Journal of Clinical Pediatric Dentistry最新文献

The present manuscript aims to provide an updated overview of the clinical management of functional posterior crossbite (FPXB) in growing subjects which can be helpful for orthodontists and pediatric dentists in daily practice. Database searches were performed until December 2023 to evaluate the published literature on the topic. The most pertinent articles were chosen for the review from the retrieved articles. No restrictions regarding the year or language of publication were applied. Additional studies were included by manually searching the references of the included studies. The manuscript has been structured for a narrative purpose. Although there is evidence of spontaneous correction in the transition from deciduous to mixed dentition, the literature suggests initiating the treatment early to increase the success rate. Early treatment involves reducing the risk for potential temporomandibular disorders and adaptations at the level of skeletal, dental, and muscle components. Recent advancements in tridimensionali (3D) imaging systems can also help define the appropriate treatment time case-by-case. Considering the prevalence and the multiple etiological factors involved in the development of FPXB in the pediatric population, orthodontists and pediatric dentists should decide the treatment time for this condition with a careful evaluation of the risk/benefit ratio.

Fissure sealants commonly exhibit weak mechanical and physical properties, potentially compromising their effectiveness in preventing dental caries. Therefore, this laboratory study aimed to synthesize and characterize experimental pit and fissure sealants in comparison with a commercially available sealant. Three different formulations of experimental pit and fissure sealing materials were synthesized using a blend of bisphenol A-glycidyl methacrylate (Bis-GMA) and triethylene glycol dimethacrylate (TEGDMA) monomers. The resin composition encompassed 70 wt.%, with 30 wt.% fillers comprising 10 wt.% silica in each composition, while 20 wt.% bioactive glasses. Specifically, group G1 employed Biomin F powder, group G2 utilized Biomin C powder, and group G3 incorporated S53P4 powder. The control group (GC) was a commercially available pit and fissure sealant (Seal-Rite). Ten disk-shaped specimens from each study group were fabricated (n = 10/group). The surface roughness, water contact angle, nanohardness (nH), elastic modulus (EM), water solubility and sorption were statistically evaluated using a one-way analysis of variance (p < 0.05). The surface roughness of the G1 & G2 groups and the water contact angle of G1, G2 & G3 groups were significantly lower compared to the control group (p < 0.05). However, nH, EM, water solubility, and sorption were notably higher in the control group compared to the experimental groups, except G1, which exhibited no significant difference from the control group (p > 0.05). The inclusion of micron-sized Biomin F powder in the experimental Bis-GMA/TEGDMA resin formulation demonstrated advantageous effects in reducing surface roughness and forming a lower contact angle without compromising the mechanical attributes.

Traditional tooth image analysis methods primarily focus on feature extraction from individual images, often overlooking critical tooth shape and position information. This paper presents a novel computer-aided diagnosis method, Collaborative learning with Mask Region-based Convolutional Neural Network (Co-Mask R-CNN), designed to enhance tooth image analysis by leveraging the integration of complementary information. First, image enhancement is employed to generate an edge-enhanced tooth edge image. Then, a collaborative learning strategy combined with Mask R-CNN is introduced, where the original and edge images are input simultaneously, and a two-stream encoder extracts feature maps from complementary images. By utilizing an attention mechanism, the output features from the two branches are dynamically fused, quantifying the relative importance of the two complementary images at different spatial positions. Finally, the fused feature map is utilized for tooth instance segmentation. Extensive experiments are conducted using a proprietary dataset to evaluate the effectiveness of Co-Mask R-CNN, and the results are compared against those of an alternative segmentation network. The results demonstrate that Co-Mask R-CNN outperforms the other networks in terms of both segmentation accuracy and robustness. Consequently, this method holds considerable promise for providing medical professionals with precise tooth segmentation results, establishing a reliable foundation for subsequent tooth disease diagnosis and treatment.

This study aimed to investigate sex differences in craniomaxillofacial parameters in children and adolescents. Lateral cephalograms were obtained from 340 subjects (141 male, 199 female) aged 6 to 18 years, and their craniofacial characteristics and cervical vertebral maturity were assessed using the quantitative cervical vertebral maturity (QCVM) method. Age-based stratified analyses on craniofacial parameters and further comparison in QCVM Ⅲ subjects were performed. Among all analyses, male subjects had significantly greater value than females in sex-different parameters except for facial convexity. The overall group had 17 sex-different parameters (ramus height, anterior facial height (AFH), posterior facial height (PFH), upper anterior facial height (UAFH), lower anterior facial height (LAFH), anterior cranial base length, posterior cranial base length, facial convexity, upper lip length, upper lip thickness, lower lip thickness, soft tissue chin thickness, nasion of soft tissue-subnasale (N'-Sn), subnasale-menton of soft tissue (Sn-Me'), subnasale-stomion inferius (Sn-Sto)). The <12 years old group showed 6 significant sex differences (AFH, LAFH, lower lip protrusion, lower lip thickness, N'-Sn, Sn-Me'). While the ≥12 years old group occurred two more parameters (mandibular body length, AFH/PFH) than the overall group. 12 cephalometric parameters had significant sex differences among QCMV III patients. After age adjustment, the number of sex-different parameters only increased in soft tissue. Craniofacial characteristics and cervical vertebrae maturation of the youngsters exhibited significant sex differences. Though females reached an earlier cervical vertebral maturation, they still had smaller craniofacial linear features. Sex differences should be taken into account in developing reference standards for cephalometric measurements and treatment planning in the clinic.

Access to preventive dental services, such as dental sealants, varies based on several factors, including insurance coverage. The aim of this study was to examine the association between different types of insurance and dental sealant placement among US children. Data from the National Survey of Children Health (NSCH) cycle 2018 was analyzed. The sample size comprised 18,012 children aged 4-14 years. The main outcome was dental sealant placement in the past year (yes/no). The primary predictor was the type of insurance (public, private, both public and private, and uninsured). Bivariate and adjusted multivariate analysis was carried out to estimate weighted prevalence and adjusted odds ratios using SAS 9.4. The adjusted multivariate results showed that dental sealant use was the lowest among uninsured children compared to publicly insured children, followed by privately insured children, and finally mixed insured (public and private) children (adjusted odds ratio (AOR): 0.70; 95% confidence interval (CI): 0.57-0.86, AOR: 0.79; 95% CI: 0.54-1.14, AOR: 0.57; 95% CI: 0.40-0.82, respectively). In conclusion, privately insured, mixed insured, and uninsured children had lower odds of dental sealant use compared to publicly insured children. There was a significant variation in the accessibility of dental sealants among US children based on their insurance coverage. Despite these disparities, every child should have access to dental sealants, regardless of insurance status.

Stress, a state of mental or emotional strain or tension brought on by challenging or demanding events might hamper a dentist's ability to react quickly and prudently. Their ability to deal with difficult patients may also be compromised, especially when dealing with frightened or anxious people. The main goal of this study was to survey a wide range of dental professionals from different backgrounds, including undergraduates, general practitioners and specialists, and determine how much stress each group was experiencing and how it affected both the participants and the treated patients. A sample size of an estimated 300 participants (defined by a 95% confidence interval and a 5% margin of error) was found to be sufficient for this investigation. About 178 responses were received to the 300 Google Forms questions, a response percentage of 59.3%. Of those surveyed, 77% had work experience ranging from zero to five years. Women made up 30% of the population, while men made up 70%. Furthermore, the patient-to-dentist ratio was neither a significant worry nor a source of stress because the majority of dentists saw between 0 and 10 patients per month. General dentists and specialists treated the patients with higher awareness, in-depth understanding and care than undergraduates did because they frequently reported having less experience than the other categories in this study did. The fact that a sizable majority of the respondents had between 0 and 5 years of experience further explains the high stress levels. High anxiety levels were present among dental undergraduates, highlighting the necessity of stress management instruction and support services in training programmes.

Dental anxiety in children has been associated with poor oral health outcomes. Behaviour management and psychological interventions have been recognized as effective methods of reducing anxiety in children with positive long-term effects. So far, no information is available on how this issue is managed in the Fijian population. The aim is to investigate the practice and perception of dental practitioners in Suva-Nausori when managing paediatric patients with dental anxiety. A cross-sectional descriptive study was conducted using a questionnaire distributed to dental practitioners in Suva-Nausori area, Fiji. The questionnaire focused on assessment methods for identifying anxious paediatric patients, management approaches, and challenges faced by practitioners. The response rate was 80% (n = 40), with almost an equal distribution between private and public practitioners of 47% and 53% respectively. Observation-based assessment was reported as the most commonly used method for identifying dental anxiety by 79% of participants. Behaviour management techniques, particularly communication and Tell-Show-Do, were widely used by 83% of practitioners. Additionally, 17% utilised both behavioural and pharmacological techniques, with oral sedation being the most common pharmacological method (71%). Local anaesthesia was identified as the most challenging procedure for anxious children. These findings indicate that dental practitioners in the Suva-Nausori area primarily utilise behaviour management techniques and oral sedation to manage dentally anxious children, indicating a limited range of techniques. There is a need for further education and training to ensure that anxious patients receive optimal management, including options such as conscious sedation tailored to individual needs.

Stainless-steel crowns (SSCs) are the most durable restorative option for deciduous teeth, although they are unsightly. However, prefabricated zirconia crowns (ZCs) look more pleasant but require substantial dental preparation. Recently, BioFlx crowns have been introduced as a white-colored alternative to SSCs, providing both flexibility and aesthetics. However, clinical trials have not assessed their oral cavity load-bearing capacity and suitability for repairing severely decayed deciduous teeth. To address this gap, the present study compared the shear stresses generated by BioFlx crowns, ZCs and the gold standard SSCs when restoring extensively decayed deciduous teeth using finite element analysis (FEA). The restoration was represented by three finite element models with the identical tooth structure: BioFlx, SSC and ZC, constructed using a Trios 3 scanner and exported for analysis using ANSYS. The FEA results showed that ZCs had the maximum axial static load stress at 40.91 MPa, followed by SSCs at 39.331 MPa and BioFlx at 14.009 MPa. ZCs produced 2.932 MPa at 45°, SSCs 3.005 MPa and BioFlx 0.3227 MPa. ZCs had a maximum primary stress of 3.055 MPa at 0°, while SSCs and BioFlx had 2.3 and 0.3017 MPa, respectively. Deformation analysis revealed that under a load direction of 90°, SSCs deformed by 5.978 mm, ZCs by 5.971 mm and BioFlx by 5.971 mm. When the load was applied at an angle of 45°, SSCs deformed by 6.527 mm, ZCs by 5.444 mm and BioFlx by 5.447 mm. SSCs deformed 5.452 mm at 0° load, while ZCs and BioFlx deformed 6.472 and 6.479 mm, respectively. Based on these findings, BioFlx crowns, in combination with the underlying core material, can withstand maximum loads, suggesting that a mutilated primary posterior tooth restored with glass ionomer cement and a BioFlx crown may be a viable option for frequent clinical use.

Evaluate the prevalence and severity of caries in permanent teeth and their association with the treatment needs of 8-12-year-old Mexican schoolchildren. The cross-sectional study was conducted on 1139 8-12-year-old schoolchildren attending two public primary schools in State of Mexico. The study used the International Caries Detection and Assessment System (ICDAS) to examine the prevalence of caries and identify treatment needs in schoolchildren. Other variables considered were age, gender, oral hygiene, dental visits ≤6 months, toothbrushing frequency, and the mother's years of education. A logistic regression model was used to identify the association between independent variables and treatment needs. In all analyses, two-tailed p values ≤ 0.05 were considered statistically significant. The prevalence of caries lesions was 82.1% (82.2% boys vs. 81.9% girls) considering all lesion categories (ICDAS 1-6), while the distribution of the severity of caries was 17.9% (ICDAS 0), 13.9% (ICDAS 1-2), 28.3% (ICDAS 3-4) and 39.9% (ICDAS 5-6). The treatment needs index was 77.3%. The logistic regression model showed that the schoolchildren with moderate (ICDAS 3-4) and extensive carious (ICDAS 5-6) lesions were, respectively, 61% Odds Ratio ((OR) = 1.61; p = 0.036) and 77% (OR = 1.77; p = 0.013) more likely to present treatment needs. Other variables, such as poor oral hygiene (OR = 1.52; p = 0.009), the mother's low level of education (OR = 1.53; p = 0.007), and a lack of dental visits (OR = 1.42; p = 0.030) were associated with dental treatment needs. The results obtained show that the 8-12-year-old Mexican schoolchildren presented a high level of treatment needs for moderate and extensive carious lesions (ICDAS 3-6). These findings reiterate the importance of implementing oral health prevention, promotion, and intervention programs to help protect the oral health of school-age children.

Quantitative analysis of adenoid size plays a pivotal role in experimental research, and imaging examinations are extensively employed for this purpose. This study aims to investigate the impact of adenoidectomy/tonsillectomy on the maxillary growth and respiratory outcomes of children. A comprehensive systematic search was conducted across multiple databases, including PubMed, Web of Science and Scopus, utilizing the following keywords: "gland resection", "tonsillectomy", "mouth breathing", "airway obstruction", "low ventilation", "obstructive sleep apnea (OSA) syndrome" and "dental maxillary growth" in articles published between January 2000 and April 2022. The eligibility criteria encompassed studies with a well-defined research question, appropriate sample size and reporting of pertinent cephalometric indices. The risk of bias was assessed using the Cochrane Risk of Bias tool. Heterogeneity between studies was evaluated using the Q test and I² statistics. Based on the meta-analysis of six studies, the odds ratio (OR) values for the influence of adenoidectomy/tonsillectomy on nasal line-nasion-sella line (NL-NSL) and mandibular line-nasion-sella line (ML-NSL) in children's maxillary growth were -0.84 and 0.58, respectively, with 95% confidence intervals (CI) of (-1.08, -0.61) and (0.34, 0.81). No heterogeneity was observed between studies (I² = 0.00% for both). In five studies, the OR values for the influence of adenoidectomy/tonsillectomy on children's maxillary growth angle formed by the sella-nasion line and line N-point A (SNA), and angle formed by the sella-nasion line and line N-point B (SNB) were -0.30 and -0.31, respectively, with 95% CI of (-0.55, -0.06) and (-0.56, -0.07). No heterogeneity was observed among studies (I² = 0.00% for both). The study indicated that adenoidectomy/tonsillectomy has a positive impact on the maxillary growth and respiratory issues in children.