Pediatric dentistry最新文献

Purpose: The purpose of this study was to compare recall attendance after dental rehabilitation with general anesthesia versus recall attendance after treatment performed with oral conscious sedation. Methods: This was a retrospective chart review of 733 patients who underwent general anesthesia or oral conscious sedation to complete dental treatment from January 2015 to February 2018. Six hundred patients received general anesthesia (GA), and 133 received oral conscious sedation (OCS). Demographic data, procedural dates, recall attendance, insurance reimbursement, and behavior scores were recorded. Results: A total of 31.8 versus 52.6 percent of the GA versus OCS group attended a periodic examination within one year of their restorative appointment. Conclusions: Oral conscious sedation patients attended periodic examinations within one year more often than general anesthesia patients. Increased mileage distance for both groups decreased the odds that patients would attend a periodic examination.

Purpose: The purpose of this study was to evaluate the surface roughness of three different brands of prefabricated pediatric zirconia crowns (ZRCs) following simulated toothbrushing with a variety of dentifrices. Methods: Ninety-six total maxillary right central incisor prefabricated pediatric ZRCs (n equals 32 ZRCs/brand) were obtained from the manufacturers: Kinder Krowns^®, NuSmile^®, and Sprig^®. ZRCs were equally assigned to dentifrices (n equals eight/dentifrice) with a variety of Relative Dentin Abrasion (RDA) values: Tom's of Maine Children's; Crest Kid's; Prevident 5000; and Crest^® Pro-Health. ZRCs were brushed 10,000 strokes with a V-8 Toothbrushing Machine using the assigned dentifrices. Pre- and post-intervention data for the surface roughness of ZRCs, represented in Ra (average roughness) and Rz (mean roughness depth), were obtained using a stylus profilometer. Data were analyzed independently using two-way repeated measures analysis of variance with the Holm- Sidak method (α equals 0.05). Results: Baseline versus brushed Ra Kinder Krowns^® with Prevident and Sprig^® with Crest Kid's indicated statistically significant differences. Sprig^® versus NuSmile^® utilizing Crest Kid's were different in change in roughness. Both baseline and brushed NuSmile^® dentifrice options were different versus all Sprig^® and Kinder^® ZRCs. Conclusions: Despite statistical significance, changes in surface roughness were small in scale. Although this study did not address toothbrushing and different dentifrices may affect the mechanical properties, durability, and/or retention properties of ZRCs, the study's results provide confidence to clinicians when using prefabricated pediatric ZRCs as a sustainable treatment option along with other restorative options, such as strip crowns and stainless steel crowns.

Purpose: The purpose of this study was to report the prevalence of early childhood caries (ECC) and severe early childhood caries (S-ECC) in the United States and to examine trends from 2013 to 2018 in children under six years of age. Methods: Data were obtained from National Health and Nutrition Examination Survey (NHANES). Data from three consecutive cycles (2013 to 2014, 2015 to 2016, and 2017 to 2018) were analyzed. A total of 3,157 children younger than six years of age were included in the analysis. The proportion of children with ECC who developed S-ECC was calculated to assess the severity of the disease burden. Multivariable logistic models were used to determine the significance of both linear and quadratic trends. Subgroup analyses were done to test trends in different population groups. Results: The overall prevalence of ECC from 2013 to 2018 was 18.6 percent; the overall prevalence of S-ECC during this interval was 10.6 percent. The prevalence of ECC decreased from 2013 to 2014 (19.6 percent) to 2015 to 2016 (17.4 percent) but increased from 2017 to 2018 (to 18.7 percent). By contrast, the prevalence of S-ECC increased substantially from 2013 to 2014 (9.8 percent) through 2017 to 2018 (11.9 percent). The proportion of children with S-ECC among those with ECC increased from 2013 (49.9 percent) to 2018 (63.4 percent; linear P=0.048) with a significant linear increase among five-year- old (P=0.013), males (P=0.037) and children in families with income 100 percent of the Federal Poverty Guideline (P=0.003). Conclusion: A greater proportion of children with early childhood caries developed from 2017 to 2018 versus 2013 to 2014.

Purpose: The purpose of this study was to evaluate the clinical retention capabilities of a self-etch adhesive system (experimental group) and conventional acid-etch (control group) techniques and compare the caries incidence within six months and 24 months of follow-up periods. Methods: A total of 47 healthy children with a mean age of 9.7 years and either sound or noncavitated erupted permanent first molars were included in the trial. A total of 188 molars were randomly assigned in a split-mouth design for the self-etch mode in the universal adhesive or conventional acid-etch. Differences in sealant retention and caries incidence were compared at six and 24 months after sealant placement using a chi-square test. Results: Within 24 months of follow-up, the retention of fissure sealant applied using conventional acid etching (41 out of 66; 62.1 percent) was significantly higher (P<0.05) than that of the fissure sealant applied using self-etching mode in the universal adhesive system (17 out of 66; 25.8 percent). There was no significant difference in caries incidence between the two groups up to 24 months after sealant placement. Conclusion: With 24 months of follow-up, the retention of the conventional acid-etching technique were superior to those of the self-etch technique.

Purpose: The purpose of this study was to evaluate the association between probable awake bruxism (PAB) and school bullying in children and adolescents. Methods: A total of 380 children and adolescents enrolled in public and private schools in the city of Lavras, Minas Gerais, Brazil, participated in this case-control study. The case group (190 children with PAB) and the control group (190 children without PAB) were matched for sex and age. Data acquisition involved questionnaires administered to the children/adolescents and their parents/caregivers. An oral clinical examination to assess attrition tooth wear was also performed. Descriptive statistics and logistic regression analyses (95 percent confidence interval [95% CI], P<0.05) were conducted. Results: Among the 380 participants, 176 (46.3 percent) were male and 204 (53.7 percent) were female. Children and adolescents who were involved in bullying episodes as victims/bullies (odds ratio [OR] equals 2.92, 95% CI equals 1.07 to 7.95, P=0.036) and victims (OR equals 1.93, 95% CI equals 1.04 to 3.57, P=0.037) were significantly associated with PAB. Children and adolescents who reported sleep problems (OR equals 2.51, 95% CI equals 1.07 to 5.89, P=0.033) were significantly associated with PAB. Conclusion: Based on the results, it was observed that probable awake bruxism is associated with involvement in episodes of school bullying and sleep problems.

Purpose: The purpose of this study was to compare the effectiveness of intranasal fentanyl combined with oral midazolam to oral midazolam alone in pediatric dental patients. Methods: Thirty-two uncooperative healthy children aged three to six years old, who met the inclusion criteria, were randomly assigned to receive oral midazolam (0.7 mg/kg) with either intranasal fentanyl (one μg/kg) or intranasal placebo (saline). A controlled, randomized, double-blinded, crossover clinical trial design was followed so that each child received both regimens. Data collected included the onset of sedation, working time, sedation and behavior assessment, and occurrence of side effects. Results: The onset of sedation time was not statistically different between the two groups (P=0.62), while the median working time of the midazolam/fentanyl sedation was sig- nificantly longer than the midazolam sedation (P<0.001). Sedation scores were significantly better with the midazolam/fentanyl sedation regimen at separation from parents (P=0.032), local anesthesia administration (P=0.018), rubber dam application (P=0.035), after five minutes of dental treatment (P=0.035), after 10 minutes (P=0.039), after 15 minutes (P=0.012), and after 20 minutes (P=0.038). Behavior scores were significantly better with the midazolam/fentanyl sedation only at local anesthesia administration (P=0.021), rubber dam placement (P=0.004), and after five minutes of dental treatment (P=0.049). Minor side effects occurred in 12.5 percent of sedation procedures and were not significantly associated with either of the two groups (P=0.70). Conclusion: The combination of oral midazolam with intranasal fentanyl sedation, when compared to oral midazolamas a single agent, significantly improved sedation and behavior during local anesthesia and operative dentistry for healthy three- to six-year-old children in addition to prolonged sedation working time.