European journal of paediatric dentistry最新文献

Aim: The Italian Society of Paediatric Dentistry (SIOI) is committed to encouraging the different health professionals taking care of children (e.g., paediatric dental practitioners, paediatricians, gynecologists, obstetricians, dental hygienists, and dieticians) to educate parents (up to the period of pregnancy) and caregivers to limit their children's consumption of cariogenic sugars. The purpose of this SIOI policy is to provide quality communication and information, based on the most updated scientific evidence, on the amount of free sugars (those classified as cariogenic) that can be consumed daily in the diet during the first two years of life, and then from childhood throughout life. This Policy communication aims to reduce the prevalence and severity of caries in both childhood and adulthood and, in addition, to prevent the occurrence of other specific non-communicable diseases (NCDs) that share the risk factor of excessive free sugar intake with caries. NCDs related to free sugar intake are obesity, type 2 diabetes mellitus (T2DM), non-alcoholic fatty liver disease (NAFLD), cardiovascular disease (CVD), hypertension, as well as some cancers and all-cause mortality.

Methods: This policy is based on the most updated and methodologically valid evidence, drawing from data found in systematic reviews (with or without meta-analysis) as well as guidelines and policies (or any official statements/documents) promulgated by the most relevant international scientific societies in this field. The references collection was carried out by searching the PubMed®/MEDLINE electronic database using the following keyword terms: sugar, monosaccharide, disaccharide, sucrose, lactose, galactose, fructose, glucose, maltose, sweetened beverage, sweet food, dessert, snack, candy, cookies, chewing gum, chocolate, dairy products, fruit juice, honey, syrup, and molasses. Only studies and statements/documents written in English, available in their full text, and published within the last 10 years were included in this policy. No restrictions were adopted on the age, gender, and provenience of study participants. The interpretation of the literature findings and the subsequent formulation of policy recommendations were based on the consensus of a multidisciplinary expert panel of researchers and clinicians working in this field.

Aim: This case report and literature review aim to elucidate the rare occurrence of bilateral root absence in permanent first molars, emphasizing its clinical implications, diagnostic challenges, management, and possible association with systemic conditions. A unique case involving a 13-year-old male diagnosed with atypical hemolytic uremic syndrome (aHUS) is presented to illustrate these points.

Methods: A comprehensive review of existing literature was conducted to explore the etiology, diagnosis, and management strategies for root absence. In addition, the detailed case study of the patient with aHUS and root absence of all four permanent first molars complements the review, providing insights into systemic impacts on dental development.

Conclusion: This report emphasizes the need for a multidisciplinary approach in diagnosing and managing dental anomalies associated with systemic diseases. Further research is recommended to understand the systemic influences on dental root development and improve patient outcomes.

Aim: X-linked hypophosphatemia (XLH) is a rare genetic disorder that causes skeletal deformities, growth retardation and oral complications, being dental abscesses the most frequent reported problem. Patient management is often poor due to a lack of care pathways, particularly in pediatric settings, and this highlights the need for updated clinical protocols. This study emphasises the importance of the role of pediatric dentists in the early recognition of XLH and in the multidisciplinary management of these patients, including early diagnosis, personalised therapies, and prevention to improve oral health and overall well-being.

Methods: A comprehensive search was conducted to identify studies focused on dental aspects in XLH pediatric patients published from 2020 and 2024. Databases such as the Cochrane Library and MEDLINE via PubMed databases were searched using terms and MeSH terms including X-linked hypophosphatemia, X-linked hypophosphatemic rickets, XLH, teeth, dental, child, oral health, and oral health-related quality of life. Only English-language articles were included.

Conclusion: In the end the complexity and rarity of XLH often results in diagnostic delays, compromising either dental or general treatment. For these reasons, the need for early diagnosis and integrated care is evident; development of specific guidelines to improve outcomes and oral health-related quality of life in growing patients is strongly required.and nutritional disorders. The study emphasises the importance of including a dental evaluation in the follow-up of premature infants from the first months of life.

Aim: To provide an updated, evidence-based guidance on preventive strategies for MIH management.

Methods: The search process was conducted on PubMed®/MEDLINE and included the most recent (last l0 years), highest-quality English-language dental literature focused on preventive strategies in MIH patients (<18 years).

Results: Preventive measures - including fluoride-, casein-, calcium glycerophosphate-, arginine-based products; bioactive glasses; biomimetic hydroxyapatite; self-assembling peptides; ozone and laser therapies; silver diamine fluoride; resin infiltration; and fissure sealants are presented.

Conclusion: Early diagnosis is essential for the implementation of preventive strategies. Given the absence of a standardised treatment protocol for MIH, therapeutic interventions should be carefully customised based on the severity of the condition, the patient's age, level of cooperation, and specific clinical needs. Adopting a combined preventive approach may significantly improve long-term outcomes.

Aim: To analyse the role of prevention, early diagnosis, and treatment timing in orthodontics, with a focus on preventive orthodontic treatment in the growing patient.

Material and methods: A narrative literature review was performed, combined with clinical evidence. Diagnostic criteria in deciduous and mixed dentition, evaluation of occlusal indicators, oral habits, and radiographic and photographic records were analysed. Literature sources included PubMed, Scopus, and EJPD publications on prevention, early orthodontics, interceptive treatment, and treatment timing.

Results: Early identification of malocclusion patterns such as cross-bites, increased overjet, and skeletal Class III discrepancies is essential for targeted interventions. Evidence demonstrates benefits in reducing traumatic risk, improving psychosocial outcomes, and simplifying future orthodontic treatment. Up to 15% of malocclusions can be completely corrected and nearly 50% improved with interceptive measures in mixed dentition. The correct timing of intervention represents a pivotal clinical variable: decisions must be based on growth status, risk evaluation, and evidence of effectiveness and predictability.

Conclusion: Prevention, early diagnosis, and treatment timing are key factors in paediatric orthodontics. Timely preventive orthodontic treatment can correct skeletal and dental discrepancies, reduce trauma risk, and improve quality of life. Clinical decisions must be evidence-based and personalised, avoiding unnecessary overtreatment. Therapeutic methods must be effective and efficient in achieving the treatment goals and, above all, must not interfere with the health of growing patients.

Background: Lichen Planus is a chronic, mucocutaneous disease that may affect the oral mucosa, skin, genital mucosa, nails, and scalp. It occurs more frequently in adults than in children. Ten cases of Oral Lichen Planus (OLP), diagnosed in children presenting to the Liverpool University Dental Hospital (UK) Oral Medicine department are presented. The case series includes four male and six female patients, ranging in age from 10 to 17 years at diagnosis. A clinical diagnosis alone was made in five patients and five patients underwent an incisional biopsy, which confirmed a histological diagnosis consistent with OLP. In one case, moderate dysplasia was diagnosed, on a background of OLP. Five patients presented with asymptomatic disease. In symptomatic cases, treatments included topical anesthetic mouthwash and topical steroid preparations. OLP is classified as an oral potentially malignant disorder and approximately 1% of patients develop oral cancer, however no cases of malignant transformation have been reported in children. None of our paediatric patients with OLP have developed oral cancer during a mean follow up time of 2 years. However, ongoing clinical monitoring is required so that malignant change can be detected at the earliest possible stage when treatment is most successful.

Background: The insurgence of external inflammatory lateral resorption (EILR) is one of the consequences of dental trauma and it can further complicate the prognosis of a compromised tooth. Long term treatment with Ca(OH)2 is the gold standard to manage EILR, and, recently, regenerative endodontic procedure (REP) has been suggested as an alternative clinical approach. The purpose of this report is to describe a case of post-traumatic EILR treated using REP.

Case report: A 9 years-old girl experienced an extrusive luxation of tooth #11. At the first visit the tooth was asymptomatic and responsive to sensitivity tests. At 3 months follow-up tooth #11 did not respond to cold and EPT, showed tenderness to palpation and a non-active sinus tract on the buccal mucosa. The radiographic examination showed a stage 3 root development, and an EILR in the distal-cervical portion of the root. A REP was performed using a calcium hydroxide medication for three weeks. Upon the second appointment the tooth and periapical tissues were asymptomatic, and the sinus tract had disappeared, medication was removed, intracanal bleeding and coagulum were obtained, MTA was positioned on the coagulum, and the crown restored with composite resin. Follow-up was established every 6 months for the first 2 years, then every 12 months for the next 5 years. At two years tooth #11 shows lack of symptoms, arrest of the resorption and presence of autologous tissue at the apex and within the root canal.

Conclusion: Regenerative endodontic procedures offer a less invasive option for treating immature teeth with EILR. However, the long-term effectiveness of REP is still uncertain and further studies are needed.

Aim: Crouzon syndrome (CS) is a rare genetic condition characterised by craniofacial malformations due to mutations in the FGFR2 gene. This study aimed to evaluate the contributing factors for Angle's Class III malocclusion in patients with CS through cephalometric analysis. Six patients with confirmed CS diagnosis were included in the study. Cephalometric measurements were performed using CT scans and compared to established norms. Pathogenic variants in the FGFR2 gene were identified in all patients. Phenotypic and cephalometric characteristics were assessed in each patient. Results showed consistent craniofacial abnormalities, including midface retrusion, mandibular prognathism, and malocclusion. Cephalometric analysis revealed specific patterns indicating growth deficiency at the posterior base of the skull, maxillary retroposition, and an anterior accommodation of the mandibular condyles in the glenoid fossa. These findings provide valuable insights into the underlying factors contributing to Angle's Class III malocclusion in patients with Crouzon syndrome.

Aim: To evaluate the role of orthodontic and craniofacial orthopaedic interventions in the prevention and management of otitis media with effusion (OME), focusing particularly on rapid maxillary expansion (RME) and its implications for Eustachian tube function.

Methods: A comprehensive search was conducted in PubMed, Embase, and Web of Science using a structured combination of MeSH terms by two expert researchers from inception to December 2024. Randomised and non-randomised prospective studies involving pediatric patients (2-18 years) with chronic OME were included. The effectiveness of preventive measures was compared with alternative treatments or no interventions. Study quality was assessed using the ROBINS-I v2 tool.

Conclusion: RME emerges as a promising preventive option for managing OME particularly in patients with orthodontic indications. By addressing structural contributors to Eustachian tube dysfunction, RME improves middle ear health and complements otolaryngological interventions. Integrating orthodontic and otolaryngological strategies represents an effective multidisciplinary approach to reducing OME incidence and recurrence. Further studies are needed to confirm the long-term stability and the generalisability of these observed benefits.

Aim: It is rare for teeth to be visible in the mouth at birth or shortly after birth, whether they are additional teeth or primary teeth that have erupted early. If there is excessive mobility, the tooth must be extracted to avoid the risk of aspiration. The aim of this study was to evaluate the characteristics of these teeth and their effects on the developing dentition in children with natal/neonatal tooth extraction.

Methods: Out of a total of 26 patients in the study, 22 were contacted by phone and 16 of them came for a follow-up visit. At the patients' follow-up appointments, the stage of dental development, amount of space and the presence of any dental anomalies were assessed.

Conclusion: Knowing the characteristics of natal-neonatal teeth, their differential diagnosis, what should be considered in treatment options, and the problems that may arise after extraction of these teeth provides an advantage in the management of these teeth, which is a rare condition.