Journal of Clinical Pediatric Dentistry最新文献

Hereditary Spherocytosis (HS) is a type of hemolytic anemia characterized by a defect in the membrane of red blood cells, which causes them to assume a spherical shape, become osmotically fragile, and be prone to early hemolysis. While it is relatively well understood in the medical field, there is limited evidence regarding the dental management of patients with this condition. Therefore, this report aims to present a case involving the extraction of permanent teeth before splenectomy in a child with HS who had been hospitalized. Additionally, treatment guidelines for these patients are proposed and developed. The patient was scheduled to undergo a total splenectomy due to splenomegaly resulting from severe hemolytic anemia. Prior to the surgery, the child was referred to the hospital's dental clinic with a chief complaint of dental pain. An intraoral examination revealed carious lesions with pulpal involvement in the first molars, and extraction was recommended to minimize the risk of post-splenectomy infection. Hematological support was provided during dental treatment since partial control of the anemia was necessary for the extraction procedure. Developing dental treatment guidelines for patients with HS is essential to ensure their safety.

Despite fluoride's widespread use in preventing dental caries, it remains a significant oral disease with some drawbacks. Consequently, new preventative agents have emerged that can function independently of fluoride. Our aim is to demonstrate the efficacy of newly developed varnishes, 3% Rennou (theobromine calcium and phosphate) and 1% Rennou, in remineralizing initial caries. In our experiment, 40 human enamel samples were randomly allocated into four groups of 10 samples each as: Group 1 (G1): 5% NaF (Colgate PreviDent®), Group 2 (G2): 1% Rennou®, Group 3 (G3): 3% Rennou® and Group 4 (G4): Casein Phosphopeptide-Amorphous Calcium Phosphate + Fluoride (MI Varnish^TM GC). To produce an artificial carious lesion in the enamel, the samples were kept in a demineralizing solution for 72 hours. Samples underwent pH cycling for 6 days in order to induce remineralization. The means of the three measurements were compared, and the percentage of Surface Microhardness Recovery in (SMHR%) was calculated. Scanning Electron Microscopy (SEM) was used for qualitative assessment of surface changes. G1 had the highest SMHR% value, followed by G3, G2 and G4. The One-way ANOVA (Analysis of Variance) showed significant differences in the SMHR% values among the groups after six days of cycling (p < 0.001). In pairwise comparisons, groups did not show differences in means of SMHR% except for G1 and G4 (p = 0.006). In the SEM Images, after treatment within the NaF group, many flaky sediments were found on the enamel surface. Similarly, the maximum mineral gain was seen in the NaF and Rennou groups. SEM images of both varnish surfaces revealed a uniform layer interspersed with shapeless precipitates. All varnishes treated artificial enamel lesions to varying degrees. However, both concentrations of Rennou showed remineralization potential comparable to 5% NaF in acceptable statistical measurements. Thus, it could be used as a potentially effective preventive measure for pediatric patients.

To investigate the impact of various self-acid corrosion adhesives in restoring ring caries in anterior deciduous teeth and the influencing factors of childhood caries. This study retrospectively analyzed the repair effect of two kinds of restoration schemes on the annular caries of children's deciduous anterior teeth. According to the repair scheme, 54 children with caries were divided into two groups. The children with 3M single bond repair were set as the control group, and the children with Clearfil SE Bond 2 repair were set as the study group. The repair effect of 6 months and 12 months of treatment and the treatment satisfaction of children were compared. Additionally, 50 children with no oral abnormalities were included as a healthy control group to analyze dental caries risk factors comparatively. The retention of dental restorations, marginal adaptation to dentin, and dental pulp vitality scores in the study group were significantly lower than those in the control group at both 6 and 12 months post-treatment, with statistically significant differences (p < 0.05). Moreover, satisfaction levels in the study group notably exceeded those in the control group (92.59% vs. 70.37%). Fisher exact test yielded a p value of 0.041. Binary logistic regression analysis revealed that daily tooth brushing habits and parental supervision were protective against dental caries occurrence. Conversely, plaque, dental calculus, proficiency in tooth brushing techniques, and post-brushing bedtime snacking emerged as independent risk factors for dental caries (p < 0.05). Compared to the conventional self-etching dentin adhesive filling regimen, the novel blended adhesive and composite resin filling significantly enhanced dental caries restoration outcomes and increased children's satisfaction. Notably, this approach was well-received by both children and their families. Further proactive measures targeting children with identified risk factors are warranted to reduce the incidence of dental caries.

Odontoma is an occasionally encountered condition that disturbs the eruption of adjacent teeth. Few reports have described multiple odontomas occurring at two adjacent sites, resulting in eruption disturbances of both primary and permanent teeth. An 8-year 2-month-old boy was referred to our hospital. Oral examination revealed that the maxillary left first molar and primary second molar were absent, and radiographic examination showed multiple compound odontomas in two regions near these unerupted teeth. The first molar gradually erupted after removal of the odontoma and excision of overlying gingiva around the tooth crown. The maxillary left second premolar spontaneously erupted at 9 years 6 months of age, but the impacted primary second molar and surrounding odontoma were located near the bottom of the maxillary sinus. The treatment plan was required to consider the completion of second premolar root development, followed by removal of the impacted primary second molar and remaining odontomas. In this case, the multiple odontomas were suspected to have disturbed the eruption of both primary and permanent teeth, and the degree of positional abnormality varied between the two teeth. This case report suggests the importance of early detection and treatment of teeth with odontoma-induced eruption disturbances.

Odontogenic keratocyst (OKC) is a common developmental odontogenic cyst in clinic patients. Odontogenic cysts are often treated by enucleation, curettage, marsupialization and decompression. With apparent advantages, marsupialization and decompression are often the preferred option for adolescents with large jaw cysts. This article aimed to report a case of large OKC involving the left mandibular second molar and third molar in a 13-year-old adolescent. Decompression was performed to preserve the second molar and inferior alveolar nerve, and the third molar was extracted. After ten months of follow-up, cyst volume decreased significantly, and the impacted second molar erupted spontaneously through the bony window. Subsequently, the residual cyst was removed by enucleation. After 18 months, the second molar erupted to the occlusal plane and played a normal function. No evidence of recurrence was found during the entire follow-up period.

To investigate the optimal timing of maxillary protraction in children with Class III malocclusion to aid comprehension of this still non-consensual topic. In all, the data of 97 children with Class III malocclusion treated by using the Delaire facemask with maxillary expansion were collected retrospectively and divided into three groups according to their dentition stages; those subjects in the mixed dentition group were further divided into three subgroups. All patients were regrouped by the cervical vertebral maturation index (CVMI) and observed closely by cephalograms at the beginning of treatment (T0) and after facemask removal (T1). Comparisons between subgroups, within groups, and the final evaluation of the increment of maxillary length were performed by different statistical methods. Similar favorable maxillary traction effects were achieved in all stages. Intragroup comparisons showed changes without significance in aspect ratio during the mixed dentition stage, while there was a significant decrease during the deciduous and permanent dentition stages. The largest increment of maxillary length was obtained when the maxillary protraction began at Cervical Stage (CS)2. However, no significant difference was found in all skeletal measurements among the three groups (deciduous, mixed and permanent dentition stages) and the three subgroups with mixed dentition. The univariable linear regression analysis also showed that CVMI and dentition stage at T1 did not have a significant impact on the increment of maxillary length. In our center, Class III malocclusion patients treated with the Delaire facemask achieved similar skeletal changes in short term, when they began the treatment at different dentition stages or CVMI stages. Starting the maxillary protraction at CS2 was likely a reliable choice for those who desired more maxillary advancement.

The sensation of pain can elevate anxiety levels, establishing a cyclical pattern that may result in the avoidance or premature termination of dental procedures. Previous endeavors employing various methods and products have produced varied outcomes. Jet injection systems, employing high pressure and velocity to deliver anesthesia without needles, offer a non-invasive option for local anesthesia administration. To assess and measure pain perception levels in a pediatric population during the restoration of young permanent teeth, comparing a needle-free injection system with the traditional dental needle method. Sixty participants with young permanent first molars requiring indirect pulp capping were enrolled, all under the care of a single operator. A simple randomization method was employed, utilizing sequentially numbered, opaque, sealed envelopes to allocate participants into two intervention groups: Group 1 and Group 2. Group 1 received traditional needle syringe anesthesia, while Group 2 received the needle-less injection system, Injex (INJEX Pharma AG, Germany). Following topical anesthesia application, local anesthesia was administered, and indirect pulp capping was performed. The Face, Legs, Activity, Cry, Consolability Scale (FLACC), Wong-Baker Scale, Time of local anesthesia (LA) Administration, Frankl Behavior Rating Scale (FBRS), and Pulse rate were evaluated and recorded at various intervals. The needle-less injection system required approximately 26.2 seconds for anesthesia administration, significantly less time than the traditional syringe (p < 0.001). FBRS score analysis revealed no significant differences between groups at all intervals. FLACC score analysis during anesthesia administration indicated lower scores in the needle-free injection group (p < 0.001). Evaluation of Wong Baker Scale (WBS) scores showed higher values in the traditional syringe needle group (p < 0.05). Using the Injex system presents a promising alternative for dental anesthesia administration, enhancing patient comfort and alleviating fear associated with traditional injections.

Silver diamine fluoride (SDF) presents a promising approach in pediatric dentistry, simplifying procedures by eliminating the need for sharp instruments or anesthesia. This study aimed to evaluate the effectiveness of 38% SDF application in arresting active caries lesions in preschool children and to assess parental acceptance of the treatment. This non-randomized, prospective, single-arm clinical study included 48 children, presenting with a total of 158 active caries lesions. The lesions were treated with 38% SDF, and their characteristics, including changes in dentin color and lesion texture, were evaluated at baseline and at a 6-month follow-up visit. The rate of lesion non-progression post-SDF application was calculated. Additionally, parents completed an oral health behavior form and the Parental Perceptions of Silver Diamine Fluoride Dental Color Changes Questionnaire to assess acceptance. The study observed a high rate of caries arrest in multi-surface teeth following SDF application. There was a statistically significant improvement in parental acceptance of SDF treatment. However, no significant interaction was observed between the treatment and either child- or parent-related variables regarding parental acceptability. The application of 38% SDF effectively arrested caries lesions in preschool children, with an observed increase in parental acceptance pre- and post-treatment.

Diagnosing congenitally missing second premolars (SPs) in early childhood is challenging due to variations in their calcification ages. In this study, we investigated the correlation between calcification grades of SPs and other permanent posterior teeth to aid clinicians in the early diagnosis of congenitally missing SPs. This cohort study retrospectively evaluated 6813 images from 9261 panoramic image records of children aged 42-78 months. The Nolla method was used to score calcification grades of first and SP and first and second permanent molars. Images were divided into 6 subgroups based on age with six-month intervals, and average calcification grades of teeth were analyzed by gender and categorized. The calcification grades of these relevant teeth were separately analyzed, specifically for Grade 0 and Grade 1 for SPs. Gender-based analysis revealed statistically significant differences in the calcification grades of 4 first premolars, 4 permanent first molars, and 2 permanent second molars. However, these differences were not significant for all 4 SPs and teeth numbered 17 and 27 between genders. Generally, Nolla grades were higher in girls compared to boys, except for all 4 SPs and tooth numbered 46. Furthermore, higher Nolla grades were observed in older age groups, which was consistent with expectations. The variability in calcification grades of SPs highlights the importance of understanding the calcification grades of other permanent teeth, which are more clearly visible on radiological images of young children. This knowledge could help clinicians in assessing the dental maturity of pediatric patients and facilitate early diagnosis of congenitally missing teeth.

Here, we used a meta-analysis approach to systematically evaluate the correlation between dental caries and dermatoglyphics. To identify findings relating to the association between dental caries and dermatoglyphics, a methodical literature search was conducted in the PubMed, Embase, Cochrane Library, and Web of Science databases from inception to August 2023. Data analysis was performed using RevMan 5.3 and Stata 15.0 software, combining odds ratios (ORs) and 95% confidence intervals (CIs). A total of eight studies were included, comprising 1563 participants, with 883 in the dental caries group and 680 in the caries-free group. The distribution of arches, loops and whorls between the dental caries group and the caries-free group did not differ significantly. Except for an observed statistical significance in the distribution of arches by study type (p = 0.02), there were no significant differences between the other subgroups. The occurrence rate of whorls was higher in the dental caries group than in the healthy group among female participants, while the distribution of loops was less frequent. Current evidence shows that in the female population, caries and dermatoglyphics were associated, however, in the overall population, the distribution of arches, loops and whorls did not correlate significantly with dental caries, according to this meta-analysis.