European Archives of Paediatric Dentistry最新文献

Purpose: The aim of this study is to perform the cross-cultural adaptation and validation of the RMS-Pictorial Scale (RMS-PS) for use with Brazilian children and adolescents.

Methods: The RMS-PS was developed to measure self-perceived dental anxiety in children. The photographs of Brazilian children reproducing the faces of the original scale were taken and discussed by a Committee of Experts. The first step was to produce four versions of the scale (a white girl, a black girl, a white boy, and a black boy) to guarantee the representativeness of the population. The scale was tested in two pre-tests before the definition of the final version of each one. An original form (5 faces) for 7-14-year-old children and adolescents a short form (3 faces) for 4-6-year-old children were developed. Sixty children and adolescents (mean age = 7.67) responded to the RMS-PS, the Facial Image Scale (FIS) and the Children's Fear Survey Scale-Dental Subscale (CFSS-DS). Statistical analyses included a descriptive analysis, the Intraclass Correlation Coefficients (ICC), the Spearman correlation, and the Mann-Whitney test.

Results: Test-retest reliability showed a good correlation for the children's self-reporting of the B-RMS-PS across the two-week interval (ICC = 0.791; 95% CI 0.673-0.870). Convergent validity was confirmed by the correlation between the B-RMS-PS and the FIS (r = 0.524, p < 0.001). The children with proxy-report dental anxiety had greater B-RMS-PS scores than those without anxiety (p = 0.010) supporting discriminant validity.

Conclusion: The B-RMS-PS showed good psychometric characteristics, being reliable and valid to be used with Brazilian children and adolescents.

Purpose: To describe the prevalence of molar incisor hypomineralisation (MIH) and a selection of potentially associated factors amongst 8-year-olds in Ireland.

Methods: This study reports cross-sectional data from the Fluoride and Caring for Children's Teeth (FACCT) study 2017. Eight-year-olds in Dublin (n = 786) and Cork-Kerry (n = 1524) were clinically examined for MIH (EAPD criteria) and dental caries (DMFT). The association between potential aetiological factors and MIH was assessed using multivariable logistic regression. Potential effects of MIH on dental caries, oral health-related quality of life (OHRQoL) and parental perceptions of the appearance of their child's permanent incisors were investigated.

Results: MIH prevalence was 11% in Dublin and 9% in Cork-Kerry. In Dublin, prevalence of MIH was higher amongst children who had health problems in the past year. There was no association between community water fluoridation and MIH in Cork-Kerry. In both regions, dental caries was higher amongst children with MIH. Parents of children with MIH in Dublin and Cork-Kerry were more likely to have noticed marks on their child's permanent incisors. In Dublin, MIH was associated with poorer parent-reported OHRQoL. Parents of children with MIH in Cork-Kerry were less likely to be satisfied with the colour of their child's permanent incisors.

Conclusions: MIH prevalence was 9-11%. The association between MIH and dental caries suggests that MIH severity in Ireland may be high. There is an urgent need for national data on MIH prevalence and severity, early identification of children with MIH and provision of preventive and treatment services in line with international best practise.

Purpose: There is controversy and debate around the use of pharmacological and physical dental behaviour support techniques amongst practitioners treating patients with challenging behaviour and intellectual and neurodevelopmental disabilities. However, the experiences of patients and caregivers remain underexplored. This scoping review aimed to identify the experience of patients with intellectual and neurodevelopemental disabilities and challenging behaviour and their caregivers regarding the use of physical and pharmacological procedures during dental care.

Methods: A scoping review was conducted, incorporating evidence from both quantitative and qualitative study designs to clarify concepts and identify gaps in the literature, using all the main medical databases.

Results: From 1575 screened records, 13 studies were included. Ten were quantitative or mixed-method studies focusing on the acceptance of behaviour support techniques from the caregiver's perspective, particularly for children with special needs. Seven studies were from the Americas, none from Europe or Africa. Two major themes emerged: validity of consent; and the acceptance of different dental behaviour support techniques by parents and caregivers.

Conclusion: The most acceptable techniques for parents and caregivers were non-invasive, behaviour based support techniques. When these failed, physical support techniques seemed to be more acceptable than pharmacological approaches (sedation or general anaesthesia), although this may be related to cultural context and/or lack of financial support. No studies reported the patient perspective of behaviour support techniques so no conclusions can be drawn as to which techniques are acceptable from the patient's point of view. Further qualitative studies are essential to explore the experiences and expectations of patients with special dental care needs.

Purpose: To determine the root resorption pattern and calculate the root resorption length of mandibular primary molars in children.

Methods: A cross-sectional and descriptive study was conducted of 367 panoramic radiographs of healthy nonorthodontic children, 169 girls with a mean age of 9.39 years and 198 boys with a mean age of 9.02 years. The length of the mesial and distal roots of the primary molar was calculated using a computer program (PixelStick®) that measures the pixels indicated in the image. Student's t test, the Mann‒Whitney U test and the Kruskal‒Wallis test were used for comparisons, and p < 0.05 indicated statistical significance.

Results: A 0.84 mm delay in root resorption of the first mandibular primary molar (74) in boys was described. There was also a delay in the resorption of the mesial root of 0.89 mm and 1.12 mm from the distal root of the second mandibular primary molar (75) in boys and a significant increase in root resorption in girls (p < 0.05). The mesial and distal roots of the first mandibular primary molar were resorbed equally; however, the mesial root of the second mandibular primary molar was resorbed before the distal root.

Conclusions: Delays in root resorption were detected in boys, whereas advances in root resorption were detected in girls. The root resorption pattern of the first mandibular primary molar was symmetrical; however, the resorption pattern of the second mandibular primary molar was asymmetric, with the mesial root being resorbed first. Clinical and radiographic monitoring of mandibular primary molars with unevenly resorbed roots is recommended to avoid the complications associated with over retained molars.

Purpose: The aim of the current study is to evaluate the possible effects of the sight of the dental needle as part of the "Tell-Show-Do" technique on children's fear, pain perception and behaviour, during anaesthesia administration.

Methods: A total of 60 4-8 year-old children with no previous experience of local anaesthesia (LA), in need of restorations under LA, were randomly assigned in G1:Hiding-Needle-Technique (HN-T) and G2:Showing-Needle-Technique (SN-T). Children's Fear Survey Schedule-Dental Subscale, Wong-Baker Faces Pain Rating Scale (WBFPS), Frankl Behaviour Scale and heart rate (HR) were used.

Results: Objective evaluation of fear, using heart rate, was significantly higher for G1:(HN-T) compared to G2:(SN-T) during demonstration at the first appointment (p value = 0.013) and needle insertion at both appointments (p value = 0.08, p value = 0.04 respectively). No statistically significant relationship was found between the two groups regarding WBFPS questionnaire and Frankl Behaviour Rating Scale.

Conclusions: The sight of the needle was not found to affect reported fear. Statistical increases in HR were observed in children, independent of age and gender. Changes in HR indicated that not viewing the needle elicited greater fear than seeing it, for children aged 4 to 8 years when "Tell-Show-Do" is used. Pain perception and behaviour were not affected.

Purpose: Molar incisor hypomineralisation (MIH) is a qualitative defect of enamel characterised by demarcated opacities. Aesthetic and functional sequelae of MIH may manifest as reduced oral health related quality of life (OHRQoL). This study aims to investigate the impact of the presence and severity of MIH on children's OHRQoL.

Methods: This cross-sectional study recruited children aged 7-16 years-of-age attending specialist paediatric dental clinics in Melbourne, Australia. Clinical examination utilised the modified European Academy of Paediatric Dentistry index to quantify the presence and severity of MIH. OHRQoL data was collected via the Child Perception Questionnaire, Parent-Caregiver Perception Questionnaire and Family Impact Statement. Causal analysis used quantile regression and included poor medical health as a confounding variable. Sensitivity analysis used the same model and different strata of MIH lesion location and severity.

Results: 131 participants with complete self-reported OHRQoL data were included in the causal analysis. The estimated average causal effect after adjusting for poor medical health showed the estimated difference in medians of child-reported OHRQoL was 6 (CI = 2.62, 12.25, p = 0.02) in the MIH group compared to the unaffected group. The estimated difference in medians of self-reported OHRQoL after adjusting for poor medical health was 7 (CI = 1.87, 11.99, p = 0.01) for severe MIH group and - 1 (CI = - 5.16, 3.62, p = 0.63) for the mild group compared to those unaffected. The estimated difference in medians of self-reported OHRQoL after adjusting for poor medical health was 5.16 (CI = - 2.42, 10.99, p = 0.15) for participants with MIH-affected incisors compared to the rest of the cohort.

Conclusions: MIH impacts children's OHRQoL as reported by self and parent/caregiver.

Purpose: The aims of this study were to identify proteomic profiles of dental pulp from deciduous teeth and compare the profiles of the two dentitions.

Methods: Teeth that were caries-free and had normal pulp conditions were collected from twelve healthy individuals. The obtained teeth consisted of deciduous teeth (n = 6) and permanent teeth (n = 6). Proteins were extracted from pulp tissue and then analysed using liquid chromatography-tandem mass spectrometry. MaxQuant was used to identify and quantify proteins from raw mass spectrometry data of the collected deciduous and previously analysed permanent dental pulp. Differentially expressed proteins (DEPs) between the dental pulp of the two dentitions were identified by a statistical analysis conducted using Metaboanalyst with criteria P-value < 0.05 and fold change > 2.

Results: A total of 3,636 proteins were identified in the dental pulp of deciduous teeth. The biological process functional classifications of these proteins were primarily concerned with cellular process, biological regulation, metabolic process and response to stimulus. Dental pulp protein profiles differed significantly between deciduous and permanent teeth, with 736 proteins being differentially expressed, the majority of which were highly expressed in the pulp of deciduous teeth. Pathway analysis indicated DEPs to be involved in tumour necrosis factor (TNF) signalling, nuclear factor kappa B signalling, and odontoclast/osteoclast differentiation.

Conclusion: While the dental pulp of deciduous and permanent teeth shares some characteristics, there are also significant differences in protein expression, with the TNF signalling pathway and odontoclast/osteoclast differentiation being promoted in the dental pulp of deciduous teeth.

Purpose: The use of cone-beam computed tomographies (CBCT) in orthodontics and pediatric dentistry is constantly increasing. The aim of this systematic review was to critically appraise and summarize evidence from clinical studies on the prevalence of incidental findings from CBCTs of children and adolescents.

Methods: Systematic literature searches without restrictions were undertaken in eight databases from inception up to March 2024 for studies reporting on incidental findings from CBCT images of children and adolescents. After duplicate study selection, data extraction, and risk of bias assessment with a custom tool based on the Joanna Briggs institute's tool for prevalence studies, qualitative (narrative) data synthesis was performed.

Results: Ten studies covering a total of 1818 patients (48.5% male; average age 12.3 years) were included. The prevalence of incidental findings ranged from 0.4 to 80.3%, but high heterogeneity was seen between studies (I² = 99%). Incidental findings were most often related to airways (63.7%), followed by bone (23.6%), teeth (19.2), spine (26.2) and temporomandibular joint (3.8%). However, several methodological issues existed with included studies (incomplete reporting of patient- or CBCT-related details, incomplete categorization and reporting on the severity of findings, small sample sizes, and research transparency issues).

Conclusion: Evidence indicates that incidental findings can be often found in the CBCTs of child and adolescent patients. However, when a CBCT image is justified for children or adolescents, it should be adequately assessed for incidental findings by either a specialist oral and maxillofacial radiologist or a dentist with appropriate training and experience.

Aim: This in vitro study aimed to evaluate the marginal gap and fracture resistance of 3D printing microfilled hybrid resin crowns in comparison to prefabricated zirconia crowns on pulpotomized primary teeth.

Materials and methods: Twenty primary molars were selected for the study and randomly divided into two groups (n = 10). Group1 received 3D printed microfilled hybrid resin crowns; Group 2 received prefabricated zirconia crowns. To simulate 6 months of oral conditions, thermodynamic cycling was performed, and the marginal gap was measured using a stereomicroscope with digital camera at 40 × magnification. For each sample, eight points along the margins for each axial surface were captured. The fracture resistance of each group was assessed by applying increasing load till crown fracture using a computer-controlled universal testing machine. Data were tested for normality using the Shapiro-Wilk test. Data were analyzed using an independent t test. A significant level was set at P < 0.05.

Results: Regarding fracture resistance, 3D printed crowns group had statistically significant higher mean values than the prefabricated zirconia crowns group; the values were 1235.97 ± 412.12 N and 576.56 ± 221.53 N, respectively (P < 0.001). However, there was no significant difference in the marginal gap between the two types of crowns with average 32.00 ± 7.54 for 3D printed crowns and average 34.14 ± 9.79 for zirconia crowns (P < 0.001).

Conclusion: 3D printed microfilled hybrid resin crowns could be a suitable esthetic alternative for restoring pulp-treated primary molars. It is possible to provide an additional esthetic solution for the parents/children to satisfy the need for esthetic restoration of primary molars.

Clinical trial: Not applicable (in vitro study).

Purpose: Molar-incisor hypomineralisation (MIH) impacts children's oral health and quality of life, but research on the stomatognathic system of unilateral cases, remains limited. This study evaluated the effects of unilateral MIH on the stomatognathic system in children, focusing on postural and masticatory activities and occlusal force contacts.

Methods: In this cross-sectional observational study, 28 children (mean age: 8.21 years) were divided into two groups: without MIH (CG) and with unilateral MIH (MIHG). Electromyography (EMG) evaluated the activity of masseter and temporalis muscles during various jaw postures and habitual chewing. Occlusal force contacts were measured using T-SCAN®. Comparisons were made between groups and sides. Statistical analysis employed the Shapiro-Wilk test, Wilcoxon signed-rank test, and paired t-test, with a significance level of 5%.

Results: EMG data demonstrated increased muscle hyperactivity in MIHG compared to CG at rest for the left temporalis muscle on the contralateral side (p < .001), during left laterality for the right temporalis muscle on the ipsilateral side (p = 0.04), and habitual chewing of soft food for the left temporalis muscle on the contralateral side (p = 0.02). Greater voluntary contraction was observed on the unaffected side in MIHG for the temporalis muscle at rest (p = 0.01) and the masseter muscle during right laterality (p = 0.02). No significant differences were found in occlusal force measurements between groups or sides.

Conclusions: This study indicates that unilateral MIH is associated with increased muscle hyperactivity in the contralateral temporalis and masseter muscles, without significant differences in occlusal force.