Pediatric dentistry最新文献

Purpose: This study systematically analyzed the published literature to evaluate the reliability of the caries experience index detection conducted in children (younger than 18 years of age) through teledental systems, comparing it with data obtained through traditional dental consultations. The question to be explored was whether dentists could use teledentistry to assess the caries risk index by calculating the DMFT (decayed, missing, and filled permanent teeth) score, thereby potentially reducing consultation time. Methods: A systematic English-language literature review was conducted, including the period from 2014 to 2024, that included the MeSH terms (("telemedicine"[Mesh]) AND "dental caries"[Mesh]) AND "DMF index"[Mesh]). Inclusion and exclusion criteria were defined according to the PICO methodology. A total of 11 manuscripts met the inclusion criteria. The methodological quality of these studies was assessed using the Newcastle-Ottawa Scale (NOS) with specific tools for cross-over studies. Results: From the 11 studies reviewed, it was suggested that teledentistry, through the use of intraoral photographs or video recordings, may represent a reliable, noninvasive, and efficient alternative for the detection of the caries experience index, compared to clinical examinations performed according to the traditional method. In most cases, the results were comparable between the two approaches. Conclusion: Incorporating teledentistry in combination with regular dental appointments could streamline clinical processes, enable effective treatment planning, and facilitate remote monitoring of the oral health status of patients, making it a timely and contemporary solution for a connected and health-conscious society-which is particularly valuable during public health crises such as the COVID-19 pandemic.

Purpose: Evaluate and compare the accuracy and completeness of responses provided by ScholarGPT and ChatGPT-4 Omni (ChatGPT-4o) to clinical questions in pediatric dentistry. Methods: Thirty clinical questions across six clinical topics were developed. Responses were collected from ScholarGPT and ChatGPT-4o and independently evaluated by six experienced pediatric dentists. The evaluators used a five-point Likert scale for accuracy and three-point scale for completeness. Accuracy was rated for factual correctness, relevance, and coherence, while completeness reflected how fully the response addressed the question. Statistical analysis was performed using non-parametric tests, including the Wilcoxon signed-rank and Kruskal-Wallis tests. Results: ScholarGPT received significantly higher median accuracy scores (five, interquartile range [IQR] equals zero) compared to ChatGPT-4o (four, IQR equals one) across all topics (P<0.001). In completeness scores, ScholarGPT (three, IQR equals one) also out-performed ChatGPT-4o (two, IQR equals zero; P<0.001). ScholarGPT showed the highest accuracy in the "fissure sealants" (five, IQR equals zero), while the lowest was observed in "development of dentition and occlusion" (five, IQR equals one). ChatGPT-4o yielded the lowest accuracy in "development of dentition and occlusion" (four, IQR equals two) and the highest in "fluoride" (four, IQR equals one). Accuracy scores varied significantly across topics for both ChatGPT-4o (P=0.012) and ScholarGPT (P=0.001). However, differences in completeness across topics were observed only for ScholarGPT (P=0.008). Conclusions: ScholarGPT provided more accurate and complete responses to pediatric dentistry questions than ChatGPT-4o, suggesting that domain-specific artificial intelligence tools can aid dental education and clinical support, though further refinement is needed.

Purpose: To compare oxygen saturation measurements when pulse oximeter sensors were simultaneously placed on the index finger and the second toe, and compare blood pressure recordings with non-invasive blood pressure (NIBP) cuffs simultaneously placed on the upper arm and the lower calf in children receiving general anesthesia. Methods: A total of 50 children, aged three to nine years, defined as ASA Class I or II receiving comprehensive dental treatment in the operating room with general anesthesia, were included. Pulse oximeter sensors were simultaneously placed on each subject's index finger and ipsilateral second toe. Non-invasive blood pressure cuffs were simultaneously placed on the upper arm and ipsilateral lower calf above the ankle. The same anesthesia regimen was used on all patients. Following induction of general anesthesia, measurements were simultaneously recorded every five minutes during the dental procedure. Results: Index finger oxygen saturation measurements were significantly lower than the second toe (P<0.001). Arm systolic blood pressure measurements were significantly lower than calf measurements (P<0.001). Arm diastolic blood pressure measurements were significantly lower than calf measurements (P<0.001). Conclusions: Discrepancy of vital sign measurements may be notable depending on the site from which measurements are obtained. If blood pressure is taken on the calf of a child in the Trendelenburg position, the reading will likely produce a higher systolic and diastolic measurement and should be interpreted with caution. A pulse oximeter placed on the first finger or second toe of healthy children can be regarded as interchangeable in a clinical setting.

Purpose: This study examines parental preferences for telehealth versus in-person follow-up visits after general anesthesia (GA) for children treated for dental caries. While GA is effective, it is costly and invasive, with high rates of recurrent caries and low follow-up. Telehealth may address barriers to follow-up care by improving accessibility and reducing travel burdens. Methods: A cross-sectional study was conducted with parents of children aged seven years and younger who underwent GA for dental caries at a university-based dental clinic. Participant data, collected via post-visit telephone survey, included demographics, visit modality preferences, and qualitative responses on motivators for modality preference. Quantitative and thematic analyses were performed to identify key factors associated with parental preferences. Results: Among 155 eligible children, 46 families participated. The majority (84.8 percent, n equals 39) preferred telehealth, citing flexibility, reduced transportation challenges, and ease of managing caregiver responsibilities. Those preferring in-person visits (15.2 percent, n equals seven) valued direct provider interaction and sought to avoid technology-related barriers. The mean distance to the clinic was significantly greater for the in-person group (104.2 km versus 49.6 km, P=0.017). Conclusions: The strong preference for telehealth suggests its potential to improve follow-up visit accessibility. However, implementation barriers must be addressed to ensure equitable telehealth integration.

Purpose: This systematic review and meta-analysis evaluated the clinical outcomes of prefabricated zirconia crowns (PZC) in primary teeth compared to stainless steel crowns (SSCs) and resin-based alternatives over six to 36 months. Methods: PubMed??, Google Scholar™, Web of Science®, Scopus, Embase®, and Cochrane Library® were searched for randomized clinical trials and observational studies. Cochrane risk of bias tool (RoB 2) and ROBINS-I were used for quality assessment. The pooled results were analyzed using either a fixed-effect model or a random-effects model, with the latter applied when heterogeneity was significant (I² >50%). Results: A total of 40 studies were included in the systematic review. Meta-analyses revealed comparable retention between PZCs and controls at six months (relative risk [RR] equals 1.04, 95 percent confidence interval [95% CI] equals 0.99 to 1.09, P=0.233) and 12 months (RR equals 1.03, 95% CI equals 0.98 to 1.08, P=0.11). Zirconia crowns showed non-significant improvement in gingival health (Cohen's d equals 1.85, 95% confidence interval equals -0.25 to 3.95, P=0.081) but significantly reduced plaque retention (RR equals 1.17, 95% confidence interval equals 1.02 to 1.34, P=0.025) at 12 months. Recurrent caries were equivalent (RR equals 1.02, 95% CI equals 0.98 to 1.05, P=0.26) and opposing tooth wear was insignificant (RR equals 0.96, 95% CI equals 0.91 to 1.00, P=0.091) at 12 months. Conclusion: While prefabricated zirconia crowns matched stainless steel crowns and resin-based alternatives in retention, gingival health, opposing tooth wear, and caries prevention, they provided superior outcomes in plaque resistance with moderate-certainty evidence.

Purpose: To examine dental general anesthesia (DGA) utilization patterns among children in Alberta, Canada, and identify factors contributing to the need for multiple DGAs (between 2010 and 2020). Methods: This retrospective population-based cohort study utilized administrative health data to investigate DGA usage among children (younger than 18 years). The study considered all children receiving DGA for oral and dentalrelated issues in publicly funded facilities, regardless of medical status. A descriptive statistic, binary logistic regression, Cox proportional regression, and Kaplan-Meier survival analysis were employed. Results: Among 30,523 children receiving DGA, the majority were younger than six years old (62.8 percent), were from low-income families (54.6 percent), and received treatment at urban hospitals. Most were medically healthy (91.2 percent) and received treatment for dental caries (77.1 percent), with restorations and extractions being the most frequent procedures. Significant predictors of multiple DGA events included younger age at first DGA, identification as having special health care needs (SHCNs), and the type of dental procedures performed during the first DGA. Conclusions: The findings of this study highlight the importance of considering patient characteristics and treatment factors when planning and delivering pediatric dental care. Special health care needs status emerged as a key factor associated with the likelihood of repeated dental general anesthesia, highlighting the need for tailored interventions and resource allocation to improve oral health equity in this population.

Purpose: To assess the current sedation practices among pediatric dentistry residents who completed their training from a children???s teaching hospital to align training methods for current residents. Methods: Using Standards for Quality Improvement Reporting Excellence guidelines, residency graduates were surveyed on current sedation practices. Information collected included demographics, year of residency completion, education experience, type of sedation medications used during residency and currently, emergency protocols, participation in continuing education courses, barriers to the provision of sedation, and clinical protocols. Descriptive statistics were completed, and information was utilized to update current sedation training protocols. Results: Fifty-four of 90 possible former residents responded, for a response of 60 percent. Thirteen respondents (24 percent) currently perform moderate sedation. Predominant sedation medication preferences have shifted from chloral hydrate to midazolam, meperidine, and hydroxyzine through the years. Conclusions: Feedback from previous learners and continual assessment of educational programs can help to align education with unsupervised practice after graduation. Changing trends in sedation practices highlight the crucial significance that residency program sedation curriculum and continuing education courses meet the needs of patients, thereby upholding a high standard of patient safety.