European Archives of Paediatric Dentistry最新文献

Purpose: The concept of Chemomechanical Caries Removal (CMCR) includes the selective removal of caries-infected tissue while preserving caries-affected tissue. However, studies examining its application to children are scarce. The aim was to assess pain perception and time duration of CMCR agents when removing caries in primary molars in a sample of children compared to the conventional method of caries removal using rotary burs.

Methods: A randomized controlled clinical trial with a split-mouth design with a sample of 60 children aged 4-9 years with 120 cavitated occlusal carious primary molars was equally distributed into 2 experiments: BRIX3000^® vs. conventional method (Experiment 1) and Carie-Care™ vs. conventional method (Experiment 2). The time duration of caries removal was recorded. Perception of pain during caries excavation was evaluated using the "Wong-Baker FACES^® Pain Rating Scale."

Results: Caries removal using the conventional method was significantly faster compared to CMCR agents in both experiments (P < 0.001 and P < 0.001). Caries removal using BRIX3000^® was significantly faster than Carie-Care™ (P < 0.001). Caries removal with BRIX3000^® or Carie-Care™ were reported less painful than the conventional method (P = 0.002 and P = 0.011, respectively).

Conclusion: The study concluded that although CMCR methods require more time for caries removal, they were reported to be less painful.

Trial registration: The study protocol was registered at www.

Clinicaltrials: gov under the identifier NCT05427591.

Aim: The aim was to investigate the salivary amino acid profile in children with protein-energy undernutrition (PEU) and its association with caries experience in the presence of other risk factors.

Methods: The study had a cross-sectional design and was carried out with 122 children (12-71 months old), classified according to their level of undernutrition (mild-GI, n = 22; moderate-GII, n = 53) or healthy controls (GC, n = 47). The children were categorized based on the presence of caries into caries-experienced groups (ceos > 0, 22 CG, 12 GI and 18 GII) and caries-free groups (ceos = 0, 25 CG, 10 GI and 36 GII). Total unstimulated and stimulated saliva were collected to determine amino acids and Streptococcus mutans, respectively.

Results: Eighteen amino acids were associated with PEU. Undernutrition and caries experience influenced the presence of the following amino acids: L-anserine, asparagine, ethanolamine, gamma-aminobutyric acid, and norleucine. Asparagine was a significant predictor of a lower probability of caries experience in a logistic regression model.

Conclusions: Salivary amino acids are associated with undernutrition in children, and the presence of asparagine in saliva relates to a lower caries risk.

Purpose: The first molars are frequently the first permanent teeth to erupt in the oral cavity, and their premature loss can significantly affect a child's oral health. This study aimed to identify determinants of dental caries on the first permanent molars among schoolchildren.

Methods: A longitudinal study was conducted with 122 mother-child pairs from the Brazilian city of Diamantina. The children were evaluated at three instants: first, between 1 and 3 years of age (T1), then, 3 years after the initial assessment (T2), and finally, 6 years after the initial assessment (T3). Socioeconomic data, child habits, visible plaque, and dental caries (assessed through International Caries Detection and Assessment System [ICDAS-II]) were collected at all three time points.

Results: The incidence of dental caries in the first permanent molars was 70.5% and was associated with the presence of caries at T1 (RR = 1.41; 95% CI 1.08-1.84) and T2 (RR = 1.58; 95% CI 1.12-2.22). The following variables at both T1 and T2 were also significantly associated with caries incidence: a high number of income dependents (RR = 1.66; 95% CI 1.17-2.35) and low brushing frequency (RR = 1.77; 95% CI 1.27-2.46). Yet, the persistence of low brushing frequency from T2 to T3 (RR = 1.32; 95% CI 1.05-1.65) was also associated with the incidence of caries.

Conclusions: The incidence of dental caries in the first permanent molars was associated with prior caries experience, low toothbrushing frequency, and schoolchildren belonging to families with a high number of income dependents. These findings highlight the importance of early preventive interventions and socioeconomic considerations in addressing childhood dental caries.

Purpose: To compare the effectiveness of Progressive Muscle Relaxation and Autonomous Sensory Meridian Response with Conventional Behaviour Guidance techniques on the reduction of dental anxiety in children aged 7-11 years during the administration of local anaesthesia.

Methods and findings: This parallel, randomised controlled trial involved 78 children requiring invasive dental treatment under local anaesthetic block, who were allocated into three groups: Progressive Muscle Relaxation, Autonomous Sensory Meridian Response, and Conventional Behaviour Guidance techniques. The primary outcome was reduction of dental anxiety, as measured by objective (pulse rate, oxygen saturation and blood pressure) and subjective (Visual Facial Anxiety Scale) parameters before, after intervention and during local anaesthesia by a blinded outcome assessor.

Results: Progressive Muscle Relaxation and Autonomous Sensory Meridian Response demonstrated a significant reduction in blood pressure during local anaesthesia (p = 0.009 and 0.042, respectively). Progressive Muscle Relaxation significantly reduced mean Visual Facial Anxiety scores after intervention (p < 0.001), whilst Autonomous Sensory Meridian Response significantly reduced these scores during injection (p = 0.002).

Conclusion: The use of Progressive Muscle Relaxation and Autonomous Sensory Meridian Response resulted in a reduction in dental anxiety and can be used as adjuncts to basic behaviour guidance techniques.

Clinical trial registration: The trial was registered at Clinical Trials Registry-India (CTRI Reg no.: CTRI/2022/09/045796, Dated 23 September 2022).

Purpose: To review the current evidence on the association between salivary protein profile and dental caries in children during mixed dentition stage.

Methods: This systematic review followed the PRISMA 2020 guidelines. Searches were run in PubMed, Scopus and Embase along with gray literature. The searches were limited to studies on humans, published from inception to February 2024. Observational studies exploring correlations between salivary proteins and caries in children during mixed dentition (6-13 years) were included. The methodological quality of included studies was analyzed independently by two reviewers using the Joanna Briggs checklist and Newcastle-Ottawa scale, respectively followed by a qualitative synthesis.

Results: A total of 17 primary studies were included. The studies recruited 1,330 subjects including 612 caries-active and 505 caries-free subjects. The total protein content was higher in caries-active subjects. Among the glycoproteins, IgA and MUC5B were higher in caries-free subjects while the levels of MUC7 were lower in the caries-free group. Antimicrobial peptides and proteinase-3 levels were also higher in caries-free subjects. Contradictory findings were reported for the association of α- amylase and carbonic anhydrase with caries status. The included studies were categorized as good quality (n = 4), fair quality (n = 12) and poor quality (n = 1).

Conclusion: Based on fair-quality studies included in this review and within its limitations, the findings revealed that salivary proteins may be associated with susceptibility to dental caries in mixed dentition. Total salivary proteins are upregulated in caries-active subjects while salivary IgA, antimicrobial peptides and proteinase-3 are increased in caries-free subjects.

Systematic review registration: The study protocol was registered in PROSPERO (registration number CRD42024517374).

Purpose: The aim of this retrospective study was to analyse the dental and medical parameters, including peri- and postoperative management and complications, of patients with special healthcare needs receiving dental treatment in a tertiary care hospital setting.

Methods: A total of 154 patients (mean age 7.8 ± 4.1 years) who received dental treatment under general anaesthesia or analgosedation at the Department of Paediatric Dentistry of the XXX University in XXXXXXX between 2021 and 2023 were divided into the following diseases: metabolic disease, nervous system disorder, congenital heart disease, tumour disease, gastroenterological disease, genetic syndrome, pulmonology disease and coagulopathy. Caries experience (dmf-t/DMF-T), type of anaesthesia and pre- and perioperative parameters were recorded.

Results: Regardless of disease, all children showed higher caries experience in the primary dentition compared to permanent dentition (mean ± standard deviation; 6.44 ± 4.85/2.01 ± 3.87). Most of the children suffered from genetic syndrome, followed by congenital heart and metabolic disease. Dental treatment was mostly performed under general anaesthesia. 92.2% of those patients were intubated orotracheally and 66.9% received antiemetics. The complication rate was lower than 3%.

Conclusions: Data show that special healthcare needs patients regardless of kind of disease are highly affected by caries and require dental treatment. Most dental restorations were performed under general anaesthesia. Regardless of disease and type of anaesthesia, the complication rate was low, which underlines the high clinical relevance of adequate dental care under general anaesthesia for this vulnerable patient group.

Purpose: While the use of antibiotics could increase the development of antibiotic-resistant microorganisms, yet, it is a standard protocol in some hospitals. Therefore, the purpose of this study was to debate this protocol by assessing the effects of prophylactic antibiotics in paediatric dental rehabilitation under general anaesthesia.

Methods: This is a quasi-study comparing existing healthy (n = 46) children aged between 3 and 6 years at two hospitals in Saudi Arabia to assess the effects of prophylactic antibiotics in paediatric dental rehabilitation under general anaesthesia. The infection condition was identified by measuring fever, and periapical lesions.

Results: No significant differences were reported in both terms. Infections in terms of fever (P = 0.295), the results revealed that 95.7% of children in the antibiotic group had no infections, whereas in the no-antibiotic group, 87% showed no infections. In terms of periapical lesions, 87.0% of the first group exhibited no periapical lesions (P = 0.343), while 8.7% had "1" (vertical bone defects or both), and 4.3% fell into the "2" category. Similarly, in the control group, 87.0% showed no periapical lesions, while 13.0% had infections.

Conclusion: Within the limitations of the present quasi-study in two Saudi-Arabian hospitals, it has been shown that although prophylactic antibiotics are still routine in some hospitals, their use is not justified in paediatric dental rehabilitation under general anaesthesia. Updating the relevant protocols in such operations is strongly recommended.

Purpose: To evaluate whether an extended home visiting programme by child health nurses and parent counsellors can prevent caries and improve oral health habits in children from low socioeconomic backgrounds.

Methods: All families in Sweden are offered one home visit when the child is two weeks old. The extended home visiting programme included five extra home visits between two and fifteen months of age where every visit had a specific theme (child safety, feeding, attachment/interaction, parenthood, social network, and self-care). Toothbrush and toothpaste, together with oral health information, were given around eight months of age. Clinical examinations and oral health habit questionnaires were conducted at 12, 24, and 36 months of age. The International Caries Detection and Assessment System was used to assess caries, and the results were compared to those of an age-matched control group following the standard child health care programme.

Results: Significantly (p < 0.05) more children had caries at 36 months of age in the intervention group (32.8%) than in the control group (10.1%). The intervention group had significantly (p < 0.05) more plaque and a greater frequency of sweet snacks and drinks. In the intervention group, significantly (p < 0.05) more parents were under the age of 25 and foreign-born. Significantly (p < 0.001) more foreign-born parents were born in high-income countries in the control group compared to the intervention group.

Conclusion: The extended home visiting programme did not improve the prevalence of caries or oral health habits in this cohort. However, since the groups differed in socioeconomic factors, the results should be interpreted with caution.