International journal of paediatric dentistry最新文献

Background: Dental caries and extrinsic black tooth stain (EBS) are prevalent among children, with current evidence suggesting a negative correlation between them. It is unclear whether the factors contributing to developing or preventing dental caries and EBS are connected or aligned.

Aim: To investigate the prevalence and associated factors of caries and EBS among children with primary, mixed and permanent dentitions.

Design: This was designed as a cross-sectional study. Probability proportionate to size sampling and simple random sampling methods were used to recruit children aged 5, 9 and 12. Three calibrated paediatric dentists conducted intra-oral examinations. Nutritional supplements, oral health-related behaviours and family background were collected. Bivariate analysis, negative binomial and binary logistic regression were performed.

Results: Caries and EBS prevalence were 83.7% and 4.7%, respectively. A decreasing trend in caries and an increasing trend in EBS prevalence were observed across three dentitions. Caries were associated with EBS, oral hygiene, vitamin intake, gender, food-pocketing habits, toothbrushing duration, dental attendance and socioeconomic status. EBS was more likely to occur in caries-free children (OR = 4.42, 95% CI 2.97,6.58, p < 0.001) and children without vitamin consumption (OR = 1.59, 95% CI 1.07, 2.36, p = 0.021).

Conclusion: The occurrence of caries and EBS varied across different dentition stages. Their risk and protective factors were not significantly aligned.

Background: Dens evaginatus is a dental morphological developmental anomaly. Failing to detect it may lead to tubercles fracture and pulpal/periapical disease. Consequently, early detection and intervention of dens evaginatus are significant to preserve vital pulp.

Aim: This study aimed to develop a deep learning model to assist dentists in early diagnosing dens evaginatus, thereby supporting early intervention and mitigating the risk of severe consequences.

Design: In this study, a deep learning model was developed utilizing panoramic radiograph images sourced from 1410 patients aged 3-16 years, with high-quality annotations to enable the automatic detection of dens evaginatus. Model performance and model's efficacy in aiding dentists were evaluated.

Results: The findings indicated that the current deep learning model demonstrated commendable sensitivity (0.8600) and specificity (0.9200), outperforming dentists in detecting dens evaginatus with an F1-score of 0.8866 compared to their average F1-score of 0.8780, indicating that the model could detect dens evaginatus with greater precision. Furthermore, with its support, young dentists heightened their focus on dens evaginatus in tooth germs and achieved improved diagnostic accuracy.

Conclusion: Based on these results, the integration of deep learning for dens evaginatus detection holds significance and can augment dentists' proficiency in identifying such anomaly.

Background: With the increasing popularity of online sources for health information, parents may seek information related to early childhood caries (ECC) from artificial intelligence-based chatbots.

Aim: The aim of this article was to evaluate the usefulness, quality, reliability, and readability of ChatGPT answers to parents' questions about ECC.

Design: Eighty questions commonly asked about ECC were compiled from experts and keyword research tools. ChatGPT 3.5 was asked these questions independently. The answers were evaluated by experts in paediatric dentistry.

Results: ChatGPT provided "very useful" and "useful" responses to 82.5% of the questions. The mean global quality score was 4.3 ± 1 (good quality). The mean reliability score was 18.5 ± 8.9 (average to very good). The mean understandability score was 59.5% ± 13.8 (not highly understandable), and the mean actionability score was 40.5% ± 12.8 (low actionability). The mean Flesch-Kincaid reading ease score was 32% ± 25.7, and the mean Simple Measure of Gobbledygook index readability score was 15.3 ± 9.1(indicating poor readability for the lay person). Misleading and false information were detected in some answers.

Conclusion: ChatGPT has significant potential as a tool for answering parent's questions about ECC. Concerns, however, do exist about the readability and actionability of the answers. The presence of false information should not be overlooked.

Background: The main goal of the nasoalveolar molding (NAM) is to mitigate the initial severity of the cleft, facilitating the subsequent surgical procedures. Nevertheless, the use of the appliance entails high stress levels for families.

Aim: The aim of this study was to assess the perceptions, attitudes, and opinions of parents whose cleft-affected children underwent treatment using the NAM technique.

Design: A cross-sectional questionnaire study was conducted on a cohort of relatives of infants born with cleft lip and palate who were treated with the NAM appliance. The parents completed a 59-item questionnaire that had been previously validated.

Results: The initial cohort consisted of 104 families. The level of satisfaction was high, and there was a direct correlation with early diagnosis. Satisfaction levels varied depending on the cleft type, with a decrease in cases of bilateral presentation. Satisfaction was influenced by the newborns' adaptation and the absence of complications. Parents who exhibited lower levels of satisfaction contemplated terminating the treatment.

Conclusions: Parents expressed high satisfaction with NAM treatment, due to effective management and understanding. Bilateral clefts and delayed diagnosis can significantly impact satisfaction. These results emphasize the importance of personalized approaches to address challenges in NAM treatment, particularly in instances of bilateral clefts and delayed diagnoses.

Background: Dental radiography is an essential diagnostic tool in paediatric dentistry.

Aim: To explore attitudes, knowledge, and related factors of paediatric dental radiography among parents who attended the radiology department of a premier public dental hospital.

Design: The study was conducted at the National Dental Hospital (Teaching) Sri Lanka among 124 parents whose children (<13-years) underwent dental radiographic examination. Data on sociodemographic characteristics, radiographic investigations, and parental knowledge and attitudes on paediatric dental radiography were collected using an interviewer-administered questionnaire. Data were entered and analyzed using the SPSS-21 statistical software package.

Results: The mean score (95% CI) of parental attitudes and knowledge on paediatric dental radiography were 17.55 (17.64-18.45) on a scale from 7 to 35 and 3.73 (3.34-4.13) on a scale from -7 to +7, respectively. Significant differences in parental knowledge were evident by child's age (p = 0.046), ethnicity (p = 0.035), and parental attitudes (p = 0.024). Binary logistic regression analysis revealed a significant independent association between parental attitudes with parental knowledge: OR (95% CI) = 2.413 (1.098-5.302) (p = 0.028).

Conclusions: Parents demonstrated less favorable attitudes but sufficient knowledge on many aspects of paediatric dental radiography. Therefore, interventions are needed to improve parental attitudes on paediatric dental radiography especially by providing child-friendly services.

Background: Root canal therapy in primary teeth is exceedingly complex due to the unique internal geometry of the pulp cavity.

Aim: The purpose of this study was to evaluate variations in primary teeth root canal morphology and applicability of the Ahmed et al. (Int Endod J, 50, 2017, 761) alphanumeric system for classifying them.

Design: A retrospective analysis of 2024 primary teeth from an existing CBCT database was performed for assessing variations in root canal morphology. Descriptive statistics and the chi-squared test were used for data analysis.

Results: The maxillary canines exhibited splitting levels of 5.9% (right) and 6.6% (left), and merging levels of 1% (both sides); maxillary lateral incisors showed splitting levels of 2.6% (right) and 0.8% (left), with no merging observed; mandibular second molars had splitting levels of 1.5% (right) and 0.8% (left), with no merging observed; and mandibular lateral incisors exhibited a merging level of 0.9% (right), with no splitting observed.

Conclusion: This study provides new insights into the variations in root canal morphology of primary teeth, particularly highlighting the variations found in primary canines. The Ahmed et al. (Int Endod J, 50, 2017, 761) classification system was found to be a useful tool for categorizing these variations.

Background: Injection pain remains a significant concern in dental procedures, often leading to patient anxiety and reluctance to seek necessary care.

Aim: This study aimed to assess the effectiveness of cryotherapy in reducing injection pain compared with topical anesthesia during intraoral local anesthesia.

Design: MEDLINE, Web of Science, EMBASE, Scopus, and Cochrane's CENTRAL databases were searched up to November 2023. Inclusion criteria involved randomized clinical trials aligned with the PICO question. Study selection, data extraction, and risk of bias assessment using the ROB-2 tool were performed. The results were synthesized through a random-effects inverse variance meta-analysis. The primary outcomes assessed were the Visual Analogue Scale (VAS) and Sound Eye Motor (SEM). Subgroup analysis was conducted for children and adults.

Results: In the meta-analysis, 31 RCTs involving 2470 subjects were included. Twenty-seven studies demonstrated cryotherapy's significant superiority over topical anesthesia in reducing injection pain via VAS in adults (p = .01), children (p = .01), and combined age groups (p < .001). Additionally, cryotherapy significantly outperformed topical anesthesia in reducing pain via SEM in children (p = .04) and combined age groups (p = .03) across 13 studies, with no significant difference in adults (p = .51). Furthermore, cooled topical anesthesia also outperformed room temperature topical anesthesia (p < .001). The certainty of the results, however, is of very low quality.

Conclusions: Our results indicate that cryotherapy significantly reduces injection pain compared with topical anesthesia, especially in children and combined age groups, but is less effective in adults. Additionally, cooled topical anesthesia is more effective than room temperature topical anesthesia. Thus, cryotherapy is a and potentially superior alternative to topical anesthesia, particularly for children.

Background: Dental caries and molar-incisor hypomineralization (MIH) are primary reasons for the extraction of first permanent molars (M1) in children, which can lead to significant dental and facial development issues such as a midline shift and temporomandibular joint disorder.

Aim: This systematic review aimed to identify key factors influencing spontaneous space closure following the early extraction of first permanent molars (M1) in children aged 5-15.

Design: We conducted a comprehensive search across Scopus, PubMed, Dimensions, Web of Science, and Cochrane databases, including the literature from 1960 to 2024. The inclusion criteria focused on clinical trials, case-control, cross-sectional, cohort studies, and case series that evaluated the impact of various factors on the spontaneous closure after M1 extraction.

Results: The analysis highlights that chronological age and the developmental stage of the second permanent molars (M2) at the time of extraction are significant predictors of successful spontaneous space closure. Additionally, the presence and angle of M2, along with the presence of third permanent molars (M3), play crucial roles but require further investigation.

Conclusion: Early assessment of M2's developmental stage and inclination, and the presence of M3 are essential for enhancing the likelihood of successful spontaneous space closure following M1 extraction in children.