during a medical procedure may have a lifelong impact. Nitrous oxide-oxygen sedation properly administered to the conscious child or adult provides an important adjunctive aid to the management of the anxious patient.

- History and characteristics of Nitrous Oxide Sedation- The definitions of minimal and moderate sedation - The advantages, drawbacks and risks of nitrous oxide sedation - The basic respiratory physiology, including the uptake and distribution of gases - Distinguish the states of anesthesia and phases of State I Anesthesia- The pharmacology, and physiology of Nitrous Oxide - The indications, contraindications, complications of inhalation analgesia and how to minimize them - The characteristics of the Nitrous Oxide/Oxygen delivery system and checklists used in nitrous oxide sedation - Clinical protocol for the use of Nitrous Oxide/Oxygen Sedation- Safety and occupational exposure considerations - Patient/population selection for maximum success- Patient, family education and Documentation - Practical tips for maximizing positive patient outcomes

Nitrous oxide has been used by dentists to provide comfort for their patients for over a hundred years. Distress and pain experienced by a child during a medical procedure may have a lifelong impact. Nitrous oxide-oxygen sedation properly administered to the conscious child or adult provides an important adjunctive aid to the management of the anxious patient.

- The modern theory of сarious tissue removal
- Various techniques for сarious tissue removal
- Selective removal
- Techniques for filling cavities
- Root caries treatment
- Lining, adhesive systems and restoration materials: selection of materials

- The modern theory of сarious tissue removal
- Various techniques for сarious tissue removal
- Selective removal
- Techniques for filling cavities
- Root caries treatment
- Lining, adhesive systems and restoration materials: selection of materials