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Autotransplantation of an inverse impacted dilacerated incisor: a case report with 11-year follow-up. 一颗反向撞击扩张切牙的自体移植:一例随访 11 年的病例报告。
IF 2.2 2区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-09-03 Epub Date: 2024-05-01 DOI: 10.23804/ejpd.2024.2017
B Sen Yavuz, E Cekmegeli, A Mentes

Background: Dilaceration can lead to impaction of maxillary incisors, resulting in both aesthetic and functional problems. This case report presents the multidisciplinary approach to managing an inverse impacted dilacerated left lateral incisor in a 9-year-old male patient.

Case report: The orthodontic alignment of the remaining three incisors was achieved within six months. After using the diode laser to remove the gingiva covering the right lateral incisor during alignment process, a lingual button was bonded. The primary left canine and the impacted permanent left lateral incisor were extracted by raising the full-thickness mucoperiosteal flap, followed by the transplantation of the dilacerated lateral incisor into its correct position, splinted to the adjacent central incisors using composite resin. Root canal treatment was performed after the apical plug was created with mineral trioxide aggregate. The composite splint was removed after three weeks, and a new bracket was bonded to the left lateral incisor. It was left passively for 18 months until the permanent canines started to erupt. Light orthodontic forces were then applied for six months, and a passive eruption was expected over three months to properly position the canines within the dental arch. After an 11-year follow-up, the incisor displayed no clinical symptoms, although radiographic examination revealed external resorption in the long-term.

Conclusion: This case demonstrates the successful and fast autotransplantation of an immature inverse impacted dilacerated incisor, highlighting the long-term clinical success and favorable aesthetic outcomes.

背景:牙齿稀疏可导致上颌切牙嵌塞,造成美观和功能方面的问题。本病例报告介绍了采用多学科方法治疗一名 9 岁男性患者左侧门牙反向撞击扩张的病例:病例报告:其余三颗门牙的正畸排列在六个月内完成。在对齐过程中使用二极管激光去除覆盖右侧切牙的牙龈后,粘接了舌侧按钮。通过隆起全厚粘骨膜瓣,拔除了主左犬齿和受影响的恒左侧切牙,然后将稀释的侧切牙移植到正确的位置,并用复合树脂与相邻的中切牙夹板固定。用三氧化物矿物骨料制作根尖塞后,进行根管治疗。三周后去除复合树脂夹板,并在左侧侧切牙上粘接了一个新的托槽。被动放置 18 个月,直到恒牙开始萌出。然后施加轻微的正畸力 6 个月,预计被动萌出时间为 3 个月,以便将犬齿正确地安置在牙弓内。经过 11 年的随访,门牙没有出现任何临床症状,但放射学检查发现门牙长期存在外部吸收:本病例展示了对一颗未成熟的反向阻生扩张切牙进行成功、快速的自体牙移植的过程,强调了长期临床成功和良好的美学效果。
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引用次数: 0
Effectiveness of silver diamine fluoride in arresting early childhood caries: a randomised controlled clinical trial. 二胺氟化银抑制儿童早期龋齿的效果:随机对照临床试验。
IF 2.2 2区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-09-03 Epub Date: 2024-06-01 DOI: 10.23804/ejpd.2024.2052
R K ElGhandour, M M H ElTekeya, A A Sharaf

Aim: Evaluate the effectiveness of biannual 38% SDF in arresting early childhood caries (ECC) compared to atraumatic restorative treatment (ART).

Methods: One hundred children (aged 2-5 years) with ECC were (2-5 years) divided equally and randomly into two groups. Test group: 38% SDF biannually; Control group: ART. The primary outcome was caries arrestarrest, which was assessed at the 3,6,9, and 12 months interval. Oral health- related quality of life (OHRQoL) was evaluated at base line and after 12 months using the Parental-Caregiver Perceptions Questionnaire (P-CPQ) and Family Impact Scale (FIS).

Conclusion: SDF was considerably more effective in arresting ECC after 12 months compared to ART. An overall significant improvement of OHRQoL was reported for both groups with SDF being faintly superior to ART.

目的:与创伤性修复治疗(ART)相比,评估一年两次的 38% SDF 在遏制儿童早期龋齿(ECC)方面的有效性:将 100 名患有 ECC 的儿童(2-5 岁)随机平均分成两组。试验组对照组:ART:ART。主要结果是龋齿抑制情况,评估间隔时间为 3、6、9 和 12 个月。口腔健康相关生活质量(OHRQoL)在基线和 12 个月后使用家长-护理者感知问卷(P-CPQ)和家庭影响量表(FIS)进行评估:结论:与抗逆转录病毒疗法相比,SDF 在 12 个月后更有效地遏制了 ECC。两组患者的 OHRQoL 均有明显改善,其中 SDF 略优于 ART。
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引用次数: 0
Replantation After Dental Avulsion: A Scoping Review and Proposal of a Flow Chart. 牙齿脱落后的再植:范围审查和流程图建议。
IF 2.2 2区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-09-03 Epub Date: 2024-07-01 DOI: 10.23804/ejpd.2024.25.03.02
N Zerman

Aim: Dental avulsion, the complete displacement of a tooth from its socket, is a severe dental trauma with a prevalence of 0.5% to 16% of all dental injuries. Replantation of avulsed teeth is common, yet recent studies show high failure rates and unpredictable long-term outcomes. This review examines clinical variables influencing intentional dental replantation decisions and proposes a treatment flow chart. A comprehensive literature search was conducted in PubMed-Medline, Scopus, WoS, and Cochrane databases using the keywords "tooth avulsion," "tooth replantation," and "tooth ankylosis." Inclusion criteria encompassed studies from January 2018 to February 2024. From 752 identified articles, 9 systematic reviews including 3 meta-analyses were selected for this scoping review. Immediate replantation is the gold standard for avulsed teeth, yet delayed replantation is more common in practice, impacting survival rates. Adherence to guidelines from the International Association on Dental Traumatology improves outcomes, especially in paediatric patients. Factors such as multiple caries, severe periodontal disease, advanced age, psychological conditions, immunodeficiency, and lack of cooperation are contraindications for replantation. Despite the high failure rate, replantation remains recommended in literature due to its potential advantages over prosthetic implants. This review highlights the complexities in decision-making for dental replantation, emphasising the need for a comprehensive approach considering individual clinical cases. A proposed treatment flow chart aims to support clinicians in predicting prognosis and making informed decisions. The review also underscores the link between dental trauma, poor oral health, and potential neglect in children, highlighting the importance of preventive measures and parental awareness.

目的:牙齿脱落是指牙齿从牙槽窝中完全移位,是一种严重的牙科创伤,发病率占所有牙科损伤的 0.5% 到 16%。对脱落的牙齿进行再植很常见,但最近的研究显示失败率很高,而且长期结果难以预测。本综述探讨了影响有意再植决定的临床变量,并提出了一个治疗流程图。以 "牙齿脱落"、"牙齿再植 "和 "牙齿强直 "为关键词,在 PubMed-Medline、Scopus、WoS 和 Cochrane 数据库中进行了全面的文献检索。纳入标准包括 2018 年 1 月至 2024 年 2 月期间的研究。本范围综述从 752 篇已确定的文章中筛选出 9 篇系统综述,其中包括 3 篇荟萃分析。即刻再植是治疗脱落牙齿的黄金标准,然而延迟再植在实践中更为常见,影响了存活率。遵守国际牙科创伤协会的指导原则可以提高治疗效果,尤其是对儿童患者。多发性龋齿、严重牙周病、高龄、心理状况、免疫缺陷和缺乏合作等因素都是再植的禁忌症。尽管再植失败率较高,但由于其与修复种植体相比的潜在优势,文献中仍然推荐再植。这篇综述强调了牙科再植决策的复杂性,强调了考虑个别临床病例的综合方法的必要性。建议的治疗流程图旨在帮助临床医生预测预后并做出明智的决定。综述还强调了儿童牙科创伤、口腔健康不良和潜在忽视之间的联系,突出了预防措施和家长意识的重要性。
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引用次数: 0
Are there any limits to the dental treatment of children? 儿童牙科治疗有限制吗?
IF 2.2 2区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-09-03 Epub Date: 2024-07-01 DOI: 10.23804/ejpd.2024.1994
J Vasakova, J Borovec, P Polackova, J Duskova

Aim: The objective of this paper is to describe and discuss the most commonly occurring limits in care provision between a dentist and a child, i.e. provider and recipient.

Methods: The study was conducted online in the form of an anonymous questionnaire survey. We were looking for dentists to answer two basic modeled situations during the treatment of deciduous teeth (filling and extraction) in 4-year-old and 8-year-old children. Each modeled situation had 9 possible clinical scenarios. The age was chosen to factor the cooperation of a preschool- and a school-age child.

Conclusion: The experience gained through clinical practice and the number of treated children show to be fundamental for the treatment of child's deciduous teeth and for the selection of a treatment method. Dentists acquire sufficient knowledge through their education in the faculties of medicine. The limit is the child itself, therefore it is desirable to build specialised centres for their treatment.

目的:本文旨在描述和讨论牙医和儿童(即提供者和接受者)之间在提供护理时最常出现的限制:研究以匿名问卷调查的形式在网上进行。我们希望牙医回答 4 岁和 8 岁儿童在治疗乳牙(补牙和拔牙)过程中的两种基本模拟情况。每种模拟情况都有 9 种可能的临床情景。年龄的选择考虑了学龄前儿童和学龄儿童的合作情况:结论:通过临床实践获得的经验和治疗儿童的数量对于治疗儿童乳牙和选择治疗方法至关重要。牙科医生通过在医学院所受的教育获得了足够的知识。儿童本身就是一个局限,因此最好建立专门的儿童治疗中心。
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引用次数: 0
Pharmacological Sedation in Paediatric Dentistry. 儿童牙科中的药物镇静。
IF 2.2 2区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-09-03 Epub Date: 2024-07-01 DOI: 10.23804/ejpd.2024.2204
F Inchingolo, A M Inchingolo, L Ferrante, E de Ruvo, A Di Noia, A Palermo, A D Inchingolo, G Dipalma

Aim: This research aims to explore and evaluate various sedation strategies used in paediatric dentistry, focusing on effectively and safely addressing dental anxiety to improve cooperation during dental treatment in paediatric patients.

Materials: To identify relevant studies for this systematic review, the Scopus, Web of Science and PubMed databases were used, combining the terms "sedation" with "pediatric dentistry" or "pedodontics" through the Boolean operators "AND" and "OR". Only literature published in English within the last ten years was included. The inclusion criteria were clinical studies, case reports and in vivo studies, while systematic reviews, meta-analyses and studies conducted on animals or in vitro were excluded. After eliminating duplicates, 544 articles were identified, of which 501 were excluded for not meeting the inclusion criteria. A further 27 articles were excluded for various reasons, including lack of retrieval, in vitro nature or being reviews. Finally, 16 articles were selected for inclusion in the review.

Conclusion: These findings underscore the importance of pharmacological management in paediatric dental care, offering valuable insights into the selection and application of sedation techniques to mitigate dental anxiety and enhance patient outcomes.

目的:本研究旨在探索和评估儿童牙科中使用的各种镇静策略,重点是有效、安全地解决牙科焦虑问题,以提高儿童患者在牙科治疗过程中的配合度:为确定本系统综述的相关研究,我们使用了 Scopus、Web of Science 和 PubMed 数据库,通过布尔运算符 "AND "和 "OR "将 "镇静 "与 "儿童牙科 "或 "儿童牙科 "结合起来。仅收录了过去十年内发表的英文文献。纳入标准为临床研究、病例报告和活体研究,而系统综述、荟萃分析和动物或体外研究则不包括在内。剔除重复文章后,共发现 544 篇文章,其中 501 篇因不符合纳入标准而被排除。另有 27 篇文章因各种原因被排除,包括缺乏检索、体外性质或正在进行综述。最后,有 16 篇文章被选入综述:这些发现强调了药物治疗在儿童牙科护理中的重要性,为镇静技术的选择和应用提供了宝贵的见解,以减轻牙科焦虑并提高患者的治疗效果。
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引用次数: 0
"Ethnic disparities in the prevalence of Molar-Incisor-Hypomineralisation (MIH) and caries among 6-12-year-old children in Catalonia, Spain". "西班牙加泰罗尼亚地区 6-12 岁儿童臼齿-内臼齿低矿化(MIH)和龋齿患病率的种族差异"。
IF 2.2 2区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-09-03 Epub Date: 2024-02-01 DOI: 10.23804/ejpd.2024.2029
E Cots, M Casas, M Gregoriano, X Busquet-Dura, J Bielsa, C Chacon, L Kragt, P Torán, F Guinot

Aim: To study the prevalence of MIH and caries in 6- and 12-year-old schoolchildren and their association with ethnic disparities and other relevant factors.

Background: In recent years, there has been uneven improvement in school children's oral health, highlighting inequalities in access to dental care and health outcomes, particularly among ethnic minorities. The most prevalent oral disease in childhood, caries, is preventable, as its risk factors are well known. However, MIH, a common condition affecting the enamel of permanent incisors and/or molars, has no established aetiology or preventive measures.

Methods: A cross-sectional study among schoolchildren was conducted in 725 children from Masnou (Barcelona, 2013) and in 577 children from Sant Andreu de Llavaneres (Barcelona, 2018-2020). Data collection was carried out by means of clinical examination and a selfreferenced questionnaire. Oral health outcomes included: presence of dental caries, presence of MIH, hypomineralised second primary molars (HSPM). All variables were analysed according to ethnic disparities and other variables such as socioeconomics, diet, hygiene habits, plaque and access to dental services. We performed multivariate Poisson regression models with robust variance to examine ethnic disparities in MIH and caries.

Conclusion: This cross-sectional study based in Catalonia, Spain showed that there are ethnic disparities in caries as observed with other child's diseases; however, they do not seem to follow the same pattern for MIH. More studies are needed (i) to explore how MIH behaves among populations in terms of inequality; (ii) to study the aetiological factors of MIH; and (iii) to identify potential factors associated with MIH and caries that have not been studied and that may contribute to the observed ethnic disparities.

目的:研究 6 岁和 12 岁学龄儿童口腔黏膜缺损和龋齿的患病率及其与种族差异和其他相关因素的关系:背景:近年来,学童口腔健康的改善情况参差不齐,凸显了在获得牙科护理和健康结果方面的不平等,尤其是在少数族裔中。儿童时期最常见的口腔疾病--龋齿是可以预防的,因为其风险因素众所周知。然而,影响恒切牙和/或臼齿珐琅质的常见疾病--龋齿却没有确定的病因或预防措施:对725名来自Masnou(巴塞罗那,2013年)和577名来自Sant Andreu de Llavaneres(巴塞罗那,2018-2020年)的学龄儿童进行了横断面研究。数据收集通过临床检查和自我参照问卷的方式进行。口腔健康结果包括:有无龋齿、有无MIH、第二初级臼齿矿化不足(HSPM)。我们根据种族差异和其他变量,如社会经济、饮食、卫生习惯、牙菌斑和获得牙科服务的机会,对所有变量进行了分析。我们使用稳健方差多变量泊松回归模型来研究MIH和龋齿的种族差异:这项基于西班牙加泰罗尼亚地区的横断面研究表明,与其他儿童疾病一样,龋齿也存在种族差异;然而,MIH 似乎并不存在同样的模式。我们需要开展更多的研究:(i) 探讨龋齿病在不同人群中的不平等表现;(ii) 研究龋齿病的致病因素;(iii) 找出与龋齿病和龋齿相关的、尚未研究过的、可能导致所观察到的种族差异的潜在因素。
{"title":"\"Ethnic disparities in the prevalence of Molar-Incisor-Hypomineralisation (MIH) and caries among 6-12-year-old children in Catalonia, Spain\".","authors":"E Cots, M Casas, M Gregoriano, X Busquet-Dura, J Bielsa, C Chacon, L Kragt, P Torán, F Guinot","doi":"10.23804/ejpd.2024.2029","DOIUrl":"10.23804/ejpd.2024.2029","url":null,"abstract":"<p><strong>Aim: </strong>To study the prevalence of MIH and caries in 6- and 12-year-old schoolchildren and their association with ethnic disparities and other relevant factors.</p><p><strong>Background: </strong>In recent years, there has been uneven improvement in school children's oral health, highlighting inequalities in access to dental care and health outcomes, particularly among ethnic minorities. The most prevalent oral disease in childhood, caries, is preventable, as its risk factors are well known. However, MIH, a common condition affecting the enamel of permanent incisors and/or molars, has no established aetiology or preventive measures.</p><p><strong>Methods: </strong>A cross-sectional study among schoolchildren was conducted in 725 children from Masnou (Barcelona, 2013) and in 577 children from Sant Andreu de Llavaneres (Barcelona, 2018-2020). Data collection was carried out by means of clinical examination and a selfreferenced questionnaire. Oral health outcomes included: presence of dental caries, presence of MIH, hypomineralised second primary molars (HSPM). All variables were analysed according to ethnic disparities and other variables such as socioeconomics, diet, hygiene habits, plaque and access to dental services. We performed multivariate Poisson regression models with robust variance to examine ethnic disparities in MIH and caries.</p><p><strong>Conclusion: </strong>This cross-sectional study based in Catalonia, Spain showed that there are ethnic disparities in caries as observed with other child's diseases; however, they do not seem to follow the same pattern for MIH. More studies are needed (i) to explore how MIH behaves among populations in terms of inequality; (ii) to study the aetiological factors of MIH; and (iii) to identify potential factors associated with MIH and caries that have not been studied and that may contribute to the observed ethnic disparities.</p>","PeriodicalId":11930,"journal":{"name":"European journal of paediatric dentistry","volume":"25 ","pages":"188-199"},"PeriodicalIF":2.2,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139982728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dentine surface morphology according to caries removal method and subsequent acid etching. 根据去除龋齿的方法和随后的酸蚀,牙本质表面形态。
IF 2.2 2区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-09-03 Epub Date: 2024-06-01 DOI: 10.23804/ejpd.2024.2062
J Ghilotti, P Manzano, M Melo, A Lozano, C Llena
{"title":"Dentine surface morphology according to caries removal method and subsequent acid etching.","authors":"J Ghilotti, P Manzano, M Melo, A Lozano, C Llena","doi":"10.23804/ejpd.2024.2062","DOIUrl":"10.23804/ejpd.2024.2062","url":null,"abstract":"","PeriodicalId":11930,"journal":{"name":"European journal of paediatric dentistry","volume":"25 ","pages":"208-213"},"PeriodicalIF":2.2,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A digital study on predictive factors for Instagram users' engagement with amber necklace-related posts. 关于 Instagram 用户参与琥珀项链相关帖子的预测因素的数字研究。
IF 2.2 2区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-09-03 Epub Date: 2024-06-01 DOI: 10.23804/ejpd.2024.1984
A P Strieder, P E Ayala Aguirre, M Lotto, T Marchini Oliveira, T Cruvinel

Aim: This study aimed to assess the engagement of Instagram users with Brazilian Portuguese posts related to amber necklaces for teething symptoms relief, identifying predictive factors that can increase users' engagement with information and misinformation.

Methods: This digital study analysed Brazilian Portuguese amber necklace-related posts on Instagram. The posts were collected using specific search strategies on CrowdTangleTM. Subsequently, two independent investigators were trained and calibrated to categorise the posts concerning the proposed outcomes. The posts were categorised according to their facticity (information or misinformation), type of media (album/photo or video/Instagram TV), sentiment (positive, neutral, or negative), author's occupation (dentist or non-dentist), and type of profile (commercial or personal). Additionally, investigators compiled information about the time of publication (days) and interaction metrics (total interaction and overperforming score). The statistical analysis assessed the inter-examiner reliability, group comparisons, and the factors associated with interaction and misinformation. P values <0.05 were considered significant.

Conclusion: Videos and personal profiles were predictive factors for higher user engagement with amber necklace posts on teething symptoms relief on Instagram, even with the warnings of health organisations and the lack of scientific evidence to confirm its efficacy.

目的:本研究旨在评估巴西葡萄牙语Instagram用户对琥珀项链缓解出牙症状相关帖子的参与度,找出可提高用户对信息和错误信息参与度的预测因素:这项数字研究分析了 Instagram 上与巴西葡萄牙语琥珀项链相关的帖子。这些帖子是通过 CrowdTangleTM 上的特定搜索策略收集的。随后,两名独立调查员接受了培训和校准,以对帖子进行分类,并得出建议结果。帖子根据其事实性(信息或错误信息)、媒体类型(相册/照片或视频/Instagram TV)、情感(积极、中性或消极)、作者职业(牙医或非牙医)以及个人资料类型(商业或个人)进行分类。此外,研究人员还汇编了有关发布时间(天数)和互动指标(总互动和超常得分)的信息。统计分析评估了检查员之间的可靠性、分组比较以及与互动和错误信息相关的因素。P 值 结论:视频和个人简介是Instagram上关于缓解出牙症状的琥珀项链帖子获得较高用户参与度的预测因素,即使健康组织发出了警告,而且缺乏科学证据证实其功效。
{"title":"A digital study on predictive factors for Instagram users' engagement with amber necklace-related posts.","authors":"A P Strieder, P E Ayala Aguirre, M Lotto, T Marchini Oliveira, T Cruvinel","doi":"10.23804/ejpd.2024.1984","DOIUrl":"10.23804/ejpd.2024.1984","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to assess the engagement of Instagram users with Brazilian Portuguese posts related to amber necklaces for teething symptoms relief, identifying predictive factors that can increase users' engagement with information and misinformation.</p><p><strong>Methods: </strong>This digital study analysed Brazilian Portuguese amber necklace-related posts on Instagram. The posts were collected using specific search strategies on CrowdTangleTM. Subsequently, two independent investigators were trained and calibrated to categorise the posts concerning the proposed outcomes. The posts were categorised according to their facticity (information or misinformation), type of media (album/photo or video/Instagram TV), sentiment (positive, neutral, or negative), author's occupation (dentist or non-dentist), and type of profile (commercial or personal). Additionally, investigators compiled information about the time of publication (days) and interaction metrics (total interaction and overperforming score). The statistical analysis assessed the inter-examiner reliability, group comparisons, and the factors associated with interaction and misinformation. P values <0.05 were considered significant.</p><p><strong>Conclusion: </strong>Videos and personal profiles were predictive factors for higher user engagement with amber necklace posts on teething symptoms relief on Instagram, even with the warnings of health organisations and the lack of scientific evidence to confirm its efficacy.</p>","PeriodicalId":11930,"journal":{"name":"European journal of paediatric dentistry","volume":"25 ","pages":"172-177"},"PeriodicalIF":2.2,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Rare diseases: a challenge in paediatric dentistry. 罕见疾病:儿童牙科面临的挑战。
IF 2.2 2区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-09-03 Epub Date: 2024-09-01 DOI: 10.23804/ejpd.2024.25.03.01
M R Giuca
<p><p>Rare diseases are an often an overlooked public health problem. Although they are infrequent, occurring on average in 100-500 people per million, these diseases represent a significant challenge in paediatric dentistry due to their complex manifestations and the need for specialised care. Conditions such as X-linked hypophosphatemic rickets (XLH), hypophosphatasia (HPP), and osteogenesis imperfecta (OI) exemplify the intersection of systemic health issues and oral health, requiring a multidisciplinary approach for their effective management. Dentists frequently play a crucial role in identifying genetic alterations through their dental manifestations and then referring patients to the geneticist for a definitive diagnosis. X-linked hypophosphatemia is the most common genetic form of rickets, with a prevalence of 1/20,000 - 1/60,000. XLH is characterised by stunted growth with disproportionate short stature, bowing of the lower limbs associated with reduced motor skills, osteoarticular pain, hypotonia, and dental and periodontal anomalies. XLH is due to inactivating mutations in the PHEX gene which cause excessive production of fibroblast growth factor 23 (FGF23). Increased concentration of FGF23 represents the main pathogenetic mechanism of XLH, stimulating urinary phosphate loss and renal 24-hydroxylase activity, and reducing renal 1α-hydroxylase activity with insufficient production of 1,25 -dihydroxy-vitamin D (1,25(OH)2D). PHEX protein is also expressed in osteoblasts, osteocytes, and odontoblasts. Regardless of FGF23's systemic effects on phosphate homeostasis, odontoblast differentiation, and dentin formation, its overexpression directly reduces osteoblast differentiation and matrix mineralisation. In patients with XLH, the deficit of 1,25(OH)2D induced by FGF23 causes poor enamel mineralisation with presence of cracks on teeth surface. XLH patients have recurrent dental abscesses with fistulas. Radiographic investigations highlight a generalised enlargement of the pulp chambers, molars with short roots, and a taurodontic appearance. Hypophosphatasia (HPP) is another condition in which dental manifestations precede systemic symptoms; it is a rare genetic disease (1/300,000 for severe forms, 1/100,000 for moderate forms. The incidence is perhaps underestimated due to missed diagnosis of moderate forms of the disease). It mainly affects bone and dental mineralisation. It is caused by pathogenic variant mutations in the ALPL gene which is located on the short arm of chromosome 1 and encodes the non-tissue-specific alkaline phosphatase (TNSALP) enzyme. TNSALP deficiency results in vitamin B6 (pyridoxine) deficiency and pathological accumulation of alkaline phosphatase substrates which may be responsible for extra-osseous manifestations, such as neurologic ones (pyridoxine sensitive seizures) as well as involvement of muscles and joints (arthropathies, muscle fatigue/hypotonia). Early non-traumatic loss of primary teeth between the ages of
牙科专业人员的作用不仅限于诊断这些罕见疾病,还包括提供具体的、为患者量身定制的治疗,鼓励定期看牙的预防性护理,以及对患者进行教育,其最终目标不仅是促进口腔健康,而且是促进患者的整体健康。
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引用次数: 0
Risk factors for Early Childhood Caries in Italian preschoolers: A cross-sectional analysis. 意大利学龄前儿童患幼儿龋齿的风险因素:横断面分析
IF 2.2 2区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-09-01 DOI: 10.23804/ejpd.2024.2289
V D'oria, S Bettocchi, V De Cosmi, M Paglia, S Colombo, S Scaglioni, C Agostoni, M Beretta, F Braiotta, C Berti, L Paglia

Aim: Early childhood caries (ECC) represent a relevant public health issue in paediatric population globally. The current study aimed to investigate the main risk factors of this condition.

Methods: This is a cross-sectional study carried out at the Child Dentistry Clinics of the Istituto Stomatologico Italiano, Milan, Italy, including patients aged 12-71 months and their parents. Demographical data, anthropometric measurements, oral hygiene and health assessment, and children's eating habits were collected.

Conclusion: Our findings, according to recommendations, suggest that the prevention of ECC needs to begin in infancy. Oral health providers, physicians, nurses, and other health care personnel play an important role in educating parents about their child's oral and dental care and food choices.

目的:儿童早期龋齿(ECC)是全球儿童群体中的一个相关公共卫生问题。本研究旨在调查这种情况的主要风险因素:这是一项在意大利米兰意大利口腔医学院儿童牙科诊所进行的横断面研究,研究对象包括 12-71 个月大的患者及其父母。研究收集了人口统计学数据、人体测量、口腔卫生和健康评估以及儿童的饮食习惯:根据建议,我们的研究结果表明,ECC 的预防应从婴儿期开始。口腔保健提供者、医生、护士和其他医护人员在向家长宣传儿童口腔和牙齿保健以及食物选择方面发挥着重要作用。
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引用次数: 0
期刊
European journal of paediatric dentistry
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