Journal of the Indian Society of Pedodontics and Preventive Dentistry最新文献

Objective: To determine the prevalence, severity, and clinical characteristics of molar incisor hypomineralization (MIH) among children in Erbil City, Iraq, and its relation to enamel hypoplasia in the primary teeth.

Materials and methods: A cross-sectional study was performed on 451 schoolchildren. MIH was diagnosed when at least one permanent incisor and one first permanent molar were affected. Lesions were categorized by severity (mild = 1, moderate/severe = 2) and extension (less than one third = 1, one third or more but less than two thirds = 2, more than two thirds = 3). Enamel hypoplasia of the second primary molar was also recorded. Data were analyzed using descriptive statistics and Chi-square tests.

Results: MIH was diagnosed in 66 children (14.6%). Boys were slightly more affected (53%) than girls (47%). The mandibular first molar (tooth 46) was most commonly affected (57.6%), followed by the maxillary central incisor (tooth 21, 51.5%). Most lesions were mild (75.9%), though 24.1% were moderate/severe. Extension analysis revealed 54.8% less than one third, 21.9% one third but less than two thirds, and 23.2% more than two thirds' lesions. Posterior teeth were significantly more severe and extensive than anterior teeth (P < 0.01). Only 30.3% of MIH children also had enamel hypoplasia.

Conclusion: MIH affects approximately one in seven children in Erbil. While most cases are mild, posterior molars frequently show severe breakdown. MIH and enamel hypoplasia appear to be distinct conditions, emphasizing the importance of early detection and preventive care.

Objective: The extent and nature of the impact of special healthcare needs (SHCNs) on oral health-related quality of life (OHRQoL) of children remain inadequately synthesized. This systematic review aimed to evaluate the association between various oral health conditions and OHRQoL among children with SHCN.

Methodology: A comprehensive literature search was conducted across electronic databases including PubMed, LILACS, Web of Science, EMBASE, Scopus, and Google Scholar, along with manual searches. Titles, abstracts, and full texts were screened by two reviewers based on predefined criteria. Data extraction, performed by two reviewers, focused on study characteristics, types of disabilities, oral health conditions evaluated, OHRQoL tools used, and key findings. Risk of bias (RoB) was assessed using Joanna Briggs Institute checklist.

Results: Of the 27 included studies, 12 had moderate RoB, whereas the rest of the studies had low RoB. The most studied conditions were dental caries (n = 24), followed by periodontal diseases (n = 11), malocclusion (n = 7), dental trauma (n = 6), and dental erosion (n = 2). The included disabilities included cerebral palsy, autism spectrum disorder, attention deficit hyperactivity disorder, visual, hearing and mental impairment, etc., Dental caries and periodontal diseases were significantly associated with poor OHRQoL in most studies. The impact of malocclusion and dental trauma on OHRQoL was inconsistent, while dental erosion showed no significant effect.

Conclusion: Dental caries and periodontal diseases adversely affect OHRQoL in children with SHCN. The evidence for other conditions remains limited and inconsistent. Future longitudinal studies with standardized, child-centered OHRQoL assessments are needed to strengthen the evidence base.

Background: Dental anxiety is one of the most frequently encountered behavioral challenges in pediatric dentistry. Art therapy has been proposed as a means of alleviating pediatric anxiety.

Aim: To evaluate the effectiveness of structured art therapy in reducing dental anxiety among children aged 6-12 years attending a pediatric dental clinic.

Materials and methods: A randomized controlled clinical trial was conducted on 150 children (87 females, 63 males) aged 6-12 years. Participants were randomly assigned into two groups: Study Group (n=75) received structured art therapy (drawing, coloring, collage) for 15 minutes before each dental visit, while Control Group (n=75) underwent routine tell-show-do behavior management. Anxiety levels were assessed using the Frankl Behavior Rating Scale (FBRS), Five-Facial Anxiety Scale (FFAS), and Child Drawing: Hospital (CD:H) scale at baseline and after three visits. Data were analyzed using paired t-test, chi-square test, and Pearson correlation, with p<0.05 considered significant.

Results: At baseline, 58.6% of participants demonstrated high or very high anxiety. Post-intervention, the study group exhibited significant reduction: 68% had little or no anxiety compared to 14.6% in controls (P<0.001). Strong correlations were observed between CD:H and FFAS (r=0.29, P<0.01) and between CD:H and Frankl scores (r=-0.32, P<0.01).

Conclusion: Art therapy is a simple, cost-effective adjunct that significantly reduces dental anxiety and improves cooperation in children.

Background: A comprehensive understanding of craniofacial growth and development is crucial for all dentists. Variability is a key principle in studying growth patterns. Cephalometrics, as a morphological diagnostic tool, quantitatively expresses this variability and plays a vital role in assessing craniofacial growth and development.

Aims: This study aims to determine cephalometric principles (skeletal and dental) for the Indore population of India and to establish cephalometric values for children in the late mixed dentition stage.

Setting and design: An observational study was performed in the outpatient department over 2 months.

Methods: The lateral cephalograms of 100 children of 11-13-year age group with normal occlusion and pleasant profile were taken, and cephalometric values were established using Steiner's analysis.

Statistical analysis used: Data were processed utilizing SPSS (Statistical Package for Social Sciences) version 25.0, IBM, Chicago. The intergroup comparison utilized the Mann-Whitney U-test.

Results: The findings of this study indicated that the children of Indore had mandibular retrusion in relation to the cranial base (SNB - 76.2), accompanied by enhanced facial convexity and a horizontal growth pattern (mandibular plane angle - 21.3).

Conclusion: The craniofacial features, which include both skeletal and dental characteristics, can be attributed to either genetic inheritance or the dietary patterns that are acquired from parents. These characteristics are unique to certain ethnic, racial, and subracial groupings, as well as to other community groups. With the growing number of children in Indore seeking professional treatment for malocclusion, it has become increasingly important to define the criteria for an esthetically pleasing and normative facial appearance within this population.

Introduction: Molar-incisor hypomineralization/MIH's high prevalence, early-onset, rapid progression, multiple teeth involvement is concerning. Providing individualized care for all affected children globally is often unfeasible, costly, and requires a significant workforce and time. This necessitates scalable solutions suitable for population level rather than traditional clinical models. Hence, practical, simplified, and effective interventions at the point of care (communities) are urgently needed. Silver diamine fluoride (SDF) and universal bonding agent (UBA) are potential field-based interventions for MIH, but comparative evidence is limited.

Aim: To evaluate the efficacies of SDF and UBA in arresting caries in MIH-affected teeth in a community-based setting using ICDAS scores.

Materials and methods: A double-blind (participants, assessors, and statisticians), randomized controlled trial was conducted in four schools in India. Of over 5000 children screened, 186 had MIH pathology; 103 consented, 89 received treatment, and 79 were followed up. A total of 212 teeth (SDF: 111, UBA: 101) were assessed after 1 year. The primary outcome was caries arrest, measured by changes in ICDAS scores. Subgroup analysis and faceted plots were used to explore clinical trends.

Results: McNemar-Bowker test showed no statistically significant change in ICDAS scores from baseline to 1 year in either group (SDF: P =0.133; UBA: P =0.125). Subgroup trends showed more stable and improved outcomes in the UBA group, particularly in ICDAS-1 and -2. SDF was limited by discoloration concerns.

Conclusion: While both materials were clinically effective, UBA demonstrated a more favorable clinical trend. The study's large sample size, real-world setting, and balanced design strengthen its applicability for population-level MIH management strategies.

Background: Silver diamine fluoride (SDF) has gained significant attention in the past decades owing to its proven efficacy in arresting active carious lesion. LASERs in combination with topical fluorides have been shown to have a synergistic effect. This study aims to evaluate and compare the pretreatment and posttreatment effect of LASER on the color stability and surface characteristics of SDF treated carious primary molars.

Materials and methods: Thirty extracted carious primary molars were allocated into three Groups: Group 1: SDF; Group 2: Pretreatment LASER followed by SDF; and Group 3: SDF followed by posttreatment LASER. Spectrophotometric analysis, Scanning Electron Microscope (SEM), and Energy Dispersive X-ray Spectrophotometer for elemental analysis were done. One-way ANOVA was used for intergroup comparisons, Paired t-test and repeated-measures ANOVA were used for intra-group comparisons. The level of significance was set at 5%.

Results: On intergroup comparison, color change (∆E) was the highest in Group 3 (32.16 + 13.40) followed by Group 1 (29.19 + 13.42) and Group 2 (25.78 + 15.48) (P value = 0.60). Color change was the highest during intra-group comparisons of baseline and posttreatment LASER in Group 3. SEM images of Group 2 revealed smooth regular compact globular structures, whereas Group 1 and 3 revealed irregular granular structures.

Conclusion: Application of diode LASER following SDF treatment significantly improved the remineralization properties of carious primary molars, as evidenced by increased mineral uptake. In contrast, LASER pretreatment resulted in the lowest color change, indicating reduced discoloration risk. These findings highlight the importance of LASER timing to optimize both therapeutic efficacy and esthetic outcomes in pediatric dental care.

Introduction: Palatal rugae, or palatal folds, are the unique anatomical features on the hard palate that emerge during fetal development and remain stable throughout the life. These features are valuable for human identification in forensic science, as they are less prone to damage from thermal exposure or physical trauma.

Aim and objectives: This study aimed to determine if there is an association between different palatal rugae patterns and terminal planes in primary dentition.

Materials and methods: The study population consisted of 600 children aged 3-6 years, classified into three terminal planes: mesial step, distal step, and flush terminal plane. Palatal rugae were analyzed using the modified Thomas and Kotze classification system, and data were assessed using the Chi-square tests.

Results: Results showed no significant differences in the number, unification, or orientation of rugae between the terminal planes. However, a significant difference was found in the shape of the rugae, with circular and wavy patterns being more predominant in the mesial and distal step terminal planes, respectively. The most common shape of the incisive papilla was droplet-shaped across all groups.

Conclusion: These findings suggest that while palatal rugae patterns can offer insights into occlusal relationships in primary dentition, they do not show strong association with the terminal planes of primary molar relationships. The study highlights the potential for early diagnosis and preventive interventions in pediatric dentistry based on palatal rugae patterns.

Background: Materials for pulpotomy have evolved to materials which can regenerate the pulp. Mineral trioxide aggregate (MTA) potentially shifts the pulpal status and promotes dentin bridge formation. Newer MTAs in premixed form are resistant to dislodgment providing excellent sealability. Premixed Injectable MTA can be directly applied on the pulpal stumps promoting ease of workability and patient convenience.

Aim and objectives: To evaluate and compare the clinical and radiographic outcome of premixed injectable MTA and conventional MTA as pulpotomy medicaments in primary teeth.

Materials and methods: Thirty teeth requiring pulpotomy from 15 subjects aged between 5 and 9 years were included. After LA administration and rubber dam application, the access cavity was prepared and the coronal pulp was amputated. Premixed injectable MTA (Endocem) was applied on the pulpal stumps in one side and conventional MTA was mixed and placed on the pulpal stumps on the other side. Glass ionomer restoration was done and stainless-steel crowns were given. Clinical and radiographic follow-up was done at 3 and 6 months.

Results: At 3 months, a 100% success rate was observed in Endocem and Angelus group, clinically and radiographically. At 6 months' follow-up, clinical success was seen in 86.67% in Angelus group and 93.33% in Endocem group. Radiographic success was seen in 86.67% in Angelus and 93.33% of Endocem group. The success rate was greater in Endocem group than Angelus group but was not statistically significant.

Conclusion: Premixed Endocem MTA can be a better alternative to conventional MTA for pulpotomy with better handling properties and faster setting time.

Context: Lateral mandibular functional shifts (LFMSH) have been found to be associated with facial asymmetry (FA), posterior crossbite, midline shift, and dissimilar molar occlusion, including uneven biting or unilateral chewing.

Aims: The aim is to evaluate the prevalence of LFMSH and its known associated factors, i.e., FA, midline deviation (MD), unilateral posterior crossbite (UPXB), posterior occlusion (PO), preferred chewing side (PCHWS), premature contacts (PC), and correlation of each factor with LFMSH among children with deciduous and early mixed dentition in a North-Indian city.

Settings and design: This cross-sectional study was conducted among the schoolchildren of North-Indian city.

Methods: This study assessed 400 school children. Extra- and intra-oral static examination was done in the maximum intercuspation position (MIP). CR was attained, and functional mandibular shift (FMSH) in any direction, with special emphasis on LFMSH, was confirmed when mandible got shifted from PC to MIP. Causative factors for PC were further assessed.

Statistical analysis: The correlation between LFMSH and associated variables was tested by the Chi-square test.

Results: The prevalence of LFMSH, FA, MD, UPXB, PCHWS, and PC were 11.8%, 10.3%, 13.2%, 13.8%, 32.8%, and 15.0%, respectively. Significant correlation (P < 0.001) was found between LFMSH and FA (74.5%), MD (100%), UPXB (100%), dissimilar PO (93.7%), PCHWS (100%), and correction of CR postphonetics (100%). PCs were found in deciduous canine and maxillary incisor regions. Crossbites in the permanent first molar and primary second molar were coexisting.

Conclusions: Significant correlation of LFMSH with associated factors emphasizes early detection, understanding of the predisposing factors for their prevention and/or early interception. Long phonetics was clinically successful in observing FMSH in the field.

Aim: To evaluate and compare the clinical efficiency and Streptococcus mutans adherence in primary molars restored with Bioflx and Zirconia crowns (ZCs).

Methodology: A split-mouth pilot study was conducted on 15 children (40 teeth) aged 4-8 years, with each child receiving both Bioflx and ZCs. Clinical parameters, including retention, color match, staining, and occlusal wear, were evaluated at 1-, 3-, and 6-month follow-ups using the modified USPHS criteria. S. mutans counts were recorded at baseline and at 1-month follow-up. Statistical analysis was carried out using the McNemar-Bowker test and repeated measures analysis.

Results: Both crowns showed 100% retention and no occlusal wear. ZCs demonstrated superior esthetics with 100% Alpha ratings and no staining, while Bioflx crowns exhibited progressive staining and shade mismatches. Both crowns significantly reduced S. mutans counts, with no significant difference between the groups (P = 0.218).

Conclusion: Within the limitations of this 6-month evaluation, ZCs demonstrated superior esthetics, while both Bioflx and ZCs showed comparable retention and similar reductions in S. mutans counts; however, long-term, multicenter studies are necessary to confirm the durability, longevity, and overall clinical performance of both crown types.