International journal of paediatric dentistry最新文献

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

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.

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.