Pediatric dentistry最新文献

Purpose: The purpose of this study was to evaluate and compare the long-term clinical retention and gingival health of prefabricated zirconia crowns (PZCs) in primary molar teeth cemented using three luting cements.

Methods: Primary molar teeth restored with PZCs (n equals 30 per group) were cemented using glass ionomer cement (GIC), resin-modified GIC (BioCem™), or adhesive resin cement (APC technique: air- particle abrasion, zirconia primer, composite resin). Crown retention, plaque accumulation, and gingival status were evaluated over three years; cumulative crown survival was assessed using Kalpan-Meier analysis. Plaque gingival scores were analyzed for within and between groups using repeated measures one-way analysis of variance.

Results: The survival of PZCs cemented using GIC was 76.7 percent, 70 percent for APC, and 50 percent for BioCem™ after three years. The mean survival for PZC in the GIC group (35.5 months) was significantly higher than for APC (34.7 months), and BioCem™ (33 months; P=0.019). Plaque accumulation around GIC-luted crowns was significantly lower (P<0.001; three-year follow-up); gingival outcomes were uniformly favorable between groups. No crown fracture was observed throughout the study period.

Conclusions: Prefabricated zirconia crowns cemented using traditional glass ionomer cement have superior retention and lower plaque accumulation compared to BioCem™ and APC after three years. PZCs provided long-term favorable gingival health outcomes irrespective of the cement used for luting the crowns.

Purpose: The primary purpose of this study was to assess the efficacy of cryotherapy applications on the success of an inferior alveolar nerve block (IANB) to reduce pain severity during a pulpectomy of primary molars with symptomatic irreversible pulpitis (SIP). The secondary purpose was to assess children's behavior before and during pulpectomy procedures and the need for supplementary local anesthesia injections.

Methods: A randomized parallel controlled trial included 170 healthy children aged five to nine years who complained of carious primary mandibular second molars with SIP. After an IANB administration, ice packs (cryotherapy group) were applied to half of the participants while the other half did not receive ice packs. During pulpectomy, pain severity was tested using the Wong-Baker FACES Pain Rating Scale (WBS). A failure of anesthesia was encountered in the case of moderate or severe pain reported. Children's behavior was assessed using Frankl's Behavior Rating Scale (FBRS) before and after clinical procedures.

Results: The overall success of IANB with cryotherapy (i. e., no or mild pain) was 79.2 percent, which was significantly superior to the control group (50.6 percent; P=0.007). The postoperative children's positive behavior proportions in the cryotherapy group were significantly higher compared to the control group (P=0.001).

Conclusions: Cryotherapy application significantly improved inferior alveolar nerve block efficacy, diminished pain intensity, and improved children's behavior during pulpectomy of primary molars with symp- tomatic irreversible pulpitis. Based on these findings, cryotherapy application after IANB deposition is recommended.

Purpose: The purpose of this in vitro study was to investigate the effect of applying silver diamine fluoride (SDF) followed by a saturated solution of potassium iodide (SSKI) on the microtensile bond strength (mTBS) of composite resin to the natural carious dentin of primary molars.

Methods: Sixty-nine extracted carious primary molars were randomly allocated to one of the three groups, where the prepared affected dentin was treated with: (1) group A-SDF/SSKI; (2) group B-SDF alone; and (3) group C-deionized water. After restoration with composite resin restorative material, specimens were prepared and tested for mTBS in the universal testing machine. Median bond strengths were compared using the Kruskal-Wallis test.

Results: The median (range) values of mTBS in groups A, B, and C were 16.99 (6.55 to 95.60), 17.71 (4.93 to 101.1), and 24.60 (5.29 to 91.7) MPa, respectively. There was no statistically significant difference in the microtensile bond strength among the three groups (P=0.94).

Conclusion: The application of either silver diamine fluoride along with a saturated solution of potassium iodide or SDF alone does not have a significant inhibitory effect on the bond strength of the composite resin to carious dentin in vitro.

Purpose: The purpose of this study was to compare one-year clinical outcomes of primary incisor strip crowns (SCs) and zirconia crowns (ZCs) and determine the frequency of pulp therapy associated with each technique.

Methods: Children aged 18 to 48 months were randomly assigned to a ZC group or SC group. Each incisor was rated as intact (I), damaged (D), or requiring treatment (TR) six and 12 months following placement.

Results: Seventy-six ZCs and 101 SCs were placed for 59 participants; ZCs were more likely to be rated I than SCs at six months (odds ratio [OR] equals 4.2; P=0.01) and 12 months (OR equals 4.0; P=0.02). There was no statistical difference in the frequency of pulp therapy between groups (OR equals 0.8; P=0.70). There were no deviations from treatment randomization in either group.

Conclusions: Zirconia crowns were more likely than strip crowns to be rated as intact at six or 12 months after treatment. The frequency of pulp therapy was not statistically different between groups.

Purpose: The purpose of this study was to use fluoride-hesitant parents as a model to identify the factors that erode versus build trust in their child's dentists.

Methods: A qualitative study was conducted using a semi-structured interview guide with fluoride-hesitant parents recruited from two dental clinics and through snowball sampling. A content analysis was performed to identify factors that erode versus build parents' trust in their child's dentist.

Results: Of the 56 parents interviewed, most were female (91.1 percent) and white (57.1 percent) and had a mean age of 41±9.7 (standard deviation) years. Factors identified included five that erode trust (having trust violated previously, sensing discrepancies, getting pushed to accept fluoride, feeling dismissed, and sensing bias) and four that build trust (being treated as an individual, having a dentist who communicates, feeling supported and respected, and having a choice).

Conclusions: Dentists' understanding of the factors that erode and build trust with parents could help providers develop patient-centered communication strategies.

Purpose: The purposes of this study were to: (1) examine adolescents' knowledge regarding e-cigarettes and e-cigarette or vaping product use-associated lung injury (EVALI), and (2) describe common misconceptions regarding e-cigarette use.

Methods: Adolescents aged 13 to 19 years were recruited in pediatric dental clinics and completed a survey questionnaire regarding their knowledge of e-cigarettes.

Results: A total of 66 adolescents participated. Forty-seven adolescents indicated knowledge of e-cigarettes. Forty adolescents recognized that most e-cigarettes contain nicotine, and 49 adolescents reported knowledge of EVALI cases. Adolescents had knowledge of possible lung damage from e-cigarette use. Adolescents also had misconceptions about e-cigarettes containing nicotine and them being less addictive than other tobacco products.

Conclusions: Adolescents were aware of e-cigarette or vaping product use-associated lung injury cases, and the majority of them viewed e-cigarette use as harmful to their health. However, some adolescents had misconceptions regarding the safety of e-cigarette use. Oral health providers should recognize that they play an important role in identifying risky behaviors amongst adolescents, incorporate adolescent-specific risk assessments into their clinical practice, and be comfortable providing anticipatory guidance about e-cigarette and nicotine use.

Purpose: The purpose of this study was to compare the retention of 3M stainless steel crowns^™ (SSCs), Kinder Krowns^® zirconia crowns (ZCs), and EZCrowns ZCs on extracted primary mandibular second molars ex-vivo.

Methods: A total of 45 extracted primary mandibular second molars were allocated randomly to either of the three groups. All teeth were mounted in Dentsply acrylic molds and then prepared for crown cementation. Crowns were cemented with glass ionomer cement (GIC). Retention testing was performed using Instron 5566A. Differences in retention between the groups were tested via Welch's analysis of variance (ANOVA), and post hoc comparisons were performed with the Games-Howell test.

Results: Welch's ANOVA resulted in statistically significant differences between the three groups (P<0.001). The mean±SD force in Newtons (N) for the SSC group, Kinder Krowns^® group, and EZCrowns group were 337.0±137.1 N, 89.4±53.6 N, and 106.5±77.7 N, respectively. Post hoc comparisons with the Games-Howell test presented that the SSC group had significantly higher retention than both the ZC groups (P<0.001). There was no significant difference between the ZC groups (P=0.76).

Conclusions: Within the limitations of this ex-vivo study results, due to their statistically significant higher retention, stainless steel crowns should be selected over zirconia crowns when in need of a full coverage restoration. But if esthetics are a concern, dentists can choose freely between either of the ZCs tested in this study.