International journal of paediatric dentistry最新文献

Background: Children with cerebral palsy (CP) face challenges in maintaining oral hygiene; data on their oral health practices and outcomes are limited.

Aim: To examine oral health practices and their association with adverse oral health outcomes among children and young adults with cerebral palsy in New Zealand.

Design: A cross-sectional, observational survey of 90 individuals with CP (aged 0-26 years) collected data on oral health behaviours, experiences, Gross Motor Function Classification System (GMFCS) and Eating and Drinking Ability Classification System (EDACS).

Results: Sixty-one (69%) reported teeth-brushing twice a day, 84 (94%) using age-appropriate fluoride toothpaste and 73 (85%) seeing a dental professional in the last 2 years. Difficulty keeping teeth clean was reported by 36 (41%) of participants and associated with 'poor' oral health (p < 0.001); toothache ≤ 12 months (p = 0.032); bad breath (p < 0.001) and bleeding gums ≤ 4 weeks (p < 0.001). Difficulty keeping teeth clean was more commonly reported for participants classified as GMFCS IV-V [19 (59%), p = 0.005] and EDACS III-V [12 (60%), p = 0.034].

Conclusion: Difficulty keeping teeth clean was commonly reported by individuals with greater physical and swallowing limitations and observed with indicators of adverse oral health. Targeted, family-centred strategies are needed to support effective oral hygiene in this population.

Background: Recent understanding of pulp biology has shifted treatment paradigms toward preservation-based approaches. Traditional diagnostic terminology and treatment protocols require updating to align with current evidence supporting the pulp's healing capacity.

Aim: Sixteen international specialists in pediatric dentistry and endodontics convened at the 3rd IAPD Summit in Porto, Portugal (November 2024) to develop consensus-based recommendations on pulp therapies in primary and permanent teeth.

Methods: Following a structured three-phase approach, experts conducted systematic literature reviews and participated in Delphi surveys using a 7-point Likert scale. Recommendations achieving > 70% consensus were categorized as strong (based on RCTs/systematic reviews), conditional (observational studies), or consensus-based statements (expert opinion).

Results: Thirty-eight evidence-based recommendations were developed across four key areas: pulp inflammation and diagnosis, caries excavation, management of pulpitis in primary and permanent teeth, and traumatic dental injuries. Key findings emphasized selective caries removal over complete excavation, calcium silicate cements as preferred materials for vital pulp therapy, and conservative approaches for managing irreversible pulpitis. Decision trees were created to support clinical implementation.

Conclusions: These consensus recommendations provide evidence-based guidance for managing pulpal diseases using minimally invasive, biologically driven tiered approaches that prioritize pulp preservation in both primary and permanent teeth.

Background: Oral health is a key public health priority in the United Arab Emirates (UAE), yet the effectiveness of the existing programmes is unclear due to limited standardised data.

Aim: To estimate schoolchildren caries prevalence across UAE over five academic years (2015-2019) and assess the associated factors.

Methods: Secondary data analysis from a national oral health screening, by the Ministry of Health and Prevention in government schools across six emirates. Students in Grade 1 (6-8 years old), Grade 7 (12-14 years old) and Grade 10 (15-17 years old) were screened between 2015 and 2019.

Results: A total of 131 451 students were screened. Overall caries prevalence was high at 60.9%, declining from 65.1% in 2015 to 49.19% in 2019 (OR = 0.51, 95% CI: 0.49-0.53, p < 0.001, compared to 2015). Prevalence was the lowest in Dubai (55.2%), and the highest in Fujairah (75.0%, OR = 2.57, 95% CI: 2.46-2.67, p < 0.001, compared to Dubai). Grade 1 students had the highest prevalence (70.5%), while both Grade 7 (55.1%; OR = 0.51; 95% CI: 0.49-0.52; p < 0.001, compared to Grade 1) and Grade 10 (57.9%; OR = 0.58; 95% CI: 0.56-0.59; p < 0.001, compared to Grade 1) were the lowest.

Conclusion: Dental caries remains highly prevalent among UAE schoolchildren, particularly in Fujairah and younger age groups. Standardised, integrated oral health policy and planning are instantly needed across the Emirates.

Background: Puppetry is a well-established three-dimensional art form of media that has been commonly utilized to tell stories and communicate messages. Its application in educational entertainment has become widespread and gained recognition.

Aim: This scoping review aimed to explore puppetry-based approaches in promoting dental and oral health for children.

Methods: A comprehensive search of eight databases was conducted using PRISMA-ScR guidelines, focusing on studies published up to August 2024.

Results: Ten studies were included in the review. A game-centered educational approach significantly enhanced children's dental knowledge and skills. Human models with mirror feedback were most effective, while giant tooth-brushing models and animal puppets had the lowest imitation rates. Puppet theater improved urban preschoolers' oral health but had no effect on rural children. Hand puppets, pop-up books, and animated videos significantly enhanced toothbrushing skills. Storytelling with hand puppets improved knowledge and attitude more than role-playing. Puppet shows and animated videos yielded notable posttest improvements in oral health knowledge and skills.

Conclusion: Puppetry-based education appears to be an effective strategy for improving oral health knowledge, attitudes, and behaviors among children, particularly in school and clinical settings.

Background: Salivary cytokine assessment provides a non-invasive method to evaluate the biocompatibility of metal-based restorative materials in paediatric dentistry. Changes in IL-17 may indicate early immunological responses to stainless steel crowns (SSCs).

Aim: To investigate salivary IL-2, IL-5, and IL-17 levels in children treated with SSCs and explore their potential immunological implications.

Design: Ten paediatric patients aged 3-9 years were included in this prospective study. Unstimulated whole saliva was collected before treatment and 7 days after SSC placement. Cytokine expression was measured using RT-qPCR. Statistical analyses included one-way ANOVA for cytokine expression and the Wilcoxon signed-rank test for salivary nickel and chromium levels, with p < 0.05 considered significant.

Results: Baseline IL-2, IL-5, and IL-17 levels were low and comparable. 7 days after SSC placement, all cytokines increased. IL-17 and IL-5 showed significant upregulation, whereas IL-2 demonstrated only a minor, non-significant change. Salivary nickel and chromium concentrations increased mildly but remained well below established safety thresholds.

Conclusion: Stainless steel crowns (SSC) placement was associated with increased IL-5 and IL-17 expression, suggesting a localised, subclinical immune response potentially linked to low-level metal-ion exposure. These findings support the use of salivary cytokines as early biomarkers for assessing the biocompatibility and immunological safety of SSCs in paediatric patients.

Trial registration: ClinicalTrials.gov identifier: (NCT06439095).

Background: Enamel affected by molar incisor hypomineralisation (MIH) exhibits reduced mechanical properties due to its disorganised prismatic structure, lower mineral density and higher protein content. These alterations increase porosity and susceptibility to posteruptive enamel breakdown. Minimally invasive treatments, such as resin infiltration, have been proposed to reinforce enamel integrity. Recent advances suggest that transillumination can guide infiltration more accurately, allowing better visualisation of lesion extent and potentially improving treatment outcomes.

Aim: This case series evaluated the clinical suitability of transillumination-aided resin infiltration, specifically the utility of using transillumination to support resin infiltration treatment, for MIH-affected molars.

Design: Five MIH-affected first permanent molars from five paediatric patients, diagnosed according to EAPD criteria for MIH, were included. One molar presented with two distinct lesions, leading to the inclusion of six lesions in total. Transillumination was used to assess the lesion appearance, to assist with selective surface removal and to monitor the resin infiltration process to assess when it was completed, that is, when the lesion either fully disappeared visually or no change was visible anymore under transmitted light.

Results: Transillumination was employed successfully to assist with resin infiltration treatment and to assess the treatment outcome. Four lesions showed partial and two complete infiltrations visually, indicating putatively that the porous lesion structure is strengthened. No complications were reported during treatment.

Conclusions: Transillumination was successfully utilised to support resin infiltration in MIH-affected molars and to visualise the quality of infiltration, serving as a potential surrogate outcome measure. Future research should explore long-term clinical outcomes and the impact on patients' quality of life.

Background: Dental caries is a widespread oral disease linked to systemic health. Asthma, a chronic airway condition, impacts quality of life and may influence oral health. While evidence on the association between asthma and caries is inconclusive, some studies suggest asthma increases caries risk. This study applies Mendelian randomization (MR) to investigate their potential causal relationship.

Methods: A bidirectional MR analysis was conducted using publicly available genome-wide association studies (GWAS) data. Suitable instrumental variables (IVs) were chosen in accordance with three key MR analysis assumptions. The primary method employed was the inverse-variance weighted (IVW) method, with supplementary methods including MR-Egger regression, Weighted Median, Simple Mode, Weighted Mode, and the MR pleiotropy residual sum and outlier techniques.

Results: MR analysis showed a significant positive association between dental caries and asthma (IVW OR > 1, p < 0.05). No causal effect of asthma on dental caries was detected (p > 0.05). Sensitivity analyses confirmed no heterogeneity or pleiotropy, supporting the robustness of these findings.

Conclusions: This study suggests that dental caries may contribute to asthma development, while asthma does not directly influence dental caries. Maintaining good oral health could help reduce asthma risk, highlighting the need for integrated oral and respiratory health strategies.