International journal of paediatric dentistry最新文献

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.

Background: Pain and anxiety during dental procedures remain major challenges in pediatric dentistry, particularly during local anesthesia administration.

Aim: This study compared the effectiveness of digital anesthesia systems versus conventional infiltration and mandibular block techniques in managing pain, anxiety, and behavioral responses in pediatric dental patients.

Design: Seventy-nine children aged 6-12 were randomly assigned to receive anesthesia via digital anesthesia system (DAS), infiltration, or mandibular block. Pain was assessed using the Wong-Baker Faces Pain Rating Scale (WBFRPS), anxiety via the Modified Child Dental Anxiety Scale (MCDAS), and behavioral responses through the FLACC scale. Statistical analyses included ANOVA, Kruskal-Wallis, and chi-square tests (p < 0.05).

Results: Children in the DAS group reported significantly lower pain scores during needle insertion, anesthetic delivery, and treatment. Post-treatment MCDAS scores decreased significantly in the DAS group, especially for items related to "tooth examination," "filling," and "gingival injection." FLACC results also indicated more favorable behavioral responses-such as relaxed facial expressions and absence of crying-in the digital group (p < 0.05).

Conclusion: Digital anesthesia appears to be a highly effective alternative to conventional techniques for minimizing pain, reducing dental anxiety, and improving behavioral cooperation in pediatric patients, supporting its broader implementation in clinical practice.

Trial registration: ClinicalTrials.gov identifier: NCT06992193.