European journal of paediatric dentistry最新文献

Aim: To show the potential of Invisalign in multi-segmental Le Fort I preparation with the aid of an occlusogram-like method.

Methods: Nine patients treated with Invisalign before segmental osteotomy of the maxilla (study sample) were matched for diagnosis, surgical procedure, and complexity of orthodontic preparation with nine patients treated with fixed appliances (control sample). A superimposition technique was adapted to complement the Invisalign software to carry out an appropriate ClinCheck in segmental pre-surgical treatments. The correct pre-surgical positions of the maxillary teeth were guided with the use of virtual added curves that followed the lower arch. The number of impressions needed in both groups to reach adequate pre-surgical coordination of the segmented arches was compared.

Conclusion: With the aid of the proposed superimposition method, during the digital simulation of presurgical movements, clear aligner therapy appears to be an effective treatment even in patients with skeletal discrepancies and craniofacial anomalies involving the need for segmental Le Fort I osteotomies. More sophisticated software will certainly be implemented in the future.

Aim: Dental caries is a common oral disease in children with special needs such as those with autism spectrum disorders (ASDs). The aim is to assess whether the type and survival of three caries management, conventional resin restorations (CR), ART technique (ART) and SDF application without caries removal (SDF), in primary teeth carried out at the Pediatric Dentistry Department of San Paolo Hospital (University of Milan) differed between children with ASDs and unaffected peers.

Methods: Data from a convenience sample of children with and without ASDs, who have received dental care for caries in primary teeth from January 2019 to June 2022, were analysed. Medical history, age, sex, teeth treated, and type of treatment were collected from dental charts. Data on success and minor and major failures of each treatment were also collected. Two survival analysis were performed, one considering both major and minor failures, a second considering only major failures. Cox Proportional Hazards multivariate logistic models were run to assess factors associated with failures. The statistical significance was set at 5% (p< 0.05).

Conclusion: In children with autism, the different techniques for approaching caries lesions seem to have the same probability of success. Therefore, the choice of treatment should be patient-oriented rather than lesion-oriented. In unaffected children, the gold standard always seems to be traditional restorative treatment.

Background: Primary headaches (PH) are a group of disorders greatly impairing quality of life, highly prevalent in growing population. Previous studies suggested a rhinogenic involvement in PH episodes. Modifications of nasal cavities and septum take place during rapid maxillary expansion (RME). This study aims to investigate the role of skeletal modifications due to RME on PH episodes.

Methods: Sixty-eight growing patients (30/38 MF 7-12 y.o 9.2 ± 1.3 SD) were enrolled. All the selected sample patients reported at least 12 PH episodes in the previous year and were diagnosed with maxillary constriction to be treated with RME. Changes in PH episodes before and after this orthodontic procedure were analysed using paired t-tests. Correlations between age and PH episodes were assessed using Spearman correlation coefficients. Correlations between cephalometric changes and PH episodes were investigated using paired t-tests.

Conclusion: RME produces significant modifications in maxillary and nasal width and lower nasal length and decreased monthly episodes of PH significantly. It can be supposed and inferred that RME has beneficial effects on PH in growing patients.

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.

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.

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.

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.

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.

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.