Pediatric dentistry最新文献

Purpose: To evaluate the accuracy and consistency of chatbots in answering questions related to special needs dentistry. Methods: Nine publicly accessible chatbots, including Google Bard, ChatGPT 4, ChatGPT 3.5, Llama, Sage, Claude 2 100k, Claude-instant, Claude-instant-100k, and Google PaLM, were evaluated on their ability to answer a set of 25 true/false questions related to special needs dentistry and 15 questions for syndrome diagnosis based on their oral manifestations. Each chatbot was asked independently three times at a three-week interval from November to December 2023, and the responses were evaluated by dental professionals. The Wilcoxon exact test was used to compare accuracy rates among the chatbots while Cronbach's alpha was utilized to measure the consistency of the chatbots' responses. Results: Chatbots had an average accuracy of 55??4 percent in answering all questions, 37±6 percent in diagnosis, and 67±8 percent in answering true/false questions. No significant difference (P>0.05) in the accuracy proportion was detected between any pairwise chatbot comparison. All chatbots demonstrated acceptable reliability (Cronbach's alpha greater than 0.7), with Claude instant having the highest reliability of 0.93. Conclusion: Chatbots exhibit acceptable consistency in responding to questions related to special needs dentistry and better accuracy in responding to true/false questions than diagnostic questions. The clinical relevance is not fully established at this stage, but it may become a useful tool in the future.

Purpose: To examine the association between parental divorce or separation (PDS) and oral health outcomes in children and adolescents in the United States (U.S.), and learn whether the association was mediated by a lack of needed dental care in the past 12 months. Methods: Data obtained from a sample of individuals who participated in the 2020 to 2021 National Survey of Children's Health (NSCH), representing 65,790,496 U.S. children and adolescents, were analyzed. A child's exposure to PDS was the independent variable. The outcome of interest was pediatric oral health, measured through parental responses to survey questionnaires indicating whether their child had dental caries, toothaches, and/or bleeding gums within the past 12 months. Analyses included descriptive statistics, bivariate analyses, logistic regression, and casual mediation analysis. Results: After controlling for demographic factors and insurance coverage, children who experienced PDS, had 30 percent higher odds of suffering from oral health problems versus those who did not (odds ratio equals 1.29; 95 percent confidence interval equals 1.16 to 1.45). The association appeared to be partially mediated by failure to receive needed dental care. Conclusions: Parental divorce or separation is associated with the oral health of children and adolescents in the United States. Findings from this population-based study highlight the potential impact of PDS on children's oral health.

Purpose: To assess oral hygiene, gingivitis, and the association between them for adolescents with cystic fibrosis (CF) compared to nonCF controls. Methods: This was a cross-sectional study of adolescents with CF aged 12 to 17 years (n=27), compared to two non-CF control groups: Medicaid-enrolled adolescents with special health care needs (ASHCN; n=60) and healthy Medicaid-enrolled adolescents (n=185). Dental plaque was a proxy for oral hygiene, and gingival bleeding was a proxy for gingivitis. This study employed confounder-adjusted binomial logistic regression to compare outcomes between adolescents with CF and controls. Results: After adjusting for confounders, adolescents with CF had significantly poorer oral hygiene than controls (CF versus ASHCN odds ratio [OR] = 2.9, 95 percent confidence interval [95% CI] = 2.0 to 4.4, P<0.001; CF versus healthy OR = 1.7, 95% CI=1.3 to 2.2, P<0.001), but there was no significant difference in gingivitis (CF versus ASHCN OR=1.3, 95% CI=0.87 to 1.9, P=0.21; CF versus healthy OR = 0.80, 95% CI=0.60 to 0.99, P=0.04). Poor oral hygiene was significantly associated with gingivitis for all adolescents (CF OR=1.2, 95% CI=1.1 to 1.4, P<0.001; ASHCN OR = 1.8, 95% CI=1.6 to 2.0, P<0.001; healthy OR = 1.2, 95% CI=1.1 to 1.3, P<0.001). Conclusions: Adolescents with CF had poorer oral hygiene than non-CF controls but similar levels of gingivitis. Future efforts should identify factors that protect adolescents with CF from gingivitis.

Purpose: To compare the efficacy of laser phototherapy, Buzzy®, and lignocaine gel in minimizing pain during intraoral injections. Methods: In this randomized controlled trial, the efficacy of standard lignocaine gel (Group A) was compared with Buzzy® (Group B) and laser phototherapy (Group C) as pre-anesthetic agents in 15 children aged eight to 12 years undergoing intraoral local anesthesia (LA). Pain perception during needle insertion was assessed objectively using the Face, Legs, Activity, Cry, Consolability (FLACC) scale and subjectively using the Visual Analogue Scale (VAS). Statistical analysis included chi-square and analysis of variance tests (P<0.05). Results: Objective assessment of pain perception using FLACC scores demonstrated that Buzzy® resulted in the highest comfort levels; 60 percent of the subjects treated with Buzzy®, 40 percent treated with laser phototherapy, and 6.7 percent treated with lignocaine topical anesthetic were judged to be relaxed and comfortable or exhibiting mild discomfort, respectively. Subjective pain assessment (self-reported using the VAS) was significantly lower in Buzzy® (0.67±0.82 standard deviation) followed by laser phototherapy (1.00±1.13) and Lignocaine gel group (2.13±1.51). Conclusions: The Buzzy® and laser phototherapy effectively reduced intraoral injection pain compared to the standard control, lignocaine gel. However, Buzzy® showed better efficacy.

Purpose: To assess existing knowledge of anesthesia and perioperative information needs/preferences in parents (parent, caregiver) of patients with special health care needs (SHCN) undergoing general anesthesia (GA) for dental procedures, and analyze the relations between caregiver anesthesia knowledge, health literacy level, and preoperative anxiety. Methods: Parents of patients with SHCN requiring GA for dental treatment completed an online survey with closed- and open-ended items assessing preferences and interest in perioperative information and educational resources, anesthesia knowledge, anxiety, and health literacy. Pearson product-moment correlation coefficients and descriptive statistics were used to summarize the findings. Results: Fifty-two parents completed the survey. Over two-thirds of the sample identified as having "high information" perioperative requirements, 42.3 percent of respondents exhibited elevated levels of perioperative anxiety, and 67.4 percent had adequate health literacy levels that were positively associated with anesthesia knowledge. Ratings of importance and interest in learning more about GA for dental treatment were high. Facilitating increased caregiver involvement before, during, and after surgery was the highest-rated resource format. Conclusions: Parents of patients with special health care needs are generally interested in receiving more information and resources about general anesthesia for dental treatment. Identified gaps in anesthesia knowledge and preferences for content and format of resources can be used to inform the development of tailored educational resources for families regarding perioperative management to ensure that parents have a complete understanding of their patients' anesthetic management and surgical care.

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.