European Archives of Paediatric Dentistry最新文献

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.

Aim: To determine the frequency and characteristics of Dense Bone Islands (DBIs) in a paediatric population residing in Chandigarh, India.

Methodology: A total of 3614 orthopantomographs (OPG) of children between the age group of 6-18 years were collected from the database of patients who underwent panoramic radiography for routine dental treatment during the period of 2018-2020. The shape, location of the lesion, and relationship of the Dense Bone Island with the tooth were identified. Data analysis was performed using IBM SPSS Statistics for Windows, Version 25.0. Categorical variables were compared using the Chi-square test with Yate's correction. p < 0.05 was considered statistically significant.

Results: DBIs were identified in 165 OPGs resulting in a prevalence of 4.56% out of which 92.1% were in the mandible and only 7.9% in the maxilla (p < 0.001). Most were of those aged between 13 and 18 years. More than half of the lesions had apical (32%) relationship with the tooth and only 14% were identified separately. Most of the DBIs were round or oval shaped (75.8%) and the rest were irregularly shaped (p < 0.001).

Conclusion: The prevalence of DBIs was lower in the younger children and diagnosis is often incidental during routine radiological examination. They do not seem to elicit any signs with clinical significance, but regular follow up is necessary to differentiate these from other benign or malignant osteoblastic entities.

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.

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: The aim of this study is to compare the effect of GSH (reduced glutathione) and KI (potassium iodide) on SDF (silver diamine fluoride) discolouration and dentine remineralisation.

Methods: Sixteen primary molars were utilised, yielding 4 dentine specimens each. Three specimens per tooth were allocated: one as a control and the others to experimental groups. Initial microhardness measurements were taken from one remaining dentine specimen per tooth. Subsequently, all groups underwent exposure to a demineralisation solution. Colorimetry assessed specimen colour, and post-second microhardness measurements on demineralised specimens, treatments were administered as follows: group 1 (control, n = 16): 38% SDF, group 2 (n = 16): 38% SDF followed by KI, group 3 (n = 16): 38% SDF with 5% GSH added by weight. Following pH cycling across all groups, colorimetry reassessed 48 dentine specimens. Final microhardness measurements ensued, followed by statistical analysis. Normality was checked via Shapiro-Wilk, and homogeneity via Levene's test. Independent samples t test compared normally distributed groups; Mann-Whitney U compared non-normally distributed groups. ANOVA compared means of normally distributed groups, and Kruskal-Wallis for non-normally distributed ones. Repeated measures ANOVA compared dependent groups with normal distribution, and Friedman test for non-normal. Post hoc Bonferroni analyses identified significant differences. IBM SPSS 25 was used to conduct analyses.

Results: The mean ΔE* values for SDF and SDF + GSH groups were significantly higher than those of the SDF + KI group (p < 0.05). Significant differences in L* values during final colour measurement were noted between the SDF + KI group and both SDF and SDF + GSH groups (p < 0.05). Although mean remineralisation microhardness measurements were higher than mean demineralisation microhardness measurements in all groups, statistical significance was observed only in the SDF and SDF + KI groups (p < 0.05).

Conclusion: The study found that the addition of 5% GSH by weight to SDF does not significantly affect discolouration. Moreover, the addition of 5% GSH to the SDF solution may have a minor impact on the remineralisation potential of SDF. The application of KI after SDF reduces discolouration and does not affect the expected remineralisation process.

Purpose: The aim of the present study was to evaluate the factors associated with failure requiring extraction after placement of preformed metal crowns (PMCs) in primary molars. Radiographic caries depth at baseline (initial/moderate and severe) and placement technique (Conventional and Hall technique) and other patient-related variables were analysed.

Methods: Clinical and radiographic records from children aged 2-10 years who had at least one primary molar treated with PMCs between 2011 and 2019 were evaluated. Chi-square test, Fisher exact tests and logistic regression analysis (α = 5%) were performed to verify the relationship between the primary outcome and categorical variables (caries depth, restorative teachnique, jaw, tooth type and gender).

Results: A total of 244 teeth treated in 165 children were included in the analysis. A total of 18 failures were observed (7.4%), of which 17 were in deep caries lesions and in which 15 had the PMC placed according to the conventional technique. Both caries lesion depth and restorative technique were associated with treatment failure (p < 0.05).

Conclusion: Taking into account the limitations of this retrospective study, treatment failures requiring extraction occurred more often in deep caries lesions when treated with preformed metal crowns (PMCs) following the conventional technique when compared to the Hall Technique.

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: To assess the attitudes of dentists in Israel to minimal intervention on primary teeth.

Methods: For this cross-sectional study, data were accessed from questionnaires that were completed anonymously by members of the Israeli Society of Paediatric Dentistry. For four clinical scenarios, the respondents were asked to describe the stage at which they would intervene, the type of preparation they would utilize, and the restorative materials they would use. The scenarios included proximal and occlusal caries in the primary molar and buccal and proximal caries in the primary maxillary incisor.

Results: Forty-six dentists completed the questionnaire. Forty-one (89%) cited that they would intervene in stages 3 and 4 (of 6) of proximal caries in the primary molar; 34 of these stated that the cavity preparation would be of the proximal box type. For occlusal caries, 37 (80%) stated they would intervene in stages 2 and 3 (of 5); 31 of these would only remove the carious lesion. Thirty-three (72%) of the respondents stated they would intervene in stage 3 (of 4) of buccal caries; 31 (67%) stated they would intervene in stage 2 (of 4) of proximal caries in the primary maxillary incisor.

Conclusion: The study reveals that specialists and non-specialists dentists in Israel use minimally invasive dentistry to treat children, either by intervening at a later stage of tooth decay or by employing conservative techniques to restore teeth. This aligns with the philosophy of minimal intervention.