European Archives of Paediatric Dentistry最新文献

Purpose: The present study aims to systematically review the literature on the effect of combined surgical-orthodontic treatment on the periodontal health of labially maxillary impacted canines, comparing the results between the three available surgical approaches, open and closed eruption technique and apically positioned flap.

Methods: Seven electronic databases and three registers were searched until September 2024 and lists of references from relevant publications were screened to identify studies (randomised (RCTs) / controlled clinical trials (CCTs) and observational) assessing the periodontal status of labially maxillary impacted canines after combined surgical-orthodontic treatment. Participants consisted of medically and periodontally healthy individuals with labially impacted canines and their untreated contralaterals as comparison. The outcomes assessed were plaque accumulation, gingival inflammation, gingival recession, probing pocket depth, keratinised gingiva width, attached gingiva width, and crestal bone loss. The risk of bias was evaluated using the ROBINS-I tool for the CCTs and Newcastle-Otawa tool for the observational studies.

Results: A total of 1829 studies were identified, and seven were included in the review (one CCT and six observational studies). All evaluated soft tissue periodontal parameters had the most negative outcomes after excisional uncovering, however these findings did not reach clinical significance. When closed eruption technique or an apically positioned flap was performed, the periodontal outcomes were similar to those of untreated teeth.

Conclusions: This review found no clinically significant adverse effects on the periodontium after combined surgical-orthodontic treatment of labially impacted maxillary canines. Further high-quality, low-bias clinical trials are needed to assess post-treatment periodontal status.

Purpose: The use of large language models (LLMs) in generative artificial intelligence (AI) is rapidly increasing in dentistry. However, their reliability is yet to be fully founded. This study aims to evaluate the diagnostic accuracy, clinical applicability, and patient education potential of LLMs in paediatric dentistry, by evaluating the responses of six LLMs: Google AI's Gemini and Gemini Advanced, OpenAI's ChatGPT-3.5, -4o and -4, and Microsoft's Copilot.

Methods: Ten open-type clinical questions, relevant to paediatric dentistry were posed to the LLMs. The responses were graded by two independent evaluators from 0 to 10 using a detailed rubric. After 4 weeks, answers were reevaluated to assess intra-evaluator reliability. Statistical comparisons used Friedman's and Wilcoxon's and Kruskal-Wallis tests to assess the model that provided the most comprehensive, accurate, explicit and relevant answers.

Results: Variations of results were noted. Chat GPT 4 answers were scored as the best (average score 8.08), followed by the answers of Gemini Advanced (8.06), ChatGPT 4o (8.01), ChatGPT 3.5 (7.61), Gemini (7,32) and Copilot (5.41). Statistical analysis revealed that Chat GPT 4 outperformed all other LLMs, and the difference was statistically significant. Despite variations and different responses to the same queries, remarkable similarities were observed. Except for Copilot, all chatbots managed to achieve a score level above 6.5 on all queries.

Conclusion: This study demonstrates the potential use of language models (LLMs) in supporting evidence-based paediatric dentistry. Nevertheless, they cannot be regarded as completely trustworthy. Dental professionals should critically use AI models as supportive tools and not as a substitute of overall scientific knowledge and critical thinking.

Purpose: A newer design of crowns known as Endocrowns was introduced for endodontically treated teeth. The aim of this in vitro study was to compare fracture resistance and failure modes of two margin preparation for computer-aided design/computer-aided manufacturing (CAD-CAM) fabricated polymethyl methacrylate (PMMA) endocrowns for primary molars.

Methods: Twenty extracted human primary molars were pulpectomized and restored with composite resin as per the standard protocol. Half the samples were prepared for endocrown with butt margin whilst the other half were given shoulder margin. The prepared teeth were scanned using a CADCAM scanner, and endocrowns were fabricated, cemented using glass ionomer luting cement, and subjected to thermocycling and chewing simulations. Samples were subjected to fracture resistance (FR) test using a universal testing machine and failure modes were assessed. Data were analysed using the Kruskal-Wallis and Chi-square test.

Results: Mean FR was 1230.6 ± 305.4 N for butt-margin endocrowns and 1355.1 ± 293.9 N in shoulder margin design (p = 0.08). For the failure mode, most samples showed less than half of the crown lost (Class II) in Group 1 and severe fracture of the crown or tooth (Class V) in Group 2. However, there was no statistically significant difference between the two designs of endocrowns (p = 0.91) for the failure modes.

Conclusions: The study concluded that the margin designs did not affect the fracture resistance and the failure modes of the PMMA endocrowns in primary molars. In vivo studies are needed to ascertain the long-term efficacy of PMMA endocrowns in endodontically treated primary molars.

Purpose: Assess the knowledge and attitudes of parents/guardians regarding their children's oral health and their preferences regarding the treatment of carious primary teeth.

Methods: A cross-sectional study including the completion of a questionnaire by parents/guardians of healthy children aged 2-12 years attending the Department of Pediatric Dentistry (NKUA). Data were collected through 35 questions regarding demographic characteristics of the participants, oral hygiene and dietary habits, and parents' knowledge of the importance of oral health and primary teeth. Treatment preferences were assessed through clinical scenarios accompanied by colored clinical photographs. Results were presented in frequency tables and comparisons with specific child and parent-characteristics were evaluated using chi-squared and Fisher's exact test.

Results: Parents were mainly females (73%), married (81%), aged > 40 years (56%), and high school graduates (57%). Most children brushed alone (56%), twice (48%) daily, with a manual toothbrush (65%) and consumed sugary snacks daily (38%). More than two-thirds of parents recognized the relationship between oral hygiene and general health (82%) and the importance of primary teeth (72%). Almost all parents would like to restore their children's asymptomatic (94%) and symptomatic (98%) primary teeth, with pulp therapy and stainless-steel crowns being the treatment of choice (58%). The decision on treatment about cavitated/non-cavitated primary teeth was not correlated with any of the parental or child-related factors. Acceptance of minimally invasive treatments was higher among highly educated parents and parents of boys.

Conclusion: Insight into parents' perceptions and preferences regarding the treatment of primary teeth is necessary and should be considered during treatment planning.

Purpose: Vital pulp treatment (VPT), including pulp capping and pulpotomy, is a conservative approach designed to maintain pulp vitality and health in reversible and partially irreversible pulpitis cases, particularly in children and adolescents with immature or mature permanent teeth. Despite extensive research, the comparation of various VPTs remains uncertain. This study evaluated the efficacy of different VPT techniques and capping materials, including calcium hydroxide (CH), mineral trioxide aggregate (MTA), and other pulp-protecting agents (PPA), and explored heterogeneity across trials, particularly with respect to pulp status (reversible vs. irreversible) and coronal restorations, using meta-regression analysis.

Methods: A systematic review and meta-analysis, adhering to PRISMA guidelines, was conducted through a comprehensive search in PubMed and Scopus up to August 2024. The PICO framework was used to define the inclusion criteria: Population (children/adolescents with vital permanent teeth diagnosed with pulp inflammation), Intervention (various VPTs), Comparison (different PPAs and restoration types), and Outcome (success rates based on clinical/radiographic criteria). Odd ratios (ORs) were calculated using random-effects models. Statistical heterogeneity was assessed using the I² test. Meta-regression analysis was performed to explore the influence of co-interventions on the success rate (P < 0.05).

Results: Nineteen randomized controlled trials involving 1183 participants were included. The meta-analysis revealed no significant difference between CH and MTA/PPA at 6 months (OR = -0.62; P = 0.26); however, at 12 months, CH demonstrated a significantly lower success rate compared to MTA/PPA (OR = -1.34; P = 0.01). Meta-regression analysis indicated that factors such as pulp status, restoration type, and VPT techniques did not significantly predict treatment success.

Conclusions: The findings suggest that various VPT techniques utilising MTA/PPA are effective for managing reversible/irreversible pulpitis in mature/immature permanent teeth in children/adolescents. In contrast, CH is less favourable and not recommended for VPT. These results reinforce the growing evidence supporting the use of MTA and other evidence-supported PPAs over CH for long-term success in VPTs.

Aim: The aim of the present cross-sectional study was to evaluate the representation of female scientists as invited speakers at two major paediatric dentistry congresses, the European Academy of Paediatric Dentistry (EAPD) and the American Academy of Pediatric Dentistry (AAPD), held between 2016 and 2023. A secondary aim was to explore association with lecture topic- or scientist-related characteristics.

Methods: The gender of all invited speakers was identified through electronically searching of scientific programmes and abstract books of the EAPD and the AAPD Congresses held between 2016 and 2023. Variables assessed were year of the congress, the continent of origin of the invited scientist, the type of meeting (congress or interim seminar) and lecture topic.

Results: A total of 462 lectures were included in the assessment and the overall representation of female scientists was 44.2%. Since 2016, yearly representation of female invited speakers exceeded in number that of male only twice, in 2021 (59.4%) and in 2023 (53.7%). For the EAPD, invited female lecturers were 41.1%, while for the AAPD Congress was 46.3%. There was equal representation of female and male speakers in seminars (50% each), although this type of meeting is solely organised by the EAPD. Pain management (62.5%), insurance (54.8%), paediatrics (55.6%) and orthodontics (52.4%) were the only thematic regions where female speakers outnumbered their male counterparts. Univariable and multivariable analyses did not reveal any overall significant association between invited speaker gender and year, congress or continent of authorship (p-value > 0.05 in all cases).

Conclusion: Women' voice representation at major paediatric dentistry congresses was found to improve, however, efforts for further improvement should persist to establish balanced representation.

Objective: The aim of this study was to assess symmetry of developmental stage of permanent teeth between the left and right side of the jaw, as well as between the maxilla and the mandible.

Methods: A sample of 150 panoramic radiographs of individuals aged 6-20 years (69 males, 81 females) were selected from an open-access radiographic collection (Maxwell Museum of Anthropology's orthodontic collection, Albuquerque, USA). All developing immature permanent teeth (n = 489) were scored by the first author using Moorrees and Demirjian tooth stages. Symmetry of developing teeth was assessed between the left and right sides of the jaw, as well as between the maxilla and the mandible using McNemar test with p < 0.05 considered significant.

Results: No significant differences were found comparing left and right sides within the maxilla (n = 489), (McNemar, p = 0.759 M, p = 0.736 D), or within the mandible (McNemar, p = 0.262 M, p = 0.707 D) using either tooth scoring method. Percentage agreement for individual teeth between left and right sides was least for third molars. Significant differences were observed comparing maxillary and mandibular teeth for both tooth scoring methods (n = 978), (McNemar, p = 0.00 M, p < 0.001 D). Percentage agreement for individual teeth between the maxilla and mandible was least for incisors.

Conclusion: In the present sample, differences in tooth formation were not significantly different in left and right side of the jaw while a significant difference (p = 0.00 M, p < 0.001 D) was observed between maxilla and mandible.

Purpose: Precise knowledge of root and canal morphology in primary teeth is critical for endodontic success, yet existing studies are fragmented and lack synthesis. This systematic review and meta-analysis addresses this gap by investigating the distribution of root numbers, canal configurations, and root lengths in human primary molars, while exploring possible influencing factors.

Methods: A literature search was conducted through PubMed, ScienceDirect, Web of Science, the Cochrane Library, and China National Knowledge Infrastructure (CNKI) up to September 2023. Retrospective studies using patients' cone-beam computed tomography (CBCT) data or cross-sectional studies utilizing computed tomography (CT) or CBCT on extracted primary molars reporting on the root canal morphology of primary molars were included. Study quality was assessed using a modified Newcastle-Ottawa Scale. A meta-analysis was performed to estimate the proportions of root and canal numbers and calculate the mean values of root lengths. Forest plots were used to present the results.

Results: The search strategy identified 799 records. After screening abstracts and full texts, 30 studies met the inclusion criteria. Of these, 2 studies had a high risk of bias, 23 a moderate risk, and 5 a low risk. The meta-analysis revealed that primary maxillary first molars were predominantly three-rooted (80.2%) with three canals (96.9%), while primary maxillary second molars were primarily three-rooted (89.7%) with three or four canals (84.4% and 14.7%, respectively). Primary mandibular first and second molars typically had two roots with M2D2 being the most common canal type, though the former showed high variability in canal configurations. Root lengths were also analyzed. Subgroup analysis indicated that heterogeneity may be influenced by country and data source, while no significant differences were associated with imaging techniques.

Conclusions: Primary maxillary molars are predominantly three-rooted with three canals, while primary mandibular molars typically had two roots with four canals. Variations in root anatomy and canal configuration should be considered during endodontic treatment of primary teeth. High heterogeneity and methodological inconsistencies limit the current evidence, highlighting the need for future research to address contributing factors to heterogeneity and to develop standardized methods for assessing root and canal morphology in the primary teeth.

Trial registration: PROSPERO registration no. CRD42023414536 on 2023.04.