International journal of paediatric dentistry最新文献

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: Initial caries lesions in primary teeth have presented a low progression rate after 2 years, but it could be higher in longer follow-ups.

Aim: To evaluate the progression rates of sound surfaces and initial and moderate caries lesions after 7 years.

Design: This prospective 7-year cohort study included 639 preschool children aged 1-5 years in 2010. In 2017, 449 children were reassessed (70.3% retention rate). Dental caries was collected using the International Caries Detection and Assessment System (ICDAS) in both assessments. Incidence rate (IR) per 100 surface-years estimated the progression rates of sound surfaces and initial and moderate lesions for worse conditions. Cox regression with shared frailty evaluated the possible risk factors.

Results: IR was 1.0% for sound surfaces, 2.8% and 4.2% for ICDAS scores 1 and 2, respectively, and about 17.0% for moderate lesions. The most significant risk factor for the progression was the presence of cavitated lesions in other teeth. The type of surface and tooth also influenced the outcome.

Conclusion: The progression rate of initial caries lesions in primary teeth remains low even after 7 years, but cavitated caries lesions in other teeth increase this risk. Moderate lesions demonstrate a higher risk of progression when compared to sound surfaces and initial caries lesions.

Chrisopoulos S, AlKhtib AO, Al Darwish MS, et al. Correlates of childhood caries: A study in Qatar. Int J Paediatr Dent. 2024; 34: 179–189. doi:10.1111/ipd.13123

In the article entitled “Correlates of childhood caries: A study in Qatar” that was previously published in Volume 34 Issue 2 of International Journal of Paediatric Dentistry, the open access funding statement was not included.

The statement has now been included.

We apologize for this error.

Background: Referrals of paediatric patients to a university clinic have been increasing over the last several years.

Aim: To evaluate characteristics of referred and non-referred patients at the University of Iowa's Pediatric Dental Clinic (UIPDC).

Design: A retrospective chart review included dental records of 340 referred and 383 non-referred patients from July 1, 2015, to May 31, 2016 (n = 723). Age, distance to the clinic, size of the patient's community, insurance, number of teeth with decay, treatment needs, educational level of the provider, and presence of patient special health care needs were obtained. Descriptive statistics, bivariate analysis, and multivariable logistic regression were performed to analyze the outcomes (alpha = .05).

Results: Referred patients were more likely to live >60 miles away, live in a community of >75 000 people, have special health care needs, have caries/greater number of teeth with decay, need endodontic treatment, and were less likely to remain patients at the clinic (p < .0001). Referred patients were also more likely to need extractions (p = .0104), but less likely to need space maintenance/comprehensive orthodontic treatment (p = .0002).

Conclusion: There was a difference in the complexity of patient treatment needs between referred and non-referred patients.

Background: There is currently insufficient evidence on potential predictors of a child's behaviour with nitrous oxide (N₂O) sedation.

Aim: To examine the association between a child's temperament and behavioural outcomes during dental treatment with N₂O sedation, and the child's perception to N₂O sedation.

Design: At the first visit (dental treatment visit), temperament was assessed using the Child Behaviour Questionnaire-Short Form and behaviour was assessed by an independent rater using the Venham Behaviour Rating Scale. At the second visit, the child's experience with N₂O sedation was elicited.

Results: Seventy-two healthy children aged between 36 and 95 months were recruited. Planned dental treatment was completed in 84.7% of the subjects. Venham behaviour success <3 and Venham behaviour success <1 were achieved in 73.6% and 33.3%, respectively. The temperament domain of effortful control was associated with Venham behaviour score (ρ = -0.266, p = .024) and Venham behaviour success <1 (OR = 3.506, 95% CI = 1.328-9.259, p = .011). Baseline Frankl behaviour score was significantly associated with all behavioural outcomes. Venham behaviour success <3 was significantly associated with a child reporting to have enjoyed the dental treatment visit (p = .026).

Conclusion: Effortful control and baseline behaviour were associated with behavioural outcomes of N₂O sedation and can be used to predict a child's behaviour.

Background: Changes in healthy and inflamed pulp on periapical radiographs are traditionally so subtle that they may be imperceptible to human experts, limiting its potential use as an adjunct clinical diagnostic feature.

Aim: This study aimed to investigate the feasibility of an image-analysis technique based on the convolutional neural network (CNN) to detect irreversible pulpitis in primary molars on periapical radiographs (PRs).

Design: This retrospective study was performed in two health centres. Patients who received indirect pulp therapy at Peking University Hospital for Stomatology were retrospectively identified and randomly divided into training and validation sets (8:2). Using PRs as input to an EfficientNet CNN, the model was trained to categorise cases into either the success or failure group and externally tested on patients who presented to our affiliate institution. Model performance was evaluated using sensitivity, specificity, accuracy and F1 score.

Results: A total of 348 PRs with deep caries were enrolled from the two centres. The deep learning model achieved the highest accuracy of 0.90 (95% confidence interval: 0.79-0.96) in the internal validation set, with an overall accuracy of 0.85 in the external test set. The mean greyscale value was higher in the failure group than in the success group (p = .013).

Conclusion: The deep learning-based model could detect irreversible pulpitis in primary molars with deep caries on PRs. Moreover, this study provides a convenient and complementary method for assessing pulp status.

Background: Changes in bone age and tooth development are late side effects of cancer therapy and can be identified by imaging examination.

Aim: To evaluate the late effects of antineoplastic treatment on bone age and dental development in childhood cancer survivors.

Design: This is a retrospective case-control study on paediatric cancer survivors of both sexes who underwent antineoplastic treatment with 5-15 years of survival. Carpal radiographs were assessed for bone age and growth curve, and panoramic radiographs were used to evaluate dental development and alterations. Carpal radiographs were analyzed using the Greulich and Pyle inspection method, and the Martins and Sakima method was used to analyze the growth curve. All tests were applied with a confidence level of 95%.

Results: The study and control groups comprised 28 and 56 patients, respectively. There was no significant difference in bone age and growth curve between the study and control groups. Nonetheless, when sex was compared to chronological and bone ages, there was a significant difference in bone age (p = 0.019) and an underestimation in both groups and sexes in the Greulich and Pyle method. As to late dental effects, dental agenesia, microdontia, gyroversion, and unerupted teeth were found. Dental shape alterations mainly involve the root region.

Conclusion: Close multidisciplinary collaboration is necessary during the follow-up period of young patients who have survived cancer.