Pediatric dentistry最新文献

Purpose: Although gingival thickness has been extensively studied in permanent dentition, the literature regarding marginal gingival thickness in primary dentition is insufficient. The purpose of this study was to assess the variations in marginal gingival thickness in preschool-age children. Methods: A cross-sectional study of 4,109 primary teeth was conducted. Using a reamer, the transgingival probing method was employed to assess marginal gingival thickness in healthy preschoolers. Inter-examiner and intra-examiner reproducibility were assessed via the intraclass correlation coefficient. Results: Descriptive statistics revealed that primary maxillary left second molars had the highest mean marginal gingival thickness (1.06 mm), whereas primary mandibular right central incisors had the lowest mean marginal gingival thickness (0.74 mm). Gender-based independent sample t-tests revealed significant differences in the values of primary maxillary right canines (females had greater values than males; P=0.03) and primary mandibular right first molars (males had greater values than females; P=0.01). An inter-arch comparison revealed significant differences between the primary second molars (maxillary more than mandibular; P=0.001). Conclusions: This study reports the first documented marginal gingival thicknesses of primary dentition. It reveals substantial variations in the values of primary maxillary right canines and primary mandibular right first molars and between primary maxillary and mandibular second molars.

Purpose: The purpose of this study was to assess, in vitro, the color stability and bleaching response of three bulk-fill composite resins-Activa™, Tetric®-N-Ceram Bulk-Fill, and Filtek™ One Bulk-Fill???and one conventional composite resin, Filtek™ Z250, after immersion in commonly consumed carbonated beverages and subsequent home bleaching with 15 percent carbamide peroxide. Methods: Ninety-six samples (two- and four-mm thick) of the materials were immersed in malt drink, energy drink, cola, or distilled water for one day, one week, and two months. After two months, samples underwent home bleaching with 15 percent carbamide peroxide gel. Spectrophotometric analysis measured color and whiteness changes pre-immersion, post-immersion, and post-bleaching. Statistical significance was determined using factorial mixed analysis of variance (ANOVA), three-way ANOVA, and Bonferroni post hoc tests (P<0.05). Results: All tested composite resins exhibited unacceptable discoloration (color change greater than 3.3) after two months in carbonated beverages. Filtek™ One Bulk-Fill and Filtek™ Z250 displayed the most significant discoloration, particularly when immersed in the malt drink (P<0.05). In contrast, Activa™ samples reached unacceptable discoloration within just one week in malt and cola drinks. Home bleaching yielded limited whiteness recovery, with Activa™ presenting acceptable whiteness post-bleaching after staining with cola and energy drinks. Conclusions: This study highlights the aesthetic risks of prolonged carbonated beverage consumption and the limitations of the assessed home bleaching technique using 15 percent carbamide peroxide. Enhanced dental education on the dietary effects of some beverages on restorative materials is indicated by these findings.

Purpose: The purpose of this study was to explore the perceived value of clinical photographs for traumatic dental injuries (TDIs). Methods: A survey was sent to members of the American Academy of Pediatric Dentistry (AAPD). The survey collected respondents' responses to case-based questions with and without photographs, and opinions about the value of photography for TDI. Results: A total of 496 respondents (5.8 percent response) completed the survey. Overall, no significant difference in correct answers was observed between cases with and without a photograph (P=0.09). The majority of respondents (82.2 percent) agreed that photographs should be taken for the management of TDIs, with 88.7 percent stating that the photographs aided in the diagnosis of TDIs. The majority of respondents acknowledged the time-saving (80.9 percent) and legal importance (77.0 percent) of photographs. Conclusion: Photographs should be taken in the management of traumatic dental injuries when possible for history and documentation purposes.

Purpose: To analyze the cariogenicity of meals served in a pre-kindergarten program and its potential influence on early childhood caries (ECC) risk in socioeconomically disadvantaged children. Methods: This study examined 123 school-provided meals over 43 days at the United Nation Childhood Development Center, part of the Oakland Unified School District pre-kindergarten program. Using cariogenicity indices developed by Evans et al., all items served were assessed for the cariogenic potential of both food and beverages. Results: The mean daily cariogenicity scores were 6.57±1.3 (standard deviation) for food and 2.89±0.78 for beverages. Breakfast foods were significantly more cariogenic than those served for lunch or supper (P<0.05). The mean daily calorie intake was 1,459±336, with lunch containing statistically higher calorie items compared to supper (P<0.05). While liquids may not significantly contribute to caries risk, breakfast foods emerged as a potential concern. Conclusions: This study's findings suggest that the food provided in school meals, particularly breakfast items, may impact early childhood caries risk among socioeconomically disadvantaged children. Given the prevalence of ECC and its societal burden, integrating assessments of food and beverage cariogenicity into school meal planning could be instrumental in mitigating ECC incidence. Collaboration between the United States Department of Agriculture and school districts in considering the cariogenic potential of foods may contribute to improved oral health outcomes in early childhood.

Purpose: To evaluate whether reduced curing performance due to compromised light tip placement can be mitigated by bulk-fill composite and/or high-intensity curing light. Methods: Plastic discs with 2.5-mm deep cavities were filled with a conventional (Mosaic™) or bulk-fill (Tetric® PowerFill) composite and cured with a BluePhase® PowerCure curing light at normal and high-power settings, with light tip placement at distance and/or 45 degree angle. Curing time and irradiance were three, five, or 10 seconds at 1,200, 2,000, or 3,000 mW/cm2 (10 samples). After 24 hours, Vickers hardness on top and bottom surfaces was measured and analyzed using analysis of variance and pairwise comparisons (α<0.05). Results: All top surfaces had higher hardness than bottom surfaces. Cure (bottom-to-top hardness ratio) was significantly affected by material, distance/angle, and curing regimen (P<0.001), and generally decreased when tip distance and angle increased. Bottom-to-top hardness ratios of bulk-fill composite (0.42 to 0.66) were significantly higher than those of conventional composite (0.20 to 0.31). High-power curing significantly increased bulk-fill's curing performance as it was specifically formulated for this curing light. Conclusions: Increased light tip distance and angle compromised composite curing. Bulk-fill composite cured better at the bottom of the restoration than conventional composite regardless of light tip distance/angle. High-power light curing improved curing performance only in bulk-fill composite. Nevertheless, due to low bottom-to-top ratios (0.20 to 0.66) across all samples, even under ideal light tip placement, both composites should be cured in increments of less than 2.5 mm.

Purpose: The purpose of this study was to investigate the trends of pediatric dental rehabilitation in hospital outpatient departments (HOPDs) and ambulatory surgery centers (ASCs) during the COVID-19 public health emergency (PHE) from 2019 to 2021 across states and demographic groups. Methods: This cross-sectional study utilized the 2019 to 2021 Transformed Medicaid Statistical Information System Analytical Files to examine trends in dental rehabilitation for children ages 12 years and younger enrolled in Medicaid or the Children's Health Insurance Program. The final analytic sample included 20,508,093 beneficiaries from 2019, 19,436,957 beneficiaries from 2020, and 20,416,440 beneficiaries from 2021. Chi-square tests were used to compare dental rehabilitation usage across groups (age, sex, race/ethnicity, and place of service). Results: Rehabilitation of Medicaid beneficiaries performed in HOPDs showed a decrease year over year (51 to 34 to 30; P<0.001), while the usage in ASCs increased (1,307 to 1,310 to 1,367; P<0.001). For all three years, the highest usage was seen in Non-Hispanic (NH) American Indian/Alaskan Native children (154, 66, 74; P<0.001), while the lowest usage was seen in NH Black children (21, 16, 17; P<0.001). Rehabilitation for Hispanic children had the greatest relative recovery over the three years (39 to 34 to 38; P<0.001). Conclusions: Dental rehabilitation usage in ambulatory surgery centers showed continued growth through the public health emergency. There was significant variation in rates across states and demographics.

Purpose: The purpose of this study was to evaluate the environmental impact of travel and anesthetic gas emissions associated with treating early childhood caries at a single institution. Methods: Outpatient preventive, treatment, and modeled general anesthesia (GA) cases in children 71 months old and younger were included in this retrospective chart review. The main outcomes were kilograms of carbon dioxide equivalents (kgCO₂e) for travel- and anesthetic gas-related emissions. Descriptive statistics and non-parametric tests were used. Results: Most subjects had a caries treatment visit (n equals 3,630 out of 5,767), and nine percent of treatment visits (n equals 353 out of 3,630) received nitrous oxide (N₂O), which added 29.4 kgCO₂eto the visit emissions. Children without caries treatment had lower travel-related emissions (median equals 7.5 kgCO₂e; interquartile range [IQR] equals 7.6) than children with caries treatment (median without N₂O equals 8.7 kgCO₂e; IQR equals 18.2; median with N₂O equals 8.4 kgCO₂e; IQR equals 10.3). Modeled GA travel emissions were estimated at 16.4 kgCO₂e (IQR equals 21.9) with between 3.8-12.9 kgCO₂e in anesthetic gas emissions. Total emissions were greatest for N₂O treatment visits (median equals 43.3 kgCO₂e; IQR equals 22.8). Conclusions: Travel-related emissions were greatest for children requiring caries treatment. Minimizing patient travel may reduce environmental impact. Nitrous oxide contributes a significant amount to a dental visit???s environmental impact. Community-focused models of care and applying systematic and practical case selection to reduce excess N₂O emissions could reduce dental care-related carbon emissions.