International journal of paediatric dentistry最新文献

Background: Molar incisor hypomineralization (MIH) is associated with enamel's existing qualitative developmental defects.

Aim: This study aimed to assess the cortical and trabecular mandibular bone morphology in pediatric patients with MIH using fractal analysis (FA) and digital panoramic radiography (DPR) with various radiomorphometric indices.

Design: A total of 75 patients, including 39 in the MIH group (MIHG) and 36 in the control group (CG), underwent clinical and radiographic examination. Three regions of interest (ROIs) were analyzed: ROI1 (mandibular ramus), ROI2 (mandibular angle), and ROI3 (mandibular anterior). Radiomorphometric measurements included mandibular cortical width (MCW), panoramic mandibular index (PMI), and mandibular cortical index (MCI). Statistical significance was defined as p < 0.05.

Results: The study revealed that the right and left MCW and PMI measurements in the CG were significantly higher compared with the MIHG (p = 0.002, p < 0.001; p = 0.022; p = 0.003). However, fractal dimension (FD) analysis of the trabecular bone structure showed no significant differences between the groups across all ROIs (p > 0.05).

Conclusions: MIH may be associated with bone development due to shared developmental factors, and the assessment of MCW and PMI in DPRs can contribute to a multidisciplinary diagnosis and treatment approach based on the growth and developmental dynamics of pediatric patients.

Background: The use of fluoride-free mouthwashes (FFM) can adversely affect the anticaries benefits of fluoride toothpaste.

Aim: This study investigated (i) the impact of FFM on the anticaries benefits of fluoride toothpaste and (ii) differences in enamel-lesion assessment between two TMR techniques.

Design: The study followed a 2 (technique) × 2 (toothpaste) × 4 (mouthwash) factorial design. Toothpaste (1100 ppm F) contained either NaF or SnF₂. Mouthwashes contained CPC or EOs. Control mouthwashes were DIW and not washed after toothpaste. Two TMR techniques, conventional specimens and single sections of enamel (n = 8), were utilized. During the 5-day/pH cycling, the specimens with artificial caries-like lesions were treated two times/day with toothpaste/1 min, followed by mouthwash/30s. There was a 4 h demineralization/day. Integrated mineral loss (ΔΔZ) and lesion depth (ΔL) were determined. Data were analyzed using three-way ANOVA.

Results: There was no statistically significant interaction between the three factors for ΔΔZ (p = 0.894) or ΔL (p = 0.410) and no difference between toothpaste for ΔΔZ (p = 0.977) or ΔL (p = 0.507). However, mouthwashes affected ΔΔZ and ΔL (both p < 0.001). The non-wash group resulted in the most remineralization. The technique did not affect ΔΔZ (p = 0.973).

Conclusion: Fluoride-free mouthwashes may decrease the remineralization potential of fluoride toothpaste, and the single-section technique is a suitable alternative in caries research. Pediatric dentists can emphasize proper hygiene and parental guidance in supervising children's brushing/rinsing.

Objective: To assess the prevalence and risk factors of chemotherapy-induced oral mucositis in 470 children with acute lymphoblastic leukemia in China, focusing on treatment-related risk factors.

Methods: This cross-sectional study included 470 children diagnosed with acute lymphoblastic leukemia in China from January 2020 to July 2022. Data were collected from electronic medical records, field investigations, and telephone follow-ups, covering sociodemographic characteristics, nutritional status, disease and treatment history, and microbiological factors. Univariate and multivariate logistic analyses were used to evaluate the association between the occurrence and severity of chemotherapy-induced oral mucositis and these variables.

Results: The prevalence of chemotherapy-induced oral mucositis was 45.1%. Significant risk factors included receiving more than five chemotherapy cycles (p < 0.001), carrying HSV-1 (p = 0.016), infection with Candida albicans (p = 0.012), undergoing chemotherapy with specific drugs containing methotrexate/daunorubicin/cytarabine (p < 0.001), having a high clinical risk stratification (p = 0.002), and being over 6 years old (p = 0.002). The severity of chemotherapy-induced oral mucositis was associated with consolidation and intensification period (p = 0.001) and B-cell immune stratification (p < 0.001).

Conclusion: The prevalence of chemotherapy-induced oral mucositis in children with acute lymphoblastic leukemia is relatively high. It emphasizes the importance of clinical medical staff paying attention to this issue and adopting targeted interventions to reduce the prevalence of oral mucositis in this patient population.

Background: Health-related outcomes in children can be associated with parental practices.

Aim: The aim of this study was to investigate if parent-child interactions and stimulation are predictive of oral health-compromising behaviors at the age of 5 years.

Design: This longitudinal study investigated oral health-compromising factors at the age of 5 years as the outcome: sugar intake between meals more than once a day, no dental appointments or appointments only for treatment, unavailability of the mother to brush her child's teeth, and the presence of dental plaque. Exposure was child stimulation at 24 months. The association was tested using ordinal logistic regression, yielding odds ratios (OR) and 95% confidence intervals (CI).

Results: A total of 1128 children were evaluated, and 46.2% had four or five positive interactions/stimulation practices. More than 80% of the mothers reported that their children had a high sugar intake and had never been to a dentist for treatment. Children with low stimulation had 1.29 greater odds of changing from no health-compromising behaviors to one or more (OR 1.29 95% CI 1.02-1.64) than those with high stimulation.

Conclusion: High parent-child interaction and stimulation were associated with lower scores of oral health-compromising practices at the age of 5 years.

Background: Breastfeeding provides essential nutrients and benefits for newborns. However, its prolonged duration has raised concerns about potential risks for early childhood caries (ECC).

Aim: To determine if prolonged breastfeeding increases the risk of dental caries in children under 71 months.

Design: Eligibility criteria included observational studies comparing ECC risk in children breastfed for over 12 months, with no language restrictions. Databases searched included PubMed, Scopus, and others, up to May 17, 2024. Risk of bias was assessed using the JBI Critical Appraisal Checklist. Meta-analyses were performed using a random-effects model.

Results: Twenty-five studies involving 19 681 participants were included. Studies showed an increased risk of ECC in children breastfed for more than 24 months (RR = 2.44; 95% CI, 1.97 to 3.02). For the 12-24 months period, no significant risk increase was found. Meta-analyses also indicated higher ECC prevalence with breastfeeding beyond 12 months (OR = 1.86; 95% CI, 1.48 to 2.35).

Conclusion: Prolonged breastfeeding beyond 24 months is associated with an increased risk of ECC. This review highlights the need for future studies to address current research limitations and better understand the relationship between prolonged breastfeeding and ECC.

Trial registration: International Prospective Register of Systematic Reviews (PROSPERO): CRD42024509212.

Background: Alveolar lymphangioma is a rare condition that commonly develops on the alveolar ridge of Black male neonates. It typically presents as a bluish, dome-shaped swelling smaller than 1 cm on the posterior alveolar ridge of the mandible or/and maxilla, that allows it to be diagnosed clinically. Most previously reported cases of alveolar lymphangioma report spontaneous resolution, and biopsy is seldom performed unless the lesion becomes symptomatic or interferes with feeding.

Case report: We report a case of oral alveolar lymphangioma on the anterior maxillary alveolar ridge of an 11-day-old infant of non-black descent. The lesion presented as a pedunculated, reddish, lobular mass in the anterior maxilla. Given its atypical presentation and the potential for feeding difficulties, an excisional biopsy was performed. The diagnosis was confirmed histologically through biopsy and supported by immunohistochemical staining.

Conclusion: This case expands the understanding of alveolar lymphangioma by reporting it in a non-Black neonate with an unusual location and appearance, emphasising the need for excisional biopsy to rule out other potential oral lesions, especially neoplasms.

Background: The study introduces novel camouflage sleeves for the 'Dental Syringe Camouflage Technique' (DSCT) as a distraction tool to reduce dental anxiety and pain in paediatric patients while evaluating its efficacy.

Aim: To evaluate the efficacy of DSCT using light-/dark-coloured sleeves to reduce needle-associated anxiety and pain in paediatric dental patients.

Design: A single-blinded, randomized clinical trial with 76 children aged 6-9 years, divided into control and experimental groups. The experimental group was further divided based on sleeve colour. Anxiety was assessed using a self-reported scale, and vital signs were monitored. Local anaesthesia (LA) was administered using conventional dental syringes (CoDSs) or camouflaged dental syringes (CaDSs). Postintervention, self-reported pain was also recorded. Data analysis compared groups and pre- and postintervention observations.

Results: A significant reduction in children's self-reported anxiety was observed in the experimental group compared to the control, with no significant differences in perceived pain. Children with lighter sleeves showed a greater decrease in anxiety scores than those with darker ones.

Conclusions: Camouflage sleeves for LA syringes reduced anxiety during administration but did not significantly impact reported pain. Lighter sleeves were more effective. No significant changes were observed in pulse rate (PR) or blood pressure (BP) with the use of CaDSs.

Background: Oral health outcomes are closely linked to the completion of necessary dental treatment.

Hypothesis or aim: This study seeks to determine the socio-demographic characteristics of children and adolescents and the clinical factors contributing to the noncompletion of necessary dental treatments within a 12-month period at Monash Health Dental Services in Melbourne, Victoria.

Design: Data were collected from seven public health dental sites, capturing all patients younger than 18 years who visited Monash Health Dental Services within a 12-month period.

Results: Of the 7160 children who attended the dental clinics, 24.2% did not complete dental treatment. The majority (79.4%) were between 5 and 17 years of age, with each additional year of age increasing the probability of having an incomplete course of care (CoC). Participants receiving 'Preventive' CoCs were less likely to have incomplete treatments, while Aboriginal and Torres Strait Islander peoples, those who spoke languages other than English or Dari and patients needing interpreters were more likely to have incomplete treatments. Attendees of the different dental clinics had differing odds of noncompletion. The model explained 11.3% of the variance in predicting noncompletion.

Conclusion: This analysis underscored the complex interplay between socio-demographic, enabling factors and clinical circumstances that contribute to incomplete CoCs.

Background: Luxation injuries to the predecessors can cause sequelae in the permanent successors.

Aim: To describe and analyze sequelae in permanent successors according to the child's age at the time of different luxation traumas (concussion, subluxation, extrusion, lateral luxation, intrusion and avulsion) in the primary dentition compared with matched controls.

Design: A retrospective analysis of 206 patients with 360 potentially damaged permanent teeth (PDPT) and 1057 permanent control teeth was performed. The PDPT was sorted into three age groups. The relative risk and level of significance (p = 0,05) of diffuse opacities, demarcated opacities, hypoplasia, and malformations were analyzed using Fischer's exact test and SPSS (version 29.0.1.0 (171), SPSS Inc. IBM Company).

Results: Hypoplasia and malformations occurred more often in the 0-2-years group and were related to lateral luxation, intrusion, and avulsion injuries in the primary dentition. Demarcated and diffuse opacities occurred in all age groups and were related to subluxation, extrusion, lateral luxation, intrusion, and avulsion injuries. The risk was found to be more than seven times greater in trauma subgroups compared to controls.

Conclusion: The younger the child is at the time of traumatic dental injury and the more extensive the luxation injury is, the greater the risk of developing a sequela.

Background: Dental pain is a public health problem that exerts a negative impact on the quality of life of children.

Aim: To determine the causal factors of dental pain in preschool children.

Design: A prospective cohort study was conducted with a random sample of 151 children aged from one to three and their parents/guardians for a period of 3 years in Brazil. Dental pain was investigated using the Brazilian version of the Dental Discomfort Questionnaire (DDQ-B) at baseline and follow-up for the calculation of incidence. The participants were examined clinically for dental caries using the International Caries Detection and Assessment System (ICDAS) and traumatic dental injury was investigated using the criteria proposed by Andreasen. Sociodemographic, economic and food consumption characteristics were investigated during baseline and in the three-year follow-up. Data analysis involved descriptive statistics and Poisson regression analyses.

Results: The incidence of dental pain was 14.6%. The incidence of caries (RR = 3.47; 95% CI: 1.05-11.47) and the absence of dental treatment (RR = 2.81; 95% CI: 1.33-5.97) were associated with a higher incidence of dental pain.

Conclusion: The incidence of dental caries and the lack of dental treatment recommended at baseline were risk factors for a greater incidence of dental pain in preschool children.