Pediatric dentistry最新文献

Purpose: To (1) examine the association of race/ethnicity with the prevalence of untreated dental caries and dental caries experience in a population of Asian-American and non-Hispanic White children in the United States, and (2) examine whether these associations vary by family income-to-poverty ratio. Methods: This cross-sectional, population-based study analyzed 4,875 children ages two to 19 years from multiple National Health and Nutrition Examination Survey data cycles (2011 to 2018). The race/ethnicity of each participating child was measured using parent/caregiver survey responses, while oral health outcome variables, untreated dental caries, and dental caries experience were measured using clinical oral health examination data. Descriptive analysis and log binomial regression analyses were performed. The final models were adjusted for the participants' demographic and household characteristics. Unadjusted and adjusted prevalence ratios (PR) and respective 95 percent confidence intervals (95% CI) were calculated. Results: Race/ethnicity was not significantly associated with the prevalence of untreated dental caries (adjusted PR equals 0.95; 95% CI equals 0.77 to 1.18) or dental caries experience (adjusted PR equals 1.03; 95% CI equals 0.92 to 1.15) among Asian-American and non-Hispanic White children. When examining variation in associations by family income-to-poverty ratio, no interaction was observed between race/ethnicity and family income-to-poverty ratio for dental caries experience and untreated dental caries (P-value for interaction ≥ 0.05). Conclusion: Despite no significant associations, additional surveillance and investigation of Asian-American subgroups are needed to determine if certain ethnic Asian-American populations suffer a disproportionate burden of oral disease.

Purpose: To use the audit study methodology to determine access for adolescents with special health care needs (ASHCN) in Ohio. Methods: An audit study of a balanced, random sample of general and pediatric dentists was conducted to assess willingness to treat simulated self-pay adolescents requiring three different levels of physical or emotional support: no support needs, minimal support such as audiovisual distraction, and significant support such as using a wheelchair for mobility. Descriptive and bivariate analyses were used. Results: Of the 221 offices successfully contacted (ratio equals 14 general dentists to one pediatric dentist), 206 completed responses to at least two scripts. For these offices, the extent of special health care needs was significantly associated with being offered an appointment (P<0.001). The simulated adolescent requiring minimal support was most successful in being offered an appointment (79.4 percent), and the simulated adolescent requiring significant support was least successful (49.7 percent). The wait time until appointment, if offered, increased significantly for the adolescent requiring significant support (P<0.001). Conclusions: Scheduling a new patient appointment for adolescents was difficult overall and more challenging as support needs for adolescents with special healthcare needs increased. Despite a willingness to pay out-of-pocket, fewer than half of ASCHN patients requiring significant support were offered a new patient appointment.

Purpose: To identify the differentially expressed proteins in the enamel of neonatal teeth versus control enamel of primary teeth through a proteomics workflow. Methods: This study involved a total of 12 primary teeth (six neonatal teeth and six control primary teeth), from which enamel blocks were sectioned. These prepared blocks were then subjected to various processes involving acid etching, desalting, reduction, and alkylation of proteins, followed by overnight tryptic digestion, to prepare protein samples for bottom-up liquid chromatography tandem mass spectrometric (LC-MS/MS) analysis. Differential expression and functional annotation of proteins were carried out using specialized bioinformatics software. Results: Enamel samples of neonatal teeth displayed an increased abundance of proteins in comparison to the control enamel of primary teeth. Elevated expression of proteins involved in osteogenesis and mineralization processes was observed in neonatal teeth enamel. However, this was accompanied by a reduced expression of KLK-4 and downregulation of levels of the protease inhibitors, suggestive of an imbalance in the protease/protease inhibitor ratio. Further, the present data points toward increased expression of odontogenic ameloblast-associated protein (ODAM) as at least one of the causative factors for the early eruption of teeth. The enrichment of proteins involved in the complement and coagulation pathways also suggests the possibility of injury or pathogen infection. Conclusion: Neonatal teeth can serve as a natural model for the detailed analysis of the functions of elevated enamel proteins in their morphogenetic growth.

Purpose: This study evaluated the effect of different autoclave sterilization cycles on surface crazing and fracture resistance of NuSmile^® BioFlx^® crowns (BFCs). Methods: Seventy-five crowns were divided into five groups (15 per group) based on the number of autoclave sterilization cycles: zero (control), one, three, five, and seven. Autoclaving was performed at 121 degrees Celsius and 15 psi for 20 minutes. The mesial surface of the crown was evaluated for crazing under 50× magnification using modified Wickersham's criteria. Subsequently, fracture resistance was assessed using a universal testing machine. Data were analyzed using Fisher's exact test and Welch's analysis of variance. Results: Surface crazing increased as the number of sterilization cycles increased. Most unsterilized crowns were free from crazing; however, after one cycle, only 20 percent remained crazing-free, while 80 percent displayed minor crazing. Following three cycles, 73.3 percent of the crowns exhibited crazing covering half the surface, and 26.7 percent extending over half the surface. After five cycles, 80 percent displayed cracks extending beyond half the surface, and 20 percent showed crazing confined to half. By seven cycles, all crowns exhibited significant crazing. Fracture resistance decreased significantly with increasing sterilization cycles, with the highest score observed in the control group and the lowest after seven cycles. Conclusions: Repeated autoclave sterilization significantly affects surface crazing and fracture resistance of BioFlx^® crowns. Clinicians should consider sterilization methods carefully, as repeated autoclaving compromises crown integrity.

Purpose: To determine US pediatric dentists' views on the feasibility and acceptability of an expanded counseling approach for early childhood caries (ECC) prevention and management that includes goal setting, action planning, and follow-up; assess their willingness to adopt these strategies in practice; and determine views on whether these strategies align with pediatric dentistry's scope of practice. Methods: For this cross-sectional observational study, all 5,925 American Academy of Pediatric Dentistry active members in 2021 were invited to a Zoom-delivered survey between November 2021 and July 2023 (28 percent response proportion, N equals 1,639). Results: Most respondents regarded identifying behavioral goals (95.6 percent), action planning (78.3 percent), and providing text follow-up (70.1 percent) as feasible and expressed willingness to incorporate these elements in practice (98.5 percent, 92.5 percent, and 71.1 percent, respectively). Most considered this expanded approach to counseling to be of interest (92.7 percent), exciting (83.2 percent), likely to happen within five to 10 years (73.8 percent), and within their practice scope (98.7 percent). More agreed that patients' families would accept this approach more than staff (84.8 percent [95 percent confidence interval equals 83.0 percent, 86.5 percent] versus 78.6 percent [76.5 percent, 80.5 percent]); 4.6 percent opposed this approach. Owners of private practices were generally less supportive than employed dentists. Conclusion: While expanded early childhood caries counseling is positively viewed by US pediatric dentists, the practice environment affects the level of support.