International journal of paediatric dentistry最新文献

Background: Important psychometric approaches (structural validity, measurement invariance) remain underdeveloped in measuring oral health-related quality of life, particularly for preschool children across diverse contexts.

Aim: This study aimed to evaluate the structural validity of the child's self-reported version of the Scale of Oral Health Outcomes for 5-year-old children (SOHO-5) and test the measurement invariance from cultural and clinical/non-clinical comparison perspectives.

Design: Three datasets were analysed: two from Brazil and one from the United Kingdom (UK). One Brazilian dataset was derived from clinical data collection (n_br-cl. = 193), while the others were from non-clinical epidemiological school-based studies (n_br-ncl. = 768, n_uk-ncl. = 296). Dimensionality was tested through parallel analysis and confirmed by unidimensional indexes. Measurement invariance across datasets was tested via multi-group Confirmatory Factor Analysis (CFA).

Results: Unidimensionality was empirically confirmed for all three datasets. The multi-group CFA tests reached partial scalar invariance threshold between the Brazilian and UK non-clinical datasets. However, there was no scalar equivalence when comparing non-clinical with clinical datasets, neither within Brazil nor between countries.

Conclusion: The child's self-reported version of the SOHO-5 is a unidimensional oral health-related quality-of-life measure that is psychometrically comparable across different cultures (partial scalar invariance), but not between clinical and non-clinical groups.

Background: Gamified tools have shown promising improvements in health promotion. However, little is known about how mothers perceive their use in improving children's oral health.

Aim: This qualitative study explored the insights of mothers of school-aged children in Jeddah, Saudi Arabia, regarding gamification tools aimed at promoting oral hygiene.

Design: Participants were selected using purposive variation sampling to capture diversity. Data were collected through semi-structured individual interviews conducted in Arabic or English.

Results: Thematic analysis revealed six key themes: engagement and motivation to play, barriers related to prolonged use, perceived usefulness, parents' concerns and conflicts, desired features, and observed effects on children's behavior. These findings reflected the varied characteristics and experiences of the participants and highlighted both the learning potential and limitations of gamified tools for oral health education. While some mothers acknowledged the positive impact of gamified tools on increasing their children's knowledge and motivation in maintaining oral hygiene, others expressed concerns regarding excessive screen time, content, and linguistic needs.

Conclusions: Gamified tools appear effective in enhancing children's oral hygiene practices, as reflected by maternal observations of improved brushing habits. Nonetheless, concerns regarding screen exposure, content suitability, and cultural appropriateness emphasize the need for more customized and engaging solutions.

Background: Silver diamine fluoride (SDF) is a viable biological approach for arresting active dental caries in children. However, the resulting dark staining is a major concern for parents, often limiting its acceptance despite clinical benefits. Therefore, evaluating parental acceptability is crucial.

Aim: This study aimed to develop and validate a Malay version of the questionnaire on parental perception and acceptance of SDF treatment in children, based on the English version by Crystal et al., for use in Malaysia.

Design: The English questionnaire was modified and translated into Malay following standardised guidelines. Content validation was performed by an expert committee, followed by pilot testing with 134 participants. Construct validity was assessed using Exploratory Factor Analysis (EFA) with Kaiser-Meyer-Olkin (KMO) and Bartlett's test. Reliability was then measured through internal consistency (Cronbach's alpha) and test-retest reliability using intraclass correlation coefficient (ICC).

Results: Nineteen out of 22 items scored an I-CVI of 1.0; three scored 0.5. S-CVI/UA was 0.86 and S-CVI/Ave was 0.93. EFA confirmed construct validity (KMO = 0.74, Bartlett's test p < 0.001). Cronbach's alpha values ranged from 0.780 to 0.919, indicating high internal consistency. ICC values (0.528-0.802, p < 0.05) showed moderate to good reliability.

Conclusion: The Malay version of the questionnaire is both valid and reliable, supporting further nationwide studies to improve its stability.

Background: Asymmetrical occlusion in children may influence maxillofacial development and oral function, yet its clinical relevance remains underexplored.

Aim: To investigate the relationship between asymmetrical occlusion and oral/physical functions in schoolchildren during the mixed dentition period.

Design: A cross-sectional study of 374 (192 boys and 182 girls) schoolchildren (Hellman's dental age IIIA-IVA) was conducted. Asymmetry indices (AIs) were calculated using occlusal force/contact area data measured with the dental prescale. Oral and physical functions were assessed using masticatory performance, grip strength, and walking speed. Statistical analyses included Chi-squared test, Mann-Whitney U test, Spearman's rank correlation, Kruskal-Wallis test, and multiple regression analysis.

Results: AI, an indicator of unilateral occlusion, varied significantly across dental age groups (p = 0.011), peaking in stage IIIC. In IIIA, AI was correlated with age and masticatory performance; in IIIB and IIIC, it correlated with both oral and physical functions; and in IVA, with body size. Multiple regression revealed that lower occlusal force/area and slower chewing rates significantly explained greater asymmetry.

Conclusions: Asymmetrical occlusion in the mixed dentition showed weak but significant correlations with some oral functions, without consistent links to physical functions. Its cross-sectional design precludes causal inference, warranting further longitudinal studies.

Background: Clinical approaches for pediatric patients requiring endodontic treatment have been associated with specialty type.

Aim: The purpose of this study was to elucidate the nuanced clinical decision-making process for endodontic treatment of pediatric patients' permanent teeth.

Design: A qualitative design was used to explore the experiences and decision-making of general dentists, pediatric dentists, and endodontists. Clinicians practicing in the United States were recruited to interview using purposive sampling methods. A framework, thematic analytic approach was used to evaluate the data.

Results: In total, 26 dentists participated in the study: 7 general dentists, 11 pediatric dentists, 6 endodontists, and 2 dual-trained specialists. Overall, clinicians reported that caries on permanent first molars were the most common reason that pediatric patients required endodontic treatment. Access to care was influenced by practitioner clinical training and knowledge; patient behavior; and financial considerations. Treatment planning was influenced by parents, referrals, and clinical philosophy.

Conclusions: The findings explain how clinician decision-making and system-level factors influence access to care for pediatric patients in need of endodontic treatment and propagate oral health disparities. Barriers to accessing care were most limiting for children and adolescents from low-income households and were likely to result in premature tooth loss.

Mandibular fractures are rare in infants under one year of age, accounting for only 0.9%-2.6% of pediatric mandibular injuries. Their infrequency is due to the unique anatomical and developmental features of the infant mandible, including increased bone elasticity and minimal exposure to high-impact trauma. Diagnosis and management are often challenging, particularly given the difficulty in symptom communication, presence of unfused skeletal structures, and developing tooth buds. We described a case of a 3-month-old infant who sustained concurrent fractures of the mandibular symphysis and left condylar head following an accidental fall from a diaper-changing table. Computed tomography revealed a greenstick fracture at the symphysis and a minimally displaced condylar fracture. In consideration of the patient's age, fracture type, and high remodeling capacity, conservative management was selected. Clinical and radiographic follow-up over three months demonstrated excellent bony remodeling without any surgical intervention. There was no functional impairment or developmental delay. This case highlights the substantial remodeling potential of the infant mandible and supports the efficacy of conservative treatment in selected cases. It also underscores the importance of distinguishing true fractures from developmental non-union in the symphyseal region. Long-term follow-up until the completion of mandibular growth remains crucial to detect potential growth disturbances.

Background: Managing necrotic primary molars is challenging due to complex root anatomy and resorption. While pulpectomy is standard, less invasive techniques like lesion sterilization and tissue repair (LSTR) are gaining interest. However, their comparative effectiveness remains uncertain.

Aim: To evaluate and compare the clinical and radiographic success of conventional LSTR, modified LSTR (with radicular pulp removal), and pulpectomy with Metapex in necrotic primary molars. Postoperative pain was also assessed.

Design: Sixty-three necrotic primary molars in children aged 3-8 years were randomly divided into three groups: (1) Group I: Conventional LSTR with triple antibiotic paste (3Mix MP). (2) Group II: Modified LSTR +3Mix MP. (3) Group III: Pulpectomy with Metapex. Clinical and radiographic assessments were done at 3, 6, 9, and 12 months. Postoperative pain was recorded immediately and after 24 h using a standard scale.

Results: A significant difference was observed after 12 months, with pulpectomy demonstrating superior outcomes compared to traditional LSTR (Table 4, p = 0.01). It also shows, radiographic success was lower in the LSTR group than the pulpectomy group when baseline radiolucency was present (p =0.047).

Conclusion: Pulpectomy showed significantly better overall radiographic results than conventional LSTR and was significantly better when there was a pre-treatment radiolucency. Pain outcomes were comparable.

Background: The pooled evidence on the effectiveness of recently developed mHealth interventions that can improve oral hygiene and oral health behavior in children and adolescents is weak.

Aim: To provide an analysis of the effectiveness of mHealth interventions in improving oral hygiene and oral health behavior of children from infancy to adolescence.

Design: Electronic search in five databases (PubMed, Scopus, Embase, CINAHL, and Cochrane) along with websites and gray literature was performed till February 2025. Two independent reviewers selected eligible studies based on the inclusion and exclusion criteria out of which 12 studies were included. Qualitative analysis was done for oral health behavior and meta-analysis was performed for measuring oral hygiene. Risk of bias, and certainty of evidence assessment were performed.

Results: Overall, mHealth interventions showed statistically significant effects on both gingival and plaque index (p < 0.05) but an insignificant effect in gingival index in adolescents (p = 0.22). While improvements in oral health behavior were observed in infants and children, these interventions proved ineffective among adolescents.

Conclusion: While m-Health interventions have proven effective in improving oral hygiene and oral health behaviors in children, their impact on adolescents remains limited. Consequently, there is an imperative need to develop more engaging and adolescent-specific mHealth interventions.

Trial registration: PROSPERO registration number: CRD42023443484.

Background: Artificial intelligence presents the potential to enhance consistency and objectivity in preclinical pediatric dentistry assessments.

Aim: To evaluate the reliability of multimodal artificial intelligence (AI) models (GPT-4o, Claude-3.7-Sonnet-Reasoning, o4-mini, DeepSeek-R1, DeepSeek-V3, and o3) compared to human experts in assessing stainless steel crown (SSC) preparations.

Design: This cross-sectional study analyzed 133 SSC preparations (27 mandibular first primary molars, 106 mandibular second primary molars) from dental students. Using a rubric assessing occlusal reduction, proximal reduction, and finishing criteria, five photographs were captured for each preparation. Images were analyzed using a Reflection-of-Thought prompt and compared to human assessments using a conventional p < 0.05 criterion.

Results: Claude-3.7-Sonnet-Reasoning demonstrated exceptional agreement with human experts (ICC = 0.89) across all preparations with consistent performance by tooth type. o4-mini showed moderate agreement (ICC = 0.57), GPT-4o weak agreement (ICC = 0.06), and o3 no agreement (ICC = -0.03), while DeepSeek models achieved 0% task completion. Error analysis revealed proximal reduction errors as the most common (39.2%), followed by finishing (33.6%) and occlusal reduction (27.1%) with significant variations in error detections between assessors, particularly for second primary molars.

Conclusions: Claude-3.7-Sonnet Reasoning demonstrates human-expert-level reliability in assessing SSC preparations. AI models offer promising complementary approaches to standardize preclinical pediatric dentistry assessments, provide immediate feedback, and reduce faculty workload.