International journal of paediatric dentistry最新文献

Background: Root canal therapy in primary teeth is exceedingly complex due to the unique internal geometry of the pulp cavity.

Aim: The purpose of this study was to evaluate variations in primary teeth root canal morphology and applicability of the Ahmed et al. (Int Endod J, 50, 2017, 761) alphanumeric system for classifying them.

Design: A retrospective analysis of 2024 primary teeth from an existing CBCT database was performed for assessing variations in root canal morphology. Descriptive statistics and the chi-squared test were used for data analysis.

Results: The maxillary canines exhibited splitting levels of 5.9% (right) and 6.6% (left), and merging levels of 1% (both sides); maxillary lateral incisors showed splitting levels of 2.6% (right) and 0.8% (left), with no merging observed; mandibular second molars had splitting levels of 1.5% (right) and 0.8% (left), with no merging observed; and mandibular lateral incisors exhibited a merging level of 0.9% (right), with no splitting observed.

Conclusion: This study provides new insights into the variations in root canal morphology of primary teeth, particularly highlighting the variations found in primary canines. The Ahmed et al. (Int Endod J, 50, 2017, 761) classification system was found to be a useful tool for categorizing these variations.

Background: Injection pain remains a significant concern in dental procedures, often leading to patient anxiety and reluctance to seek necessary care.

Aim: This study aimed to assess the effectiveness of cryotherapy in reducing injection pain compared with topical anesthesia during intraoral local anesthesia.

Design: MEDLINE, Web of Science, EMBASE, Scopus, and Cochrane's CENTRAL databases were searched up to November 2023. Inclusion criteria involved randomized clinical trials aligned with the PICO question. Study selection, data extraction, and risk of bias assessment using the ROB-2 tool were performed. The results were synthesized through a random-effects inverse variance meta-analysis. The primary outcomes assessed were the Visual Analogue Scale (VAS) and Sound Eye Motor (SEM). Subgroup analysis was conducted for children and adults.

Results: In the meta-analysis, 31 RCTs involving 2470 subjects were included. Twenty-seven studies demonstrated cryotherapy's significant superiority over topical anesthesia in reducing injection pain via VAS in adults (p = .01), children (p = .01), and combined age groups (p < .001). Additionally, cryotherapy significantly outperformed topical anesthesia in reducing pain via SEM in children (p = .04) and combined age groups (p = .03) across 13 studies, with no significant difference in adults (p = .51). Furthermore, cooled topical anesthesia also outperformed room temperature topical anesthesia (p < .001). The certainty of the results, however, is of very low quality.

Conclusions: Our results indicate that cryotherapy significantly reduces injection pain compared with topical anesthesia, especially in children and combined age groups, but is less effective in adults. Additionally, cooled topical anesthesia is more effective than room temperature topical anesthesia. Thus, cryotherapy is a and potentially superior alternative to topical anesthesia, particularly for children.

Background: Dental caries and molar-incisor hypomineralization (MIH) are primary reasons for the extraction of first permanent molars (M1) in children, which can lead to significant dental and facial development issues such as a midline shift and temporomandibular joint disorder.

Aim: This systematic review aimed to identify key factors influencing spontaneous space closure following the early extraction of first permanent molars (M1) in children aged 5-15.

Design: We conducted a comprehensive search across Scopus, PubMed, Dimensions, Web of Science, and Cochrane databases, including the literature from 1960 to 2024. The inclusion criteria focused on clinical trials, case-control, cross-sectional, cohort studies, and case series that evaluated the impact of various factors on the spontaneous closure after M1 extraction.

Results: The analysis highlights that chronological age and the developmental stage of the second permanent molars (M2) at the time of extraction are significant predictors of successful spontaneous space closure. Additionally, the presence and angle of M2, along with the presence of third permanent molars (M3), play crucial roles but require further investigation.

Conclusion: Early assessment of M2's developmental stage and inclination, and the presence of M3 are essential for enhancing the likelihood of successful spontaneous space closure following M1 extraction in children.

Background: Various scanning methods aim to reduce intraoral scanner errors, yet no specific approach targets paediatric patients.

Aim: Evaluate continuous (C) and noncontinuous (NC) scanning patterns' impact on the trueness and duration of paediatric digital impressions.

Design: A standard pedodontic typodont model was scanned with a Trios 4 Move+ IOS using four scanning strategies. C1 and C2 followed continuous scanning from the right molars, with different directions. NC1 scanned noncontinuously from the right molar, with breaks every four teeth. NC2 began at the right primary incisor, with breaks after every three teeth. Each scan, performed five times by one researcher, was timed. Industrial scanning provided reference data. Deviations were analyzed using the MIXED procedure.

Results: NC1 had higher deviations in the lower jaw, whereas C1 and NC1 showed higher deviations in the upper jaw (p < .001). C1 had significantly higher deviations in the upper jaw than the lower jaw (p = .041). NC2 had the longest scanning time in both upper and lower jaws (p = .002).

Conclusion: Paediatric digital impressions benefit from starting at the anterior and incorporating breaks, although this increases scanning time.

Background: Eruption of primary teeth is associated with local and systemic manifestations. Understanding the global prevalence is necessary to formulate the standard guidelines for management.

Aim: To evaluate the global prevalence of problems associated with teething in infants and children aged 0-36 months.

Design: PubMed, LILACS, Web of Science, Scopus, and EMBASE were searched on May 31, 2023, and it was updated on January 31, 2024. Gray literature and reference search were performed. Cross-sectional, case-control, and cohort studies done in hospital or community settings, reporting the prevalence of signs and symptoms during the eruption of primary teeth in infants aged 0-36 months, were included. Two reviewers extracted data using a pre-piloted sheet. Data were analyzed and pooled by using random-effects meta-analyses.

Results: Twenty-five studies were included. The global prevalence of teething problems was 80.0% (95% confidence interval [CI]: 67.8-89.9). The most common local symptom was increased biting (65.9%, 95% CI 37.5-89.3), and irritability (60.7%, 95% CI 50.6-70.3) was the most common general symptom.

Conclusion: The pooled prevalence of teething problems was estimated to be 80%. There was a variability in the prevalence of teething problems based on geographic location.

Background: Dental practitioners must develop feasible and evidence-based strategies to help parents/caregivers successfully implement daily oral hygiene measures among their children with autism spectrum disorder (ASD).

Aim: This scoping review aimed to explore challenges faced by parents/caregivers while performing routine oral hygiene care among their children with ASD.

Design: A methodological framework recommended by Arksey and O'Malley and reporting guidelines prescribed by PRISMA-ScR were adopted. A database search was conducted across PubMed, Scopus, Web of Science, EMBASE, and ClinicalKey, to identify articles that addressed challenges faced by parents/caregivers while performing routine oral hygiene care for their children with ASD.

Results: The search yielded 4934 articles. Following the inclusion/exclusion criteria, nine articles were included in this scoping review. A qualitative analysis of included articles following the PICOS coding criteria revealed major themes. These consisted of various home oral hygiene practices followed by parents/caregivers, and challenges faced by them during home oral hygiene care owing to underlying sensory, behavioral, physical, and/or functional problems experienced by their children with ASD.

Conclusion: Challenges experienced by parents/caregivers of children with ASD were numerous, which resulted in deviations from routine oral hygiene practices from recommended guidelines for the prevention of dental caries.

Background: Several lesions can affect the oral and maxillofacial region, with trends influenced by lifestyle and age.

Aim: To investigate the occurrence of oral and maxillofacial lesions in paediatric patients assisted in an oral medicine diagnostic service in Brazil over 20 years.

Design: A retrospective cross-sectional study was performed in an oral medicine diagnostic service (1999-2019). Data included sex, age, anatomic site, and diagnosis from clinical records of children (0-9 years) and adolescents (10-19 years). Lesions were diagnosed through clinical examination. Biopsy and histopathologic examination were performed when necessary.

Results: Among 10 530 records, 702 (6.67%) were from patients aged 0-19 years diagnosed with oral or maxillofacial lesions. A high frequency of females was observed (58.1%). Reactive/inflammatory lesions were the most common group of lesions (45.2%), followed by abnormalities of teeth/developmental defects (17.8%) and pulpal and periapical diseases (8.5%). Mucocele/ranula was the most common lesion in children (29.3%) and adolescents (25.3%). Lips were the most affected anatomic sites.

Conclusion: Most lesions were benign, and mucocele/ranula was the most frequent. Our results did not differ from those of histopathological-based studies, but they provided information on the occurrence of oral and maxillofacial lesions to dentists and paediatricians.

Background: Hypohidrotic ectodermal dysplasia (HED) is a hereditary disorder with agenesis of ectodermal derivatives, causing oligodontia or anodontia. Dentures are needed to improve the patients' mastication.

Aim: This study aimed at preliminarily evaluating the masticatory function changes in Chinese individuals with HED after prosthetic rehabilitation from childhood to adolescence.

Design: This longitudinal study enrolled 10 HED patients. Data were collected during childhood and adolescence, respectively. The healthy children and adolescents were recruited as the control group. The surface electromyography (EMG) of masseter (MM) and anterior temporalis (TA) muscles during clenching and chewing were recorded. The EMG activity, asymmetry index (As), activity index (Ac), and chewing cycle were analyzed. The masticatory efficiency was measured by spectrophotometry with subjective masticatory ability assessed by a questionnaire.

Results: The EMG activities and masticatory efficiency of HED patients during childhood and adolescence were mostly lower with a higher As (p < .05). The chewing process enhanced the TA activity and balanced the As of HED adolescents (p > .05). The HED adolescents showed a more prevalent TA activity (p < .05).

Conclusion: The masticatory function of the growing HED patients was functionally inferior to the dentate individuals with a narrowed gap from childhood to adolescence.