International journal of paediatric dentistry最新文献

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: Children with special healthcare needs (CSHCN) experience higher unmet dental treatment needs than their healthy peers (NSHCN).

Aim: We compared dental treatment received by CSHCN and NSHCN at academic dental hospitals in South Africa (SA).

Design: Clinical records of 1-16-year-old children who had dental treatment under general anaesthetic (GA) between 2017 and 2023 were reviewed. Descriptive analyses were performed, and the Chi-square/Fisher's exact test used to analyse the categorical variables.

Results: Four hundred records (CSHCN: 116 [29%] and NSHCN: 284 [71%]) were analysed. The median age at assessment was 5 years (IQR: 3-6.5). CSHCN were older than NSHCN, (p < 0.001). More CSHCN (52.6%) than NSHCN (25.4%) were referred from primary health centres, (p < 0.001). Caries was the main dental diagnosis. Multiple extractions were done in 54.7% of CSHCN < 6 years and 52.8% of 6-11-year-old NSHCN. Restorative treatment was performed in 26.1% of 6-11-year-old CSHCN and 27.2% of NSHCN < 6 years.

Conclusions: Most of the CSHCN and NSHCN who needed GA were young with extensive caries. Treatment provided to both groups was primarily extractions, perhaps due to late presentation and limited resources. Timely preventative strategies for children at risk of caries could enhance oral health and reduce the burden of GA in SA.

Background: There is currently insufficient evidence on potential predictors of a child's behaviour with nitrous oxide (N₂O) sedation.

Aim: To examine the association between a child's temperament and behavioural outcomes during dental treatment with N₂O sedation, and the child's perception to N₂O sedation.

Design: At the first visit (dental treatment visit), temperament was assessed using the Child Behaviour Questionnaire-Short Form and behaviour was assessed by an independent rater using the Venham Behaviour Rating Scale. At the second visit, the child's experience with N₂O sedation was elicited.

Results: Seventy-two healthy children aged between 36 and 95 months were recruited. Planned dental treatment was completed in 84.7% of the subjects. Venham behaviour success <3 and Venham behaviour success <1 were achieved in 73.6% and 33.3%, respectively. The temperament domain of effortful control was associated with Venham behaviour score (ρ = -0.266, p = .024) and Venham behaviour success <1 (OR = 3.506, 95% CI = 1.328-9.259, p = .011). Baseline Frankl behaviour score was significantly associated with all behavioural outcomes. Venham behaviour success <3 was significantly associated with a child reporting to have enjoyed the dental treatment visit (p = .026).

Conclusion: Effortful control and baseline behaviour were associated with behavioural outcomes of N₂O sedation and can be used to predict a child's behaviour.

Background: Initial caries lesions in primary teeth have presented a low progression rate after 2 years, but it could be higher in longer follow-ups.

Aim: To evaluate the progression rates of sound surfaces and initial and moderate caries lesions after 7 years.

Design: This prospective 7-year cohort study included 639 preschool children aged 1-5 years in 2010. In 2017, 449 children were reassessed (70.3% retention rate). Dental caries was collected using the International Caries Detection and Assessment System (ICDAS) in both assessments. Incidence rate (IR) per 100 surface-years estimated the progression rates of sound surfaces and initial and moderate lesions for worse conditions. Cox regression with shared frailty evaluated the possible risk factors.

Results: IR was 1.0% for sound surfaces, 2.8% and 4.2% for ICDAS scores 1 and 2, respectively, and about 17.0% for moderate lesions. The most significant risk factor for the progression was the presence of cavitated lesions in other teeth. The type of surface and tooth also influenced the outcome.

Conclusion: The progression rate of initial caries lesions in primary teeth remains low even after 7 years, but cavitated caries lesions in other teeth increase this risk. Moderate lesions demonstrate a higher risk of progression when compared to sound surfaces and initial caries lesions.

Background: Binge drinking has been linked to traumatic dental injury (TDI). Once drunk, adolescents are more prone to accidents, which may result in orofacial injury.

Aim: This study evaluated the possible association of binge drinking with a number of traumatised teeth in a population of 12-year-old Brazilian adolescents in 2013 and 2015.

Design: This study was longitudinal, carried out with 588 adolescents at two moments, 2013 and 2015. TDI, overjet and lip protection were assessed by calibrated examiners. Binge drinking data were collected through the Alcohol Use Disorders Identification Test. Sociodemographic indicators were obtained through a questionnaire answered by the parents/guardians. The Poisson regression model with a random effects intercept was estimated.

Results: A higher prevalence of traumatised teeth was observed among adolescents who binge drink (IRR = 1.37; 95% CI: 1.05-1.80; p < .05). The prevalence was also significantly higher among adolescents in this age range with a ≥ 3-mm overjet and those with inadequate lip protection (IRR = 1.99; 95% CI: 1.44-2.76; p < .001 and IRR = 3.41; 95% CI: 2.57-4.53; p < .001, respectively).

Conclusion: A greater number of traumatised teeth were found among adolescents who reported binge drinking and had severe overjet and inadequate lip coverage.

Background: Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease of childhood, and temporomandibular joints (TMJs) are involved in 39%-78% of patients.

Aim: The aim of this systematic review was to assess the effectiveness of conservative approaches in improving TMJ arthritis in children and adolescents affected by JIA.

Design: PubMed, Scopus, and Web of Science were systematically searched from the inception until February 25, 2024, to identify observational studies presenting participants with a diagnosis of JIA affecting the TMJ, rehabilitative approaches for TMJ arthritis as interventions, and clinical or radiological assessment of TMJ arthritis as outcome.

Results: Of 478 papers suitable for title/abstract screening, 13 studies were included. The studies evaluated the effectiveness of intra-articular (IA) corticosteroid (CS) injections, IA infliximab injections, arthrocentesis alone or in combination with IACS injections, occlusal splint, functional appliance, and physiotherapy. The effectiveness of IACS injections was shown in eight studies. IA infliximab injections did not appear to significantly improve TMJ arthritis.

Conclusion: Results of this systematic review suggested that conservative treatments, especially IACS injections, might be effective in improving TMJ arthritis in patients affected by JIA. Further studies with a higher level of evidence and more representative samples should be conducted.

Background: The use of panoramic radiography (PR) is a complementary examination to aid in the diagnosis of cases in paediatric dentistry. The lack of specific protocols for these devices, however, can result in high doses of radiation, affecting critical organs such as the thyroid.

Aim: To evaluate the discrepancies in ionizing radiation received by the thyroid during PR examinations using anthropomorphic paediatric simulators built from computed tomography images.

Design: Two anthropomorphic paediatric phantoms were printed and used, representing children aged 6 and 11 years, with an opening in the thyroid region for the insertion of dosimetric radiographic films. The simulators were subjected to different pre-existing protocols in the PR devices. The radiographic films were processed and analysed using a luxmeter.

Results: The radiation dose to the thyroid was higher in the 6-year-old phantom than in the 11-year-old phantom, for given exposure factors. In addition, there was an increase in dose in children's protocols compared with small adult protocols.

Conclusion: Therefore, companies that develop PR equipment must develop child protocols for separate age groups that will consequently reduce the radiation dose in children, especially in their critical organs.