International journal of paediatric dentistry最新文献

Background: Vertical bitewing radiographs (VBWs) are often used in paediatric dentistry but no clinical studies have been conducted to evaluate the feasibility or effectiveness of their use.

Hypothesis/aim: To evaluate the quality of VBWs taken in children by undergraduate dental students.

Design: VBWs were taken for high-caries-risk children using two types of vertical holders: Snap-A-Ray and Red Rinn XCP. Trained and calibrated examiners assessed VBW quality including positioning errors, visibility of crown and furcation area of primary molars and presence of permanent successor. Association between VBW quality scores and independent variables was investigated using ordinal logistic regression (α = 5%).

Results: A total of 150 VBWs were evaluated. Radiographs were rated as excellent (10.67%), diagnostically acceptable (72%) and diagnostically compromised (17.33%). VBWs allowed the visualisation of the entire primary molar crown (80.55%), furcation (90.54%) and permanent successors (86.37%). Common positioning errors included horizontal errors (48.67%) and coning off (38.67%). Use of the Red Rinn XCP holder was significantly associated with improved VBW quality compared to Snap-A-Ray (p = 0.045).

Conclusions: The use of vertical bitewings allowed visualisation of the primary molars crown, furcation area and presence of permanent successors. The use of a Red Rinn vertical holder can improve the quality of the bitewing radiographs by avoiding positioning errors.

Background: The International Caries Classification and Management System (ICCMS) advocates for nonsurgical approaches in early carious lesions and minimally invasive restorations in advanced cases.

Aim: This study investigated Thai dentists' adherence to ICCMS guidelines for managing caries in children and adolescents and explored factors influencing their decisions.

Design: A web-based questionnaire collected demographic information and routine treatment preferences for various stages of carious lesions from participants. Descriptive statistics and regression analyses were employed to examine relationships between management strategies and demographics.

Results: A total of 442 dentists participated. Their agreement with ICCMS guidelines for occlusal caries ICDAS 2, 3, and 4 in primary dentition was 39.6%, 53.9%, and 42.5%, respectively, and in permanent dentition was 34.4%, 46.8%, and 39.6%, respectively. The agreement rate with ICCMS guidelines for approximal caries RA1, RA2, RA3, and RB4 in primary dentition was 69.6%, 78.0%, 12.4%, and 99.5%, respectively, and in permanent dentition was 70.8%, 68.3%, 19.0%, and 97.7%, respectively. Factors associated with restorative treatment decisions included years since graduation, postgraduate education, and practice type.

Conclusions: Participants did not comply well with ICCMS recommendations for occlusal caries, some employed destructive techniques instead of noninvasive approaches. However, most participants followed ICCMS guidelines for approximal caries, except for RA3 stage.

Background: Dental impressions are crucial in pediatric dentistry, but exaggerated gagging can obstruct this process. Various methods have been proposed to manage the gag reflex (GR).

Aim: This study aimed to evaluate and compare the effectiveness of laser acupuncture and electroacupuncture in controlling children's GR.

Design: A three-armed randomized controlled trial was conducted with 63 patients aged 6-9, with excessive GR, scheduled for dental impressions. Participants were assigned to one of three groups: low-level laser (n = 21), microcurrent stimulation with a Meridian pen (n = 21), and a control group with a deactivated pen (n = 21). Gag preventive index (GPI) was taken, and dental anxiety was assessed using the Facial Image Scale (FIS), pulse rate (PR), and blood oxygen saturation (SaO₂). Significance was set at p < 0.05.

Results: All interventions influenced GPI scores. The Meridian pen and laser groups achieved better GPI scores (p < 0.001) than the control group. FIS scores between the Meridian pen and laser groups were comparable, differing significantly from the control group (p < 0.001). The Meridian pen and laser groups showed greater reductions in PR (p < 0.001) and higher SaO₂ post-intervention (p < 0.001).

Conclusion: The Meridian pen and laser outperformed the control group, demonstrating effectiveness in enhancing physiological and subjective measures.

Trial registration: ClinicalTrials.gov identifier: NCT06422286.

Background: The growing demand for esthetic restorative materials highlights the need to evaluate their marginal accuracy and fracture resistance to ensure optimal clinical outcomes for primary molars.

Aim: The aim was to assess the vertical marginal gap distance and fracture resistance of esthetic restorative materials after cyclic loading.

Design: Forty extracted primary molars were randomly divided into four groups: Group I, stainless steel veneered crowns with tooth-colored material; Group II, prefabricated monolithic zirconia crowns; Group III, yttria-partially stabilized zirconia computer-aided design/computer-aided manufacturing (CAD/CAM) crowns; and Group IV, hybrid ceramic CAD/CAM crowns. A stereomicroscope was used to measure the vertical marginal gap distance. The fracture resistance was then evaluated by applying cyclic loading.

Results: Group I (1710 μm) exhibited the highest total median vertical marginal gap distance, followed by Groups II, III, and IV (418.3, 341.7, and 86.7 μm, respectively; with an overall statistically significant difference, p < 0.001). Regarding fracture resistance, Group III exhibited the best performance (2018.5 ± 236.0 N), followed by Groups II, IV, and I (1185.4 ± 326.1, 782.8 ± 278.5, and 728.3 ± 247.4 N, respectively). The CAD/CAM crowns exhibited better marginal gap distances than the prefabricated crowns. The CAD/CAM hybrid ceramic crowns exhibited better marginal accuracy than the CAD/CAM zirconia crowns.

Conclusions: Zirconia crowns showed promising results regarding marginal adaptation, whereas hybrid ceramics showed promising results regarding fracture resistance.

Background: Vital pulp therapy (VPT) is one of the treatments recommended for vital deep carious permanent molars. However, postoperative pain remains underexplored in children and adolescents who have undergone VPT.

Aim: This study investigated the incidence, intensity, duration, temporal pattern, and analgesic intake of postoperative pain following VPT in children and adolescents. Additionally, factors associated with postoperative pain incidence were explored.

Design: A prospective cohort study was conducted in 159 patients aged 6-18 years, involving 174 VPT-treated teeth. Pain intensity, measured with the Wong-Baker FACES Pain Scale (WBFPS), and analgesic intake were recorded daily for 7 days post treatment.

Results: Over the 7-day period, 40.23% of patients experienced postoperative pain. Mean pain intensity decreased from 3.43 ± 1.96 on Day 1 to 1.26 ± 1.71 on Day 2. About 52.86% of patients were pain-free between Days 1 and 2, and over 97% were pain-free by Day 7. Analgesics were taken by 25.86% of patients. Compared with the protective liners group, the more invasive types of VPT were associated with higher odds of pain.

Conclusion: Postoperative pain following VPT was common; however, it was mild, controllable with analgesics, and resolved in most patients. The more invasive VPT types were linked to an increased incidence of pain.

Background: Limited reports are available regarding bonding of universal adhesives to primary teeth' enamel.

Aim: To evaluate the effect of application mode and aging on microtensile bond strength (μTBS) of universal adhesives to primary enamel.

Design: Ninety-six human primary molars were randomly assigned to three groups: SU: Scotchbond Universal (3M); CU: Clearfil Universal Bond Quick (Kuraray Noritake); iBU: iBond Universal (Heraeus Kulzer), then subdivided according to phosphoric acid etching time into three subgroups (SG): SG1: 0s; SG2: 15s; SG3: 30s. Samples were incubated for 24 h, while separate samples for SG1 & SG2 were aged for 6 months. After μTBS testing, light microscope was used for evaluating failure patterns and SEM for the adhesive interface. Data were analyzed using linear mixed model and post hoc tests (p < 0.05).

Results: Selective etching increased μTBS of universal adhesives to enamel (p < 0.001) without significance between 15 and 30 s etching (p > 0.05). Six-month aging significantly reduced the μTBS of SU in SG2 (p < 0.014) when compared to 24 h aging.

Conclusions: Selective etching with phosphoric acid remains the gold standard for bonding universal adhesives to primary teeth enamel. While etching time showed no significant effect on immediate μTBS, aging may affect the μTBS of SU applied on 15 s etched enamel.

Background: Teledentistry integrates telecommunications with dental practice, facilitating the exchange of clinical information and images for remote dental consultation and treatment planning. This approach enables dental care access across long distances, addressing the need for flexible healthcare solutions.

Aim: This study aimed to evaluate the effectiveness of teledentistry compared to clinical in-person dental diagnosis in pediatric patients during the COVID-19 pandemic.

Design: The study sample consisted of 200 children aged 3-13 years, each undergoing both teledentistry-based and in-person clinical dental diagnosis. Caries index scores, including DMFT/dmft and DMFS/dmfs, as well as the identification of specific dental conditions such as molar incisor hypomineralization (MIH), black tooth staining, periodontal disease, dental trauma, and orthodontic anomalies, were recorded in both diagnostic settings. Statistical analysis was conducted using chi-square, Wilcoxon, and Fisher's Exact tests.

Results: The mean age of participants was 7.86 ± 2.40 years. Caries index scores (DMFT/dmft, DMFS/dmfs) showed compatibility between teledentistry and clinical diagnoses. While "d/D, f/F, ds/DS, fs/FS" scores were observed to be higher in clinical diagnoses compared to teledentistry, the difference was not statistically significant (p > 0.05). Scores for "m/M" and "ms/MS" were identical in both diagnostic methods. Additionally, the prevalence of dental anomalies, including MIH, black tooth staining, periodontal disease, dental trauma, and orthodontic anomalies, was comparable across both diagnostic approaches.

Conclusion: Findings suggest that teledentistry serves as an effective alternative to clinical in-person diagnosis for pediatric dental consultations and treatment planning, demonstrating comparable accuracy in identifying caries and dental anomalies in children.

Background: Orofacial cleft is the most common craniofacial deformity, resulting in facial anatomical disorders.

Aim: To evaluate maxillary dental arch symmetry of children with unilateral complete cleft lip, alveolus, and palate before and after primary surgeries.

Design: A total of 27 dental casts were analyzed: (T1) Presurgical; (T2) Postsurgical 1; and (T3) Postsurgical 2. Six linear measurements were analyzed (I-C', I-C, I-T', I-T, C'-T', and C-T). Paired t test, Pearson correlation, and ANOVA, followed by the Tukey test, were conducted (α = 5%).

Results: The asymmetry was confirmed by I-C versus I-C' across all periods and I-T versus I-T' (at T1). The Pearson correlation test showed significant values for Δ1×Δ2 and Δ1×Δ3, but not for Δ2×Δ3. The longitudinal analysis showed that the I-C' mean was greater at T1 than at T2/T3 (p < 0.001). The I-C mean was smaller at T1 than at T2/T3 (p < 0.001). I-T' was greater only at T3 (p < 0.001). I-T, C'-T', and C-T means were greater at all periods.

Conclusion: The maxillary asymmetry of children with unilateral cleft lip and palate is inherent to the cleft type, evidenced by the maxillary hypoplasia in the smaller segment, probably higher in the anterior region (I-C').

Background: In recent times, bioceramic calcium silicates have gained attention due to high success rates with pulpotomy in primary teeth.

Aims: To evaluate and compare the clinical and radiographic outcomes of three different bioceramic calcium silicate cements in vital deciduous teeth treated with pulpotomies over a period of 24 months.

Design: Children aged 4-9 years, with deep dentinal caries (ICDAS 4-6) in primary molars, having no history of spontaneous pain or signs of non-vitality were included in the study. Following clinical and radiographic evaluation 117 primary molars diagnosed as having reversible pulpitis received pulpotomy treatment, after randomly being assigned into three groups based on the bioceramic calcium silicate medicament used: a pre-mixed syringe-loaded MTA putty (NeoPUTTY); a traditional powder-liquid hand mix MTA material (NeoMTA Plus), and a precapsulated, trituration mixed material (Biodentine). Clinical and radiographic evaluation was done at 6, 12, 18 and 24 months.

Results: The cumulative clinical and radiographic success for NeoPUTTY was 92%, NeoMTA Plus 97% and for Biodentine 95% and 89%, respectively, after 24 months follow-up.

Conclusion: The clinical and radiographic success rates of all three bioceramic calcium silicate cements were found to be high, with no significant differences over a period of 24 months.

Trial registration: Clinical trial registration number: CTRI/2021/03/031655.