International journal of paediatric dentistry最新文献

Background: Molar incisor hypomineralization (MIH) is associated with enamel's existing qualitative developmental defects.

Aim: This study aimed to assess the cortical and trabecular mandibular bone morphology in pediatric patients with MIH using fractal analysis (FA) and digital panoramic radiography (DPR) with various radiomorphometric indices.

Design: A total of 75 patients, including 39 in the MIH group (MIHG) and 36 in the control group (CG), underwent clinical and radiographic examination. Three regions of interest (ROIs) were analyzed: ROI1 (mandibular ramus), ROI2 (mandibular angle), and ROI3 (mandibular anterior). Radiomorphometric measurements included mandibular cortical width (MCW), panoramic mandibular index (PMI), and mandibular cortical index (MCI). Statistical significance was defined as p < 0.05.

Results: The study revealed that the right and left MCW and PMI measurements in the CG were significantly higher compared with the MIHG (p = 0.002, p < 0.001; p = 0.022; p = 0.003). However, fractal dimension (FD) analysis of the trabecular bone structure showed no significant differences between the groups across all ROIs (p > 0.05).

Conclusions: MIH may be associated with bone development due to shared developmental factors, and the assessment of MCW and PMI in DPRs can contribute to a multidisciplinary diagnosis and treatment approach based on the growth and developmental dynamics of pediatric patients.

Background: Evidence suggests that pediatric patients requiring endodontic treatment in the permanent dentition are often a "missed population".

Aim: This study surveyed pediatric dentists and endodontists about the frequency with which they encounter pediatric patients requiring endodontic treatment, their training, practice patterns, and decision-making considerations for the treatment of immature permanent teeth.

Design: Surveys were distributed to endodontists (n = 2457) and pediatric dentists (n = 3974) in the United States. Data were analyzed using descriptive statistics and X² analysis. The level of significance was set at 0.05.

Results: The response rate was 13.1% (n = 840). The frequency of clinicians encountering pediatric patients requiring endodontic treatment for permanent teeth did not differ significantly by specialty. Pediatric dentists and endodontists reported statistically significant differences in their practice patterns related to the performance of vital pulp therapy (p < 0.001) and procedures for necrotic immature permanent teeth (p < 0.001). Among specialists, apexification was more frequently performed than regenerative endodontic procedures (REPs) (p < 0.001). When asked to consider clinical and patient factors related to the treatment of necrotic immature permanent teeth, pediatric dentists most frequently responded that they were "unsure" of their preferred treatment.

Conclusion: Standardized clinical knowledge and management of immature permanent teeth between specialties may improve interdisciplinary care for pediatric patients.

Background: Alveolar lymphangioma is a rare condition that commonly develops on the alveolar ridge of Black male neonates. It typically presents as a bluish, dome-shaped swelling smaller than 1 cm on the posterior alveolar ridge of the mandible or/and maxilla, that allows it to be diagnosed clinically. Most previously reported cases of alveolar lymphangioma report spontaneous resolution, and biopsy is seldom performed unless the lesion becomes symptomatic or interferes with feeding.

Case report: We report a case of oral alveolar lymphangioma on the anterior maxillary alveolar ridge of an 11-day-old infant of non-black descent. The lesion presented as a pedunculated, reddish, lobular mass in the anterior maxilla. Given its atypical presentation and the potential for feeding difficulties, an excisional biopsy was performed. The diagnosis was confirmed histologically through biopsy and supported by immunohistochemical staining.

Conclusion: This case expands the understanding of alveolar lymphangioma by reporting it in a non-Black neonate with an unusual location and appearance, emphasising the need for excisional biopsy to rule out other potential oral lesions, especially neoplasms.

Background: Dental pain is a public health problem that exerts a negative impact on the quality of life of children.

Aim: To determine the causal factors of dental pain in preschool children.

Design: A prospective cohort study was conducted with a random sample of 151 children aged from one to three and their parents/guardians for a period of 3 years in Brazil. Dental pain was investigated using the Brazilian version of the Dental Discomfort Questionnaire (DDQ-B) at baseline and follow-up for the calculation of incidence. The participants were examined clinically for dental caries using the International Caries Detection and Assessment System (ICDAS) and traumatic dental injury was investigated using the criteria proposed by Andreasen. Sociodemographic, economic and food consumption characteristics were investigated during baseline and in the three-year follow-up. Data analysis involved descriptive statistics and Poisson regression analyses.

Results: The incidence of dental pain was 14.6%. The incidence of caries (RR = 3.47; 95% CI: 1.05-11.47) and the absence of dental treatment (RR = 2.81; 95% CI: 1.33-5.97) were associated with a higher incidence of dental pain.

Conclusion: The incidence of dental caries and the lack of dental treatment recommended at baseline were risk factors for a greater incidence of dental pain in preschool children.

Background: The study introduces novel camouflage sleeves for the 'Dental Syringe Camouflage Technique' (DSCT) as a distraction tool to reduce dental anxiety and pain in paediatric patients while evaluating its efficacy.

Aim: To evaluate the efficacy of DSCT using light-/dark-coloured sleeves to reduce needle-associated anxiety and pain in paediatric dental patients.

Design: A single-blinded, randomized clinical trial with 76 children aged 6-9 years, divided into control and experimental groups. The experimental group was further divided based on sleeve colour. Anxiety was assessed using a self-reported scale, and vital signs were monitored. Local anaesthesia (LA) was administered using conventional dental syringes (CoDSs) or camouflaged dental syringes (CaDSs). Postintervention, self-reported pain was also recorded. Data analysis compared groups and pre- and postintervention observations.

Results: A significant reduction in children's self-reported anxiety was observed in the experimental group compared to the control, with no significant differences in perceived pain. Children with lighter sleeves showed a greater decrease in anxiety scores than those with darker ones.

Conclusions: Camouflage sleeves for LA syringes reduced anxiety during administration but did not significantly impact reported pain. Lighter sleeves were more effective. No significant changes were observed in pulse rate (PR) or blood pressure (BP) with the use of CaDSs.

Background: Moderate sedation is a behavior guidance technique in pediatric dentistry, and evaluating existing regimens can improve sedation outcomes and safety.

Aim: To determine if behavior at consult and sedation medication dosages is associated with sedation success and the patient's behavior using diazepam, meperidine, and hydroxyzine (DMH) regimen.

Design: A retrospective chart review of 324 patients who underwent 404 oral moderate sedations with (DMH) from April 2017 to June 2022. Sedations were graded as Successful or Unsuccessful and Positive (Frankl F3 or F4) or Negative (Frankl F1 or F2) behavior. Primary variables included Frankl behavior at consult and medication dosages. Logistic regression models were used to determine if these factors were associated with sedation success and behavior while adjusting for other patient and sedation characteristics.

Results: DMH yielded mostly successful sedations (89%) and Positive Behavior (Frankl F3 or F4) (72%). Lower Frankl scores at consult (OR: 2.3, p = 0.0140) were associated with increased odds of sedation failure. Increased age (OR: 0.8, p = 0.0047) was associated with decreased odds of failure. Meperidine dose demonstrated a significant association with improved sedation while controlling for age and behavior (p < 0.0001).

Conclusion: The (DMH) is an effective moderate sedation regimen. Patient selection is a significant factor in sedation success.

Objective: To assess the prevalence and risk factors of chemotherapy-induced oral mucositis in 470 children with acute lymphoblastic leukemia in China, focusing on treatment-related risk factors.

Methods: This cross-sectional study included 470 children diagnosed with acute lymphoblastic leukemia in China from January 2020 to July 2022. Data were collected from electronic medical records, field investigations, and telephone follow-ups, covering sociodemographic characteristics, nutritional status, disease and treatment history, and microbiological factors. Univariate and multivariate logistic analyses were used to evaluate the association between the occurrence and severity of chemotherapy-induced oral mucositis and these variables.

Results: The prevalence of chemotherapy-induced oral mucositis was 45.1%. Significant risk factors included receiving more than five chemotherapy cycles (p < 0.001), carrying HSV-1 (p = 0.016), infection with Candida albicans (p = 0.012), undergoing chemotherapy with specific drugs containing methotrexate/daunorubicin/cytarabine (p < 0.001), having a high clinical risk stratification (p = 0.002), and being over 6 years old (p = 0.002). The severity of chemotherapy-induced oral mucositis was associated with consolidation and intensification period (p = 0.001) and B-cell immune stratification (p < 0.001).

Conclusion: The prevalence of chemotherapy-induced oral mucositis in children with acute lymphoblastic leukemia is relatively high. It emphasizes the importance of clinical medical staff paying attention to this issue and adopting targeted interventions to reduce the prevalence of oral mucositis in this patient population.

Background: Health-related outcomes in children can be associated with parental practices.

Aim: The aim of this study was to investigate if parent-child interactions and stimulation are predictive of oral health-compromising behaviors at the age of 5 years.

Design: This longitudinal study investigated oral health-compromising factors at the age of 5 years as the outcome: sugar intake between meals more than once a day, no dental appointments or appointments only for treatment, unavailability of the mother to brush her child's teeth, and the presence of dental plaque. Exposure was child stimulation at 24 months. The association was tested using ordinal logistic regression, yielding odds ratios (OR) and 95% confidence intervals (CI).

Results: A total of 1128 children were evaluated, and 46.2% had four or five positive interactions/stimulation practices. More than 80% of the mothers reported that their children had a high sugar intake and had never been to a dentist for treatment. Children with low stimulation had 1.29 greater odds of changing from no health-compromising behaviors to one or more (OR 1.29 95% CI 1.02-1.64) than those with high stimulation.

Conclusion: High parent-child interaction and stimulation were associated with lower scores of oral health-compromising practices at the age of 5 years.