International journal of paediatric dentistry最新文献

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.

Background: Tongue-lip motor function is essential for speech and swallowing. However, research on oral diadochokinesis (ODK), an indicator of this function, remains limited among Japanese children.

Aim: To provide foundational ODK data in Japanese children and examine its associations with grade, sex and dental and anthropometric variables.

Design: Data from the 2022-2023 Kuroishi Oral Health Study were analysed for 464 third- to sixth-grade students. ODK (/pa/, /ta/, /ka/), grade, sex, total number of teeth, decayed, missing and filled permanent teeth (DMFT) index, and body mass index (BMI) were examined using analysis of variance, t-tests, and multiple regression.

Results: Mean ODK values increased with grade, with sixth-graders showing significantly higher values than third-, fourth- or fifth-graders. Across all syllables, girls showed significantly higher values than boys in fourth or fifth grades, with no significant differences in third or sixth grades. No significant associations were found between ODK and the total number of teeth, DMFT index or BMI.

Conclusion: This study provides foundational ODK data in Japanese children, highlighting grade- and sex-related variations. These findings enhance the understanding of tongue-lip motor function development and may serve as a reference for future research and clinical assessments.

Background: Preoperative familiarisation using virtual reality (VR) devices before dental treatment is an innovative strategy to manage dental anxiety in children.

Aim: To evaluate the effectiveness of preoperative immersive and non-immersive VR exposure in children with dental anxiety and its correlation with physiological response.

Design: A total of 66 children aged 9-12 years with dental anxiety were randomised into immersive VR exposure (IVRE), non-immersive VR exposure (NIVRE), and control groups. Before receiving a fissure sealant on one permanent molar, IVRE participants navigated a virtual dental clinic, NIVRE participants viewed dental-themed cartoons, and controls waited as usual. Pre- and post-intervention anxiety (Malay-MCDAS_f) and pulse rate were analysed using ANOVA, paired t-tests, and Pearson's correlation.

Results: Of 66 participants, two dropped out. IVRE and NIVRE significantly reduced dental anxiety compared to control (IVRE vs. Control: p = 0.008; NIVRE vs. Control: p = 0.009), with large effect sizes. No significant differences in PR reductions between groups (p = 0.052, d = 0.09), indicating a small clinical effect. A significant postoperative correlation existed between Malay-MCDAS_f and PR (r = 0.285, p = 0.022).

Conclusion: VR reduced children's preoperative dental anxiety but did not significantly affect pulse rate. The correlation between self-reported anxiety and physiological response highlights VR's potential as an adjunct in paediatric anxiety management (197 words).

Trial registration: ClinicalTrials.gov identifier: NCT05854329; National Medical Research Register: NMRR ID-23-01114-ATC.

Background: The association between light-polymerised resin-based fluoride-releasing sealants and pit-and-fissure caries on primary molars is unclear.

Aim: To investigate the efficacy of resin-based fissure sealants in preventing caries on primary molars.

Design: In this retrospective study of patients attending a tertiary dental hospital for at least 30 months, records of 106 children (275 teeth) were reviewed. Sealant placement on primary molars in the outpatient clinic (OPC) and under general anaesthesia (GA) was recorded, measuring caries incidence over time.

Results: Of the 275 teeth, 94 (34.2%) developed caries during this period. Among those carious teeth, 17 teeth (18.1%) were sealed compared to the 77 (81.9%) non-sealed (p < 0.001). In molars that developed caries, those sealed under GA were associated with longer caries-free mean duration compared to the non-sealed molars (3.07 years compared with 2.32 years, respectively, p < 0.001). Among teeth sealed in OPC, one tooth developed caries. An adjusted hazard ratio of 0.048 (95% CI: 0.025-0.090, p < 0.001) demonstrated a 95.2% lower hazard of caries development in the sealant group compared to the non-sealant group.

Conclusion: Sealed primary molars are less likely to develop pit-and-fissure caries in OPC and GA, with a substantial long-term protective effect observed in the GA-treated group.

Background: Temporomandibular Disorders (TMD) in children are often under-recognized, with prevalence estimates typically approaching 70% according to recent epidemiological studies. This range complicates interpretation and highlights the need for standardized diagnostic protocols. Facial biotype has been proposed as a potential risk factor, given reported links between craniofacial features and temporomandibular joint alterations, yet pediatric evidence remains limited.

Aim: To determine the prevalence of TMD and its association with facial biotype in Chilean children aged 7-14 years, providing relevant data for early clinical intervention.

Methods: A cross-sectional study evaluated TMD and facial biotypes in 83 participants aged 7-14. Axis I of the DC/TMD adapted for children identified TMD, incorporating recognized diagnostic criteria. Cephalometric analysis using Ricketts' VERT index determined each participant's facial biotype.

Results: The study found a 27.71% TMD prevalence. A significant association was observed between the dolichofacial biotype and articular disorders, specifically disc displacement with reduction and arthralgia. These findings suggest a potential relationship between facial biotype and articular disorders in pediatric populations.

Conclusion: Among Chilean children aged 7-14, TMD prevalence reached 27.71%. Furthermore, the dolichofacial biotype was linked to articular disorders, highlighting the value of recognizing facial patterns to facilitate early intervention.

Background: Although dental fear and anxiety are common in children and adolescents, they are not well-defined constructs and may not capture critical clinical aspects. Dental phobia (DP) is more well-defined as a specific phobia that includes the criteria of functional impairment.

Aim: To investigate the prevalence and covariates of DP.

Design: A representative sample from two birth cohorts in Trondheim, Norway (n = 666) was assessed at age 16. A diagnostic interview using the Kiddie Schedule for Affective Disorders and Schizophrenia was conducted with both parent and adolescent. Personality traits, intelligence, and executive functioning were also assessed.

Results: The prevalence of DP was estimated to 3.7% (95% CI: 2.7%-5.1%), whereas 8.0% (95% CI: 6.5%-9.9%) had intra-oral injection phobia (I-OIP). Generally, DP was not associated with anxiety, depressive disorders, personality traits, or poor executive functioning. However, DP was comorbid with social anxiety disorder and had more symptoms of ADHD, hyperactivity-impulsivity, and lower verbal intelligence than those without DP.

Conclusions: Dental phobia is prevalent in adolescence and exists independently from other anxieties, although persons with DP more often experience social anxiety, hyperactivity, impulsivity, and difficulties understanding advanced language. These tendencies could lead to challenges with interaction and comprehension during dental visits.

Backgrounds: Maximum willingness to pay (WTP) for a health benefit is linked to perceived value.

Aim: This study assesses WTP for a service package in cleft lip and palate patients and identifies influencing factors.

Design: In this cross-sectional study, demographic, disease type, socioeconomic variables, and WTP for a service package reducing patients' problems were measured. A two-part regression model was used to identify factors influencing WTP.

Results: Among 491 participants, 57% were male. 320 (65.17%) patients were willing to pay for the package, with an average of 79.42 USD. The highest mean WTP was for cleft palate and lip (65.27 USD). Family monthly expenditure was the only significant model variable; spending 50-100 USD compared to < 50 USD increased the likelihood of WTP by 1.79 times. Heads of families were willing to pay more for girls and for patients over 2 years. Each increase in child order raised WTP by 8.44 USD, while each additional sibling reduced it by 6.02 USD.

Conclusion: WTP for cleft lip and palate services was lower than expected. Better family financial status increased the likelihood of WTP, while both financial and demographic factors influenced the amount.

Background: Children in rural and underserved communities face persistent barriers to oral health care, including limited access to providers. Teledentistry may offer a scalable strategy to improve access, education, and treatment adherence.

Aim: To evaluate the effectiveness of teledentistry interventions in improving oral health outcomes, treatment compliance, and educational engagement among pediatric populations in low-access settings.

Design: A systematic review was conducted following PRISMA 2020 guidelines. Eleven studies published between 2011 and 2025 were included, comprising randomized controlled trials, cohort studies, and school-based implementations. Interventions included synchronous video consultations, asynchronous data transmission, mobile apps, and social media-based education.

Results: Teledentistry interventions improved treatment adherence (66.7%-96.9%), reduced plaque and bleeding indices in orthodontic patients, and enhanced access to screening and referrals in schools. Mobile-based education promoted better hygiene behavior. Most studies reported high satisfaction and minimal technological issues. However, variability in intervention types and outcome measures precluded meta-analysis.

Conclusion: Teledentistry is a feasible and effective tool for addressing pediatric oral health disparities in underserved settings. It supports prevention, education, and early intervention. Future studies should emphasize standardized outcomes, long-term impact, and cost-effectiveness.

Trial registration: This systematic review is registered in PROSPERO under the registration number CRD420251066189.

Background: Molar incisor hypomineralization (MIH) often poses challenges in achieving effective anesthesia. The role of neuromodulation as a potential alternative to local anesthesia injections in managing MIH-affected teeth remains unexplored.

Aim: This study evaluated the efficacy of neuromodulation in providing pain relief during vital pulp therapy for MIH-affected permanent molars.

Design: A triple-blind, randomized clinical trial in 35 children (70 M) aged 6-12 assessed pulpotomy pain management. Teeth were randomly assigned to neuromodulation (Synapse Dental Pain Eraser) for 3 min and mock injection (experimental group), or to conventional infiltration of local anesthesia preceded by inactive control probes (control). Pain was evaluated using the Sound, Eye, Motor (SEM) scale, along with anesthesia need, patient satisfaction, and anesthesia duration. Data were analyzed using independent t-tests with significance set at p < 0.05.

Results: The experimental group reported higher no-pain scores (29%) compared to the control group (20%). Supplemental anesthesia was required in 11% of cases in the experimental group and 19% in the control group. Neither showed a statistically significant difference (p = 0.42 for pain scores; p = 0.36 for supplemental anesthesia).

Conclusions: Neuromodulation demonstrated comparable effectiveness to local anesthesia alone in managing pain during pulpotomy in MIH molars, and its use should be further studied.

Trial registration: ClinicalTrials.gov identifier: CTRI/2024/06/069004.