European Archives of Paediatric Dentistry最新文献

Background: Oral health plays a critical role in overall well-being, particularly among adolescents, including those with intellectual disabilities. Caregivers, particularly mothers, play an essential role in guiding and supporting these adolescents in maintaining good oral health. This study examined the oral health problems and challenges faced by children with intellectual disabilities from the perspective of their mothers.

Methods: Semi-structured interviews were conducted with 22 mothers of intellectually disabled adolescents aged 12-18 years in Pondicherry, India. A purposive sampling method was employed to gather information-rich insights from a diverse group of mothers. The interviews were guided by an interview protocol that included open-ended questions about the challenges in maintaining oral health, experiences with dental care providers, and perceived need for support. Thematic analysis was conducted to identify and interpret key themes.

Results: The study identified six key themes affecting the oral health of adolescents with intellectual disabilities from maternal perspectives: physical and behavior challenges, limited access to specialized dental care, financial constraints, lack of professional support and education, emotional and psychological impact on mothers, and social stigma and isolation.

Conclusion: The identified themes highlight the need for comprehensive and multifaceted interventions to address the physical, logistical, financial, educational, and emotional challenges. By understanding and addressing these barriers, healthcare providers, policymakers, and support organizations can improve oral health outcomes and the overall quality of life for adolescents with intellectual disabilities and their families.

Purpose: To evaluate the alteration of pre-post informing anxiety levels and behavioural scores of the children in the groups between those who were shown the multimedia-application and verbally explained.

Methods: In this randomized controlled study, healthy children, who applied to a paediatric-dental-clinic who never had a dental visit or dental procedure rather than oral examination were included. In the waiting room evaluation of children with a behaviour-control-list and Frankl's-Behaviour-Rating-Scale were performed, Venham-Picture-Test (VPT) was shown to the children. Then, the random information method (with a multimedia-application or verbally) was used for giving information. Finally, the child was observed whilst sitting in the dental chair and meeting with dentist, the behaviour-control-list was filled out again, and child's behaviour were re-scored.

Results: A total of 56 children [mean (± sd) age of 7.3 (± 1.1)] participated. There was no statistically significant difference between the median values of the change in Frankl and VPT-scores after the information (p = 0.261 and p = 0.651, respectively). The percentage change of pre-post informing in definitively negative children according to Frankl's score was higher in the multimedia application group (25%). Besides, the percentage change in children scored with score 5-6 according to VPT was also higher in multimedia-application group (25%-28.6%, respectively, for scores 5-6).

Conclusion: Although the score changes after the information procedure were more pronounced in the multimedia-application group for both VPT and Frankl-scores, the difference was not statistically significant. Multimedia applications seem to offer a promising modern tool for patient education before dental examination in 6- to 9-year-old children.

Purpose: Equimolar oxygen-nitrous oxide mixture (EMONO) is considered as a reference for dental care in children. Completion of dental treatment has usually been used as a criterion to assess EMONO treatment. However, other patient-reported outcomes are needed. We sought to assess the prevalence of complete therapeutic effects (analgesia and anxiolysis) experienced by children during dental care under EMONO and identifying associated factors.

Methods: A national prospective observational multicentric study was conducted between September 2018 and June 2020 in 13 French university hospitals. Participants were children between 3 and 15 years of age requiring dental care under EMONO.

Results: 677 children were analyzed. Anxiolysis and analgesia were experienced by a large majority of patients (86.5% and 79.0%, respectively, and 73% experienced both effects). Several factors were associated with both analgesia and anxiolysis effects: the presence of expected effects (no loss of judgment and slight decrease in level of consciousness), the absence of agitation and distress, a positive perception of EMONO and ethnicity.

Conclusion: Most patients benefit from the therapeutic effects (anxiolysis and analgesia) expected by EMONO during dental treatment. It is reassuring to observe that most sociodemographic characteristics and medical history do not seem to influence the effectiveness of care. The study was registered at www.

Clinicaltrials: gov under the reference number NCT03453411.

Aim: A reliable tool to visualise children's early stress signs to prevent dental fear development is needed. The aim was to evaluate the commercially available, CE marked, Shimmer3 GSR + unit's ability to indicate for stress as a reaction of fear or pain for a non-invasive dental treatment (NI) and an invasive dental treatment (I).

Methods: Patients 14-16 years old were invited to undergo an oral check-up (NI) or an orthodontic premolar extraction (I), respectively. Digital data, measured via electrodes and optical pulse probe, placed on the wrist and fingers, monitored by the Shimmer3 GSR + unit, was transferred via Bluetooth to the HP-laptop. The observed digital parameters were: heart rate based on photoplethysmography (PPG), galvanic skin response (GSR), and 3-axis gyroscope and accelerometer signals for hand movements. Protocols for patient self-report scales were used: coloured analogue scale for pain intensity, facial analogue scale for the mood, and a dental fear scale. Descriptive statistics was performed.

Results: The NI-group: 20 patients, (14.6 ± 0.5 years), underwent 20 oral check-ups. The I-group: 14 patients, (15.3 ± 0.5 years), underwent 28 premolar extractions. All patients tolerated the Shimmer3 GSR + unit well. The GSR signal increased significantly, at start and during the oral injection, in the I-group. The GSR amplitudes persisted throughout and post the dental injection. No general uniform pattern or high GSR amplitudes were produced regarding NI-group.

Conclusions: Considering the limitations of this study, the following conclusions can be made: the invasive treatment resulted in a specific unison GSR pattern, while the non-invasive procedure showed individually scattered GSR reactions. The commercially available CE-marked Shimmer3 GSR + device indicated the patient's stress response triggered by the invasive anaesthetic procedure.

Purpose: The purpose of this study was to investigate and compare in vitro the influence of preformed metal crowns (PMC) versus zirconia crowns (ZC) on the extent of artifact formation and the diagnostic quality of magnetic resonance imaging (MRI).

Methods: Standard crown tooth preparations were performed on Typodont models. PMC and ZC were cemented on all primary molar teeth (n = 8) of the respective models. MRI scans were taken for the Typodont alone (control), PMC, and ZC, using a 3 T MRI machine and common MRI sequences. The diameter of image distortion was measured around the dental materials. Data was analyzed using a mixed model analysis.

Results: The average artifact size for PMC was 54.9 mm (range 19.6-110.7 mm) and 12.8 mm (range 5.5-20.7 mm) for ZC. The artifact size was associated with the MRI pulse sequence and dental material, with PMC showing larger artifact diameters than ZC for all MRI sequences (p < 0.001). The control had sensitive sequences for AxT2* and DWI sequences with MRI artifacts of 11.4 mm and 10.7 mm, respectively.

Conclusions: It is important that dentists are aware of the potential of dental materials to cause unfavourable MRI artifacts. When areas of the brain requiring MRI preclude the use of PMC, ZC may be considered as an alternative to extractions. Further clinical studies are required to evaluate the impact of dental materials on the image quality of MR scans in vivo.

Purpose: To assess the impact of the picture exchange communication system (PECS) on oral hygiene motivation and practices in healthy children aged five to seven years.

Methods: A total of 160 healthy children aged five to seven years were included in this study. At the first visit, the participants' guardians were asked to answer a questionnaire focussing on the sociodemographic, and the oral hygiene habits of the participants. All participants received a clinical examination to assess their dental caries experience using the ICDAS score, gingival condition using the gingival index (GI), and the amount of accumulated dental plaque using the Turesky Modification of the Quigley-Hein Plaque Index (TQHI), followed by comprehensive explanation of the proper oral hygiene protocol. The participants were randomly divided into two equal groups; the PECS group and the control group. The participants were re-assessed after 6 months. The collected data were statistically analysed using the Statistical Package for Social Sciences (SPSS) software version 23 at a p-value ≤ 0.05.

Results: By the end of the follow-up period, the PECS group reported significantly greater adherence to regular tooth brushing (p = 0.006) with a frequency higher than twice per day (p < 0.000) and no need for parental motivation (p < 0.001), and had significantly lower mean GI and TQHI scores (p < 0.000). Most of the participants' guardians reported that the PECS cards were useful for use and that they would continue to use them 66/76 (86%).

Conclusion: The PECS was found to be effective in motivating children to adhere to proper tooth-brushing practices, as reflected by improvements in their oral health status and gingival condition.

Purpose: The aim of this study is to compare the application of inferior alveolar nerve block (IANB) anaesthesia in children with traditional plastic syringe (TPS) and computer-controlled injection device Dentapen^® using two different modes [continuous mode (DC) and ramp-up mode (DR)] in terms of pain.

Methods: This study included 96 children aged 7-12 who were determined to be positive (3) or definitely positive (4) according to the Frankl Behaviour Evaluation Scale and in need of treatment who had IANB anaesthesia indication in the right and left regions. Patients were divided into three groups and compared in terms of pain felt during IANB anaesthesia according to heart rate, oxygen saturation, Wong Baker Pain Rating Scale, Face Legs Activity Cry Consolability Pain Scale and patient preference distributions.

Results: Heart rate values increased significantly during the injection of IANB anaesthesia with all methods [TPS, DC and DR methods (p < 0.05)]. No significant differences were found in terms of pain between the TPS, DC and DR methods in the intragroup and intergroup assessments. However, among the patient preferences of TPS and DC methods, the number of patients who preferred the DC method was found to be statistically significantly higher those who preferred the TPS method (p = 0.026).

Conclusion: Although the TPS group scored higher than the Dentapen^® groups in terms of pain, the difference between the investigated IANB anaesthesia techniques was not statistically significant. However, the majority of the patients preferred the Dentapen^® device compared to the TPS. It appears that more research is needed on the Dentapen^® device in local anaesthesia applications in children.

Aims: To evaluate and compare the efficacy of manual toothbrush, audio-tactile performance (ATP) method, and musical toothbrush on plaque control and oral hygiene maintenance in visually impaired children.

Methods and results: The current observational study included 60 visually impaired children aged 9-16 years who were randomly divided into 3 groups, each with 20 children receiving oral hygiene instructions in different modes: Group 1 (Control) manual toothbrush, Group 2 (ATP) audio-tactile performance method with a manual toothbrush, and Group 3 musical toothbrush. Both manual (groups 1 and 2) and musical toothbrushes (Group 3) were changed after 3 months for better efficiency. Oral hygiene index simplified (OHI-S) and Rustogi Modified Navy Plaque Index (RMNPI) plaque scores were recorded at baseline, at the end of 1, 3, and 6 months. The collected data were statistically analysed using SPSS version 21. The intra- and inter-group comparisons were analysed using one-way ANOVA, and the multiple group comparisons were analysed using the Tukey HSD test. In intragroup comparisons from baseline to 6 months, both OHI-S and RMNPI plaque scores were reduced for group 3, only OHI-S plaque scores were reduced for group 2. Intergroup comparisons revealed a statistically high significant difference in OHI-S plaque scores from baseline to 6 months and RMNPI plaque scores from 1 to 6 months.

Conclusion: The motivation and education with musical toothbrushes and audio-tactile performance (ATP) method could aid in the improvement of oral hygiene maintenance of visually impaired children.

Purpose: Dens evaginatus (DE) is characterised by the presence of a tubercle projection, which when fractured may lead to pulpal pathology. The aim of this study was to assess prevalence of DE in the local population and the long-term outcomes of asymptomatic DE premolars managed with tubercle grinding and composite overlay.

Methods: This is a retrospective cohort study of 9-year-old Singaporean children. The primary outcome was the success of prophylactic management of asymptomatic DE premolars with a single session of tubercle grinding and composite overlay, as determined by the absence of clinical signs or symptoms. The factors associated with survival of DE premolars treated were evaluated using Cox proportional hazard regression.

Results: The prevalence of DE among Singaporean children was 7.1% (12,677/178,801). DE premolars were more prevalent among females (56.1%) and those of Chinese ethnicity (87.1%). At the tooth level, 26,875 asymptomatic DE premolars were prophylactically managed with tubercle grinding and composite overlay and 2471 DE premolars did not receive any intervention. The mean review period was 46.2 ± 20.2 months. The success rate for DE premolars that received the intervention was significantly higher (p  < 0.001) at 98.9% versus 94.1% in untreated DE premolars. Cox proportional hazard regression revealed that mandibular second premolars (p  < 0.001), DE premolars with fractured tubercles at the time of diagnosis (p  < 0.001) and children of Chinese ethnicity (p  = 0.002) were significantly associated with a higher risk of failures.

Conclusion: The prophylactic management of asymptomatic DE premolars with a single-session tubercle grinding and composite overlay is a successful treatment option.