International journal of paediatric dentistry最新文献

Background: Lysosomal storage diseases (LSDs), a group of inborn errors of metabolism, include various subtypes, for example, mucopolysaccharidosis (MPS) and Gaucher disease (GD). Besides the physical/mental disabilities, they suffer from several oral deteriorations.

Aim: To evaluate the oral health status of Egyptian children with LSD.

Design: Thirty LSD children and thirty non-LSD children were enrolled for this study according to the inclusion and exclusion criteria. Dental indices were used to assess caries prevalence and periodontal status. Saliva samples were collected from all enrolled children to estimate interleukin 6 (IL-6), tumor necrosis factor-α (TNF-α), and protein levels as well as Streptococcus mutans and Lactobacilli colony counts.

Results: Children with MPS and GD showed non-significant differences in decayed, missing, or filled teeth (DMFT) scores (p = .115). Scores of dmft showed a significant increase in MPS, but not in GD children (p = .020, p = .127). Children with LSD showed significantly increased Modified Gingival Index (MGI), Plaque Index (PI), Oral Hygiene Index (OHI-s) scores (p < .001) and salivary IL-6 and TNF-α (p = .007, p = .001, p < .0001, p = .002, respectively) and salivary total proteins (p = .001) levels. Unexpectedly, non-significant differences were observed in salivary Streptococcus mutans or Lactobacilli counts in children with MPS and GD (p = .058, p = .420, p = .502, p = .053, respectively).

Conclusion: To our knowledge, this is the first article that evaluates Egyptian children with LSD. We demonstrated high caries prevalence in primary teeth, not permanent teeth, in children with MPS and poor gingival/hygiene status in children with MPS and GD, which triggered a state of inflammation. The daily supplement intake prevented oral bacterial growth. The most probable cause of oral alterations is decreased salivary flow rate, as deduced from a significantly increased salivary protein.

Background: Limitations in traditional caries detection tools have driven the development of alternatives methods, focused on the early lesion detection such as near-infrared digital imaging transillumination (NIDIT).

Aim: The aim of this study was to evaluate the performance of NIDIT compared with bitewing radiography (BWR) in the detection of interproximal carious lesions in children.

Design: A retrospective audit of data from children who had NIDIT, BWR and intraoral photographs was conducted. Carious lesions were scored on a tooth surface level with BWR acting as the primary reference for comparison. Accuracy was determined using multi-class area under the curve (AUC), and correlation was determined using Fleiss' Kappa.

Results: Data from 499 tooth surfaces involving 44 children were included in this study. The average age across the participants was 86 months (~7 years) with an average dmft (decayed, missing and filled teeth in primary dentition) of 5.29. Multi-class AUC comparing NIDIT to BWR was 0.70. The correlation between NIDIT and BWR was moderate (0.43), whereas the correlation between photographic examination and BWR was 0.30, which is fair.

Conclusion: When compared to BWR, NIDIT showed a high specificity but a low sensitivity for proximal caries detection in primary teeth.

Background: Sleep hygiene measures and meditation may reduce stress and improve sleep quality, but their effect on the occurrence of sleep bruxism in children has not yet been investigated.

Aim: To explore the effects of sleep hygiene measures combined with mindfulness meditation (relaxation audio) in the management of probable sleep bruxism (SB) in children.

Design: This clinical trial (no. NCT04501237) randomized 36 children with 3-8 years of age. Probable SB detection was performed according to the criteria established by the International Consensus on The Assessment of Bruxism-2018. Intervention group was instructed to practice sleep hygiene measures and mindfulness meditation (i.e., the use of a digital app to broadcast audio relaxation) each night before bedtime for 5 weeks; control group did not receive guidance for therapies. Parents completed a bruxism diary for 5 weeks, and the outcome was the number of SB episodes-day reported in the week (ranging from 0 to 7) in each period. A multilevel mixed-effects Poisson regression model was performed.

Results: A total of 32 children (mean age: 6.1 years) completed the study. The children who received the therapies related to sleep hygiene measures and mindfulness meditation had a reduction in the SB incidence rate ratio (IRR) of 46% (IRR = 0.54 [Confidence Interval 95%, 0.45-0.65]) during a 5-week observation period. The sensitivity analyses did not show relevant changes in the measure of the effect.

Conclusion: Sleep hygiene measures combined with mindfulness meditation reduced the SB in children.

Background: Primary teeth segmentation on cone beam computed tomography (CBCT) scans is essential for paediatric treatment planning. Conventional methods, however, are time-consuming and necessitate advanced expertise.

Aim: The aim of this study was to validate an artificial intelligence (AI) cloud-based platform for automated segmentation (AS) of primary teeth on CBCT. Its accuracy, time efficiency, and consistency were compared with manual segmentation (MS).

Design: A dataset comprising 402 primary teeth (37 CBCT scans) was retrospectively retrieved from two CBCT devices. Primary teeth were manually segmented using a cloud-based platform representing the ground truth, whereas AS was performed on the same platform. To assess the AI tool's performance, voxel- and surface-based metrics were employed to compare MS and AS methods. Additionally, segmentation time was recorded for each method, and intra-class correlation coefficient (ICC) assessed consistency between them.

Results: AS revealed high performance in segmenting primary teeth with high accuracy (98 ± 1%) and dice similarity coefficient (DSC; 95 ± 2%). Moreover, it was 35 times faster than the manual approach with an average time of 24 s. Both MS and AS demonstrated excellent consistency (ICC = 0.99 and 1, respectively).

Conclusion: The platform demonstrated expert-level accuracy, and time-efficient and consistent segmentation of primary teeth on CBCT scans, serving treatment planning in children.

Background: Social disadvantage leads to dental caries during childhood.

Aim: This study investigated whether dental caries occur earlier in children from households experiencing social disadvantage than those not experiencing social disadvantage.

Design: The overall risk of, and relative time to, early childhood caries (ECC) according to sociodemographic characteristics in Victoria, Australia, was quantified. Records for 134 463 children in Victoria, Australia, from 2009 to 2019 were analysed. Time ratios (TR) and hazard ratios (HR) of carious lesion(s) in early childhood were estimated.

Results: Compared with reference groups, Indigenous children had an adjusted TR of 0.80 (95% CI: 0.78, 0.82), children from households with languages other than English had an adjusted TR of 0.83 (95% CI: 0.82, 0.84), and dependants of concession cardholders had an adjusted TR of 0.81 (95% CI: 0.80, 0.81); therefore, 20%, 17% and 19% reduced times to the first carious lesion, respectively. The estimated HRs were 1.57 (95% CI: 1.49, 1.67) for Indigenous children, 1.46 (95% CI: 1.42, 1.50) for children from households with other languages and 1.57 (CI: 1.53, 1.60) for dependants of concession cardholders.

Conclusion: Preventive oral health interventions must be targeted early in children from households experiencing social disadvantage to avoid social inequities in ECC.

Background: Supervised toothbrushing (STB) significantly reduces the incidence and progression of dental caries. School years present a favorable age for introducing such healthy habits for a lifetime.

Aim: To estimate the cost-effectiveness of implementing a STB program in India in preventing dental caries incidence.

Design: An operational framework of a national STB program was devised. A mathematical model was then developed to evaluate this program's clinical effectiveness and economic impact in the Indian scenario. This study considered a hypothetical cohort of the Indian population aged from 6 to 75 years. Two groups were compared: no intervention and STB in government schools. The health outcomes assessed were a number of tooth caries incidences averted and quality-adjusted life years gained.

Results: The STB program in the government schools of India would prevent at least one tooth from developing caries in an individual's lifetime. Considering the current treatment-seeking behavior, the STB program saves INR 153 (US$ 1.95) per carious tooth incidence averted and INR 22 202 (US$ 283) per QALY gained.

Conclusion: In India, the school-based STB program is expected to be a cost-effective strategy for reducing the dental caries burden and its associated treatment costs.

Background: Teledentistry can improve access to care, but children's acceptance of different imaging techniques is underexplored.

Aim: The aim of this study was to assess children's acceptance of intraoral cameras and smartphones for caries detection.

Design: A randomized controlled trial was conducted in rural Egyptian nurseries, with children aged ≤ 6 years randomized into intraoral camera or smartphone groups. Behavior during imaging was assessed using four indicators: fear, mouth-opening difficulty, opposition, and cooperation, with a total score calculated from their sum. Imaging time was recorded, and mood was assessed using the Positive and Negative Affect Scale. Linear regression assessed associations between behavior and time with technique and mood, adjusting for confounders.

Results: The study included 508 children, mean (SD) = age 4.54 [1.04] years. Children in the intraoral group showed higher fear and difficulty keeping their mouths open, with lower overall behavior scores (mean [SD] = 16.64 [2.95] vs. 17.18 [3.06], B = -1.05, p < 0.001). The intraoral camera required less time (mean [SD] = 3.62 [1.49] vs. 5.33 [2.82] minutes, B = -1.56, p < 0.001). Positive mood improved behavior (B = 0.25, p < 0.001), while negative mood increased time (B = 0.30, p < 0.001) and worsened behavior (B = -0.64, p < 0.001).

Conclusion: Smartphones improved behavior, while intraoral cameras were more time-efficient. Device choice should balance efficiency with child comfort.

Trial registration: ClinicalTrials.gov identifier: NCT06019884.

Background: Teledentistry integrates telecommunications with dental practice, facilitating the exchange of clinical information and images for remote dental consultation and treatment planning. This approach enables dental care access across long distances, addressing the need for flexible healthcare solutions.

Aim: This study aimed to evaluate the effectiveness of teledentistry compared to clinical in-person dental diagnosis in pediatric patients during the COVID-19 pandemic.

Design: The study sample consisted of 200 children aged 3-13 years, each undergoing both teledentistry-based and in-person clinical dental diagnosis. Caries index scores, including DMFT/dmft and DMFS/dmfs, as well as the identification of specific dental conditions such as molar incisor hypomineralization (MIH), black tooth staining, periodontal disease, dental trauma, and orthodontic anomalies, were recorded in both diagnostic settings. Statistical analysis was conducted using chi-square, Wilcoxon, and Fisher's Exact tests.

Results: The mean age of participants was 7.86 ± 2.40 years. Caries index scores (DMFT/dmft, DMFS/dmfs) showed compatibility between teledentistry and clinical diagnoses. While "d/D, f/F, ds/DS, fs/FS" scores were observed to be higher in clinical diagnoses compared to teledentistry, the difference was not statistically significant (p > 0.05). Scores for "m/M" and "ms/MS" were identical in both diagnostic methods. Additionally, the prevalence of dental anomalies, including MIH, black tooth staining, periodontal disease, dental trauma, and orthodontic anomalies, was comparable across both diagnostic approaches.

Conclusion: Findings suggest that teledentistry serves as an effective alternative to clinical in-person diagnosis for pediatric dental consultations and treatment planning, demonstrating comparable accuracy in identifying caries and dental anomalies in children.