Pediatric dentistry最新文献

Purpose: The purpose of this study was to assess the knowledge, attitude, and training of pediatric dental residents and faculty on the management of patients who belong to the LGBTQ (lesbian, gay, bisexual, transgender, and queer) community. Methods: This cross-sectional survey included a 16-item questionnaire to assess the attitudes and training regarding the LGBTQ population, separately for pediatric dental residents and faculty across the United States. Statistical significance was set at the level of five percent, and data were analyzed using descriptive statistics, Wilcoxon rank-sum, and Fisher's exact tests. Results: In total, 132 residents and 40 faculty members completed the survey (response rates equal 14.4 percent and 16.9 percent, respectively). Residents were significantly more likely to respond that requiring LGBTQ training should be in the curriculum and that they have acquired skills to provide equal service to both LGBTQ and non-LGBTQ patients and families (faculty equals 35 percent, residents equals 57.6 percent; P<0.001). Residents were significantly more likely than faculty to respond that the American Academy of Pediatric Dentistry should publish an exclusive policy statement regarding LGBTQ oral health disparities (faculty equals 40 percent, residents equal 62.1 percent; P=0.01). Conclusions: The resident and faculty of pediatric dentistry programs in the United States have adequate awareness of managing lesbian, gay, bisexual, transgender, and queer (LGBTQ) patients in the dental office and are willing to treat these patients, and most respondents have an interest in further education.

Purpose: Using a systematic review to answer the following question: What are the treatment patterns for mild and severe molar hypomineralization in permanent teeth? Methods: Electronic searches were conducted to identify randomized clinical trials (RCT) that related treatment to molar hypomineralization- (MH) affected permanent molars in children from five to 16 years old. Data extraction and risk of bias evaluation, using the Cochrane risk of bias tool, were performed for all included studies. Studies were selected according to PICOS criteria. RCTs relating mild and severe MH to treatments on permanent molars were included. Studies analyzing clinical techniques, whether single or any association of tech- niques for restorative and desensitizing treatments, were included. Studies involving another disease or comparing different types of enamel defects related to trauma and hereditary were excluded. The certainty of the evidence was evaluated using the GRADE approach. Results: The electronic search was performed on MEDLINE via PubMed, Embase, Cochrane Library, and Grey literature up to May 9, 2022. Of the 5,201 studies initially identified, 88 were fully assessed and 14 RCTs were included. A total of 2,399 interventions were analyzed in 576 patients. Certainty of evidence was found to be of low quality for the outcomes remineralization, structural integrity maintenance, and decay prevention, and very low quality for hypersensitivity decrease and retention. Conclusions: Mild molar hypomineralization needs remineralization, desensitization, sealants, and close follow-up. Severe MH requires restoration both to treat hypersensitivity and reconstruct the affected teeth. Yellow-brown defects have a poor prognosis.

Purpose: The purpose of this split-mouth design study was to evaluate the clinical success and survival of glass hybrid (GH) and direct composite with short fiber-reinforced composite (SFRC) after selective caries removal in restorations of permanent first molars that were affected by molar hypomineralization (MH). Methods: Thirty-one children aged six to 12 years with severe MH were randomly assigned as follows: group one equals GH (Equia Forte^® HT) and group two equals SFRC (EverX Flow TM ) covered by micro-hybrid composite (G-Aenial® posterior composite). For selective caries removal, only disorganized dentin in the pulpal and the axial wall was removed using low-speed tungsten carbide burs and hand instruments. The restoration longevity was evaluated at baseline and six, 12, and 24 months after treatment according to modified US Public Health Service (USPHS) criteria. Results: Seven GH and two SFRC restorations failed within two years of the follow-up period. The clinical success of all restorations decreased statistically over time for retention and marginal adaptation criteria of USPHS criteria (P<0.001 for both criteria). The direct composite with SFRC was 3.32 times (confidence interval equals 1.26 to 8.79) more successful than GH restorations in terms of retention according to the USPHS criteria (P=0.016). However, survival at 24 months was 93.5 percent (±4.4 standard error [SE]) and 77.4 percent (±7.5 SE) for SFRC and GH restorations, respectively. Conclusion: The retention of the direct composite with short fiber-reinforced composite was superior to glass hybrid restorations at 24 months in the management of molar hypomineralization-affected molars.

Purpose: To assess the oral health status of children with Down syndrome (DS) in the United States and evaluate the oral health needs of families with DS. Methods: Among 320 parents who consented to participate, 260 (81.2 percent) surveys were completed. A survey was distributed through the National Down Syndrome Society to parents of children with DS up to age 21 years, which asked questions about children's general and oral health. Results: Parents who reported that their children had difficulty rinsing and spitting were more likely to report their child's overall general health as poor (P<0.05). Parents' frequency of daily toothbrushing was similar to their children's toothbrushing habits (P<0.05). Conclusions: Dysphagia for children with Down syndrome may negatively impact oral health in addition to general health. Encouraging parental involvement in oral care for children with DS may lower their risk for oral disease. Continued support is needed to ensure dental school education includes training for the treatment and management of patients with DS.

Purpose: To evaluate the association between the introduction of total sugar foods (TSF) in the first six months of age and the prevalence of early childhood caries (ECC) and its consequences for dental pulp in preschool children. Methods: A representative cross-sectional study was conducted with 533 preschool children (four to six years old) in Ribeirão das Neves, Brazil. The decayed, missing, and filled teeth (dmft) index was used for determining ECC. The visible pulp, oral mucosa ulceration due to root fragments, fistula, and abscess (pufa) index was used for the pulp consequences of dental caries. Parents/caregivers answered a questionnaire addressing sociodemographic characteristics and the children's diet. Statistical analysis was performed using multiple logistic regression (P<0.05). Results: The multiple logistic regression model adjusted for family income and breastfeeding showed that preschool children who were introduced to TSF prior to six months of age were 1.58 times more likely to have ECC (95 percent confidence interval equals 1.09 to 2.30). The multiple logistic regression model, adjusted for family income, breastfeeding, and brushing behaviors, showed that preschool children who were introduced to TSF prior to six months of age were 2.30 times more likely to have pulp consequences (95 percent confidence interval equals 1.35 to 3.91). Conclusion: The early introduction TSF is associated with a higher prevalence of early childhood caries and pulp consequences in preschool children. The negative effects on oral health may be greater when the introduction of TSF occurs prior to six months of age.

Purpose: To compare the effectiveness of articaine local infiltration with lidocaine inferior alveolar nerve block (IANB) for restorative treat- ment of primary mandibular molars (PMMs). Methods: In this double-blind, parallel-design, randomized, controlled, clinical trial, participants were enrolled according to specified inclusion criteria (four to 10 years of age, need of PMM restorations, Frankel four behavior) and randomly assigned into either an articaine or lidocaine group. One investigator administrated all local anesthesia (LA). Nineteen trained and calibrated exam- iners, blinded to LA type, evaluated participants' reactions during LA administration and treatment using Modified Behavioral Pain Scale (MBPS). Participants rated their experiences using Wong-Baker FACES Pain Rating Scale (WBFS). The subjects' blood pressure and pulse were recorded throughout procedures. Statistical analysis employed Mann Whitney-U test, repeated measures analysis of variance (P<0.05), and Cohen's kappa. Results: A total of 110 participants (n equals 55 per group; mean age equals 6.42 years; 60 percent males) were enrolled. The mean MBPS rating during LA administration was higher for lidocaine IANB (3.89) compared to articaine infiltration (2.24; P<0.001). The mean MBPS rating through- out treatment was higher for the lidocaine group (2.51) compared to articaine group (1.69; P=0.012). The lidocaine group had a mean WBFS score of 1.64, while for the articaine group WBFS was 0.872 (P=0.089). All physiological measurements were within normal limits with no difference between groups. Conclusions: This study demonstrated that local infiltration with articaine was less distressing upon administration and may be considered safe and effective alternative to lidocaine IANB for restorative treatment in PMMs.

Purpose: The purpose of this study was to find potential risk factors associated with the occurrence of developmental defects of enamel (DDE) in permanent dentition of a birth cohort in Southern Brazil. Methods: This study is a 2004 birth cohort carried out in the city of Pelotas, Rio Grande do Sul, Brazil. A subsample of 996 children was clinically examined at 12 to 13 years of age. The pre- and perinatal variables used for this study were: twin pregnancy; type of delivery; prematurity; birth weight; Apgar score in the first and fifth minute; health problems at birth; and intensive care unit admission at birth. Gender and family income variables were also collected. Some postnatal variables were collected: "hospitalization in the first 24 months"; "breastfeeding"; "respiratory diseases in the first 48 months"; "urinary infection in the first 48 months"; and "ear pain in the first 48 months." To assess an association between the presence of DDE and various risk factors, unadjusted and adjusted Poisson regression with robust variance was performed with a respective prevalence ratio. Results: The prevalence of DDE was 40.8 percent. The variables investigated did not present a statistical association with DDE. Conclusion: No association of developmental defects of enamel in permanent dentition with any of the factors investigated in this study was found.

Purpose: To design, fabricate, and evaluate in vitro 3D printed space maintainers (SMs) and compare their retentive capabilities to tradi- tional stainless-steel (SS) space maintainers. Methods: E-Guard was selected as the printing material based on flexural strength and elastic modulus. SMs with a claw design were printed, cemented to testing blocks, and vertically loaded to determine failure strength and flexure (n equals 10). The intaglio surfaces of SM bands, printed with plain, crosshatched, or horizontal ridges, were cemented to extracted primary teeth. The force needed to dislodge the bands was compared to cemented traditional SS bands (n equals 14). Results: Flexural strength (mean±standard deviation [SD]) of E-Guide, E-Dent, and E-Guard materials was 65±12, 90±13, 134±25 MPa, respectively. Elastic modulus (mean±SD) was 1.54±0.40, 2.49±0.14, 2.65±0.89 GPa, respectively. When subjected to vertical loading, the mean failure load of 3D printed SMs (E-Guard) was 124 N and the mean deflection at fracture was 1.73 mm. Retention strengths (mean±SD) of 3D printed bands were 32±13, 43±13, 43±16 N for the plain printed, cross- hatched, and horizontal ridges designs, respectively. The retention strength of traditional SS bands was 126±27 N. Conclusions: E-Guard had superior mechanical properties among tested printing resins. Strength and deflection under the vertical load of claw-design 3D printed space maintainers may be adequate as a viable alternative to traditional SMs. Retention of 3D printed SMs was significantly lower than for traditional SS bands. Textured intaglio surfaces did not significantly improve the retention of 3D printed bands.