Journal of Clinical Pediatric Dentistry最新文献

Preemptive analgesia is an important strategy used in pediatric dentistry to intercept pain signals in neural pathways early, thus mitigating the perception of pain and enhancing overall patient comfort. Pedodontists often encounter challenges in conducting the therapy and managing uncooperative patients, when addressing enamel defects of the Molar-incisor hypomineralization (MIH) type. The aim of this study is to demonstrate the impact of preemptive analgesia on optimizing behavioral management and restorative treatment strategies for immature permanent molars exhibiting severe MIH and Treatment need index 4 (TNI), through the effective control of pain. This study comprised 27 cases with MIH level 3 Posteruptive breakdown (PEB), indicating post-eruptive enamel breakdown, with initial hypersensitivity scores exceeding 4 on the Wong-Baker Scale, was conducted over 12 months, between January 2023-January 2024. Data on pediatric patients aged between 5 years and 4 months and 7 years and 1 month with varying degrees of sensitivity in their permanent first molars before the completion of the eruption process were collected. Pain intensity was systematically evaluated at six specific time points: before and after the administration of analgesic medication as well as during restorative treatment using the Wong-Baker scale and data from the Face, Legs, Activity, Cry, Consolability index (FLACC). Statistical analysis for Wong-Baker scores and FLACC index indicated statistical significance (p < 0.05) for Mann-Whitney and Wilcoxon tests, respectively t-test. The comparison of mean scores recorded before and after preemptive analgesia during rotary instrumentation moments for the Wong-Baker index (4 > 0.29) and for the FLACC index (8.47 > 1.71) indicates the positive influence of administering ibuprofen. In conclusion, preemptive analgesia, alongside standardized anesthesia, significantly improved intraoperative pain management and behavioral outcomes.

Dental caries is a complex condition that results from a combination of genetic and environmental factors. Several genes have been found to play a role in teeth development and have been associated with various dental traits. In this study, our objective was to examine the potential correlation between the ectodysplasin a receptor (EDAR)-associated via death domain (EDARADD), Lactoperoxidase (LPO) and Actinin Alpha 2 (ACTN2) gene polymorphisms and susceptibility to dental caries. The study included a total of 600 participants, comprising 300 individuals with dental caries and 300 caries-free controls. The genotyping of the EDARADD (rs79233817), LPO (rs8178275) and ACTN2 (rs114880747) gene polymorphisms was performed using the tetra-primer amplification refractory mutation system Polymerase chain reaction (PCR) method. Individuals with dental caries were found to have a significantly higher frequency of the A allele (minor allele) for rs79233817 compared to controls. The specific single nucleotide polymorphism (SNP) (rs79233817) was associated with an increased risk of dental caries (DC) in both the co-dominant and dominant genetic models (p-value < 0.05). In addition, the study's findings revealed a significant association between the rs114880747 SNP and susceptibility to dental caries (p-value < 0.05). A higher frequency of the A allele (minor allele) of rs114880747 was observed in patients compared to the healthy controls. It is also worth mentioning that there was no association between rs8178275 susceptibility to dental caries (p-value > 0.05). It can be inferred that the EDARADD gene polymorphism (rs79233817) and ACTN2 gene polymorphism (rs114880747) potentially play a role in the genetic susceptibility to dental caries. To validate and delve deeper into these findings, it is necessary to conduct additional studies with larger sample sizes in diverse populations. This will help to establish the robustness of the results and further investigate the underlying mechanisms involved.

To evaluate the effects of facemask therapy on skeletal class III malocclusion in the Vietnamese population. This interventional trial enrolled a total of 31 children, dividing them into two age groups: Children aged 7 to 9 (54.8%), who were in the pre-pubescent or early mixed dentition stages, comprised one group. The other group consisted of 14 children, representing 45.2%, who were in the mid-pubescent or late mixed dentition stage, aged 7 to 9. All of them had skeletal class III maxillary deficiency (Angle formed by the A-nasion line and B-nasion line ≤0°, Wits appraisal ≤2). The study aimed to investigate how age affects changes in lateral cephalometric measurements before and after treatment. The research involved clinical records, lateral cephalograms, and dental casts. Both qualitative and quantitative variables were evaluated using specific statistical tests. Fisher's exact test was used for qualitative variables, while paired samples t-tests and independent samples t-tests were used for quantitative variables. In cases where the data did not follow a normal distribution, the Wilcoxon test and Mann-Whitney U-test were used (p ≤ 0.05). The study found that using a facemask improved the skeletal, dental and soft tissues. It led to a forward movement of the maxilla and a rotation of the mandible, resulting in a better relationship between the maxilla and mandible. The upper incisors shifted from a crossbite to a positive overbite, and the upper lip protruded forward. The concave face became more prominent and aesthetically pleasing. Most individuals (80.6%) had positive outcomes, with the highest proportion among children aged 7-9 years. Based on the study's findings, the facemask was highly effective for both age groups in skeletal class III malocclusion. The group of children aged 7-9 years with maxillary deficiency was more efficacious than the group of children aged 10-12 years.

Congenital craniofacial anomalies (CFAs) are among the most common birth defects, significantly affecting the appearance, oral function and mental health of patients. These anomalies are etiologically complex, involving genetics, environmental factors and gene-environment interactions. While genetic studies have identified numerous potential causal genes/risk loci for CFAs, the pathogenic mechanisms still largely remain elusive. Proteomics, the large-scale analysis of proteins, offers a comprehensive view of disease pathogenesis and their systemic effects. During the past two decades, the application of proteomics in CFA research has uncovered many biomarkers for early diagnosis and shed light on underlying mechanisms driving these anomalies. Here, we review the advancements and contributions of proteomics to congenital CFA research, outlining technological advances, novel findings from human body fluid proteomics, and integrative multi-omics approaches.

Information regarding the influence of resorption and glide paths on debris extrusion in primary teeth is lacking. Therefore, we evaluated debris extrusion with and without resorption and with and without the use of a path file in primary molar teeth prepared with ProTaper Ultimate (PTU) Prime and TruNatomy (TRN) Prime rotary file systems. Forty resorbed and forty non-resorbed primary molar teeth were collected. Both groups were divided into four subgroups (n = 10). The Eppendorf tubes were weighed pre-debris. The distal canals of the teeth were prepared with PTU Prime and TRN Prime file systems, with and without the use of path files. The debris-filled tubes were weighed, and the weight of only the extruded debris was calculated by subtraction. The data were analyzed using a three-way analysis of variance (ANOVA) test. The presence of tooth resorption significantly increased debris extrusion, and the use of a path file significantly decreased debris extrusion (p < 0.001). The binary and ternary interactions of the three evaluated parameters among the groups showed no significant differences in terms of the amount of debris extruded (p > 0.05). While debris extrusion was observed in all groups, the use of a glide path file in primary teeth before the preparation process resulted in less debris extrusion.

The present cross-sectional study was conducted to evaluate various caries risk factors in children from low socio-economic groups and to assess if children with broad contacts between one or more primary molars (type I and S) should be categorized as at high caries risk. Clinical examinations were performed on 107, 3- to 10-year-old children from low socio-economic settings. Contact types along with other caries risk factors (insurance, diet, plaque, and fluoride use, and diet habits) were analyzed for effect on presence of caries lesions (prevalence) and caries experience (decayed, missing, filled teeth). 78% of the study population had dental caries lesions, with an average dmft of 5.6. Of the 277 evaluated contacts, 88% were categorized as broad contacts. Multivariate analyses failed to validate that broad contacts were a predictor of dental caries lesions. However, the analysis showed an association of insurance status, plaque index with dmft. In conclusion, the present study could not implicate broad contacts as a factor that increased caries risk in the studied population; however, it validates the importance of insurance status, plaque index, as well as diet frequency as predictors of dental caries lesions.

This study compares the clinical efficacy of erbium-doped:yttrium-aluminium-garnet (Er:YAG) laser and traditional dental turbine in caries removal in children. The study cohort comprised 78 children aged 5 to 10 years with caries in two symmetrical maxillary molars. Different carious sides of the same child were randomly divided into control and observed sides. For each child, the caries on the control side were treated with a traditional dental turbine, while the observed side was treated with an Er:YAG laser. The study evaluated the use of anesthetics, pain levels, tooth hypersensitivity and the occurrence and severity of tooth fractures during caries removal with different methods. Additionally, the clinical anxiety and cooperative behavior of the children were observed. The time required for caries removal and cavity preparation by both methods was recorded, and the success rate of treatment was assessed after one year of follow-up. The results indicated a significant reduction in the use of anesthetics, pain and the incidence and severity of tooth hypersensitivity with the use of Er:YAG laser (p < 0.05). No significant difference was found in the occurrence of tooth fractures between the two groups (p > 0.05). The children treated with Er:YAG laser demonstrated better clinical anxiety levels and cooperative behavior. However, the time required for cavity preparation was longer with the use of Er:YAG laser (p < 0.05). After a 12-month follow-up, there was no significant difference in the success rate of treatment between the two groups (p > 0.05). In conclusion, compared to the traditional dental turbine, the use of Er:YAG laser improves treatment comfort and cooperation in children with caries and reduces the need for intraoperative anesthetics.

The aim of this systematic review is to comparatively evaluate the Triphala and chlorhexidine mouthwashes efficacies in decreasing plaque formation and gingivitis in children. With a priori-set inclusion and exclusion criteria's and relevant MeSH terms, the PubMed, Cochrane and Ovid SP were scrutinized from the year 1980 to April 2023 for prospective articles. Outcomes evaluated were plaque formation and gingivitis through Plaque index and Gingival index. Five studies were finally included and were analyzed qualitatively and quantitatively. Meta-analysis, was performed using a random effects model. Plaque index (PI) and Gingival Index (GI). There was no significant difference between reduction in the gingivitis and plaque accumulation between Triphala and chlorhexidine mouthwash groups in children (p value 0.83, 0.96).

Advances in computer-aided design/computer-aided manufacturing (CAD-CAM) technologies and adhesives have enabled the use of endocrowns as an effective and conservative treatment option for restoring endodontically treated teeth in pediatric populations. Thus, this case report presents the treatment of a severely damaged premolar tooth with coronal pulpotomy and a 3D-printed endocrown restoration. A 13-year-old patient with pain due to profound caries in the left maxillary second premolar tooth was referred to the Department of Pediatric Dentistry at Gazi University in Ankara, Türkiye. Deep dentinal caries and severe tissue loss were revealed in the clinical examination. No periradicular lesions were detected in a radiographic examination, and there was no inflammation in the pulp. The selected intervention was a two-step process involving a coronal pulpotomy followed by a custom 3D-printed endocrown restoration. No clinical complications or radiographic pathologies were observed over a two-year follow-up period, and the patient was satisfied with the final esthetics and function of the restoration. 3D-printing technology can be successfully integrated into pediatric restorative dentistry and offers a conservative, efficient, and esthetically pleasing treatment option for children with severely damaged dentition.

The accomplishment of a successful pulpectomy depends on multiple factors that involve targeted removal of the causative irritants and soft and hard tissue debris by mechanical and chemical means. Compare and evaluate the efficacy of canal preparation and volumetric filling using conventional files and two rotary file systems using cone beam computed tomography (CBCT). Thirty freshly extracted human primary second molars were randomly divided into three groups of 10 teeth each. After access opening and working length determination, pre-operative volume analysis was done using CBCT. The canals were then instrumented by either hand K-files, ProTaper rotary files or Kedo-SG Blue rotary files. Post-operative volume analysis was performed using CBCT. All the canals were obturated using Metapex and scanned again using CBCT. Mean values of the pre- and post-operative canal volumes were analyzed using one-way Analysis of Variance (ANOVA). Inter- and intra-group volumetric changes were analyzed statistically using a post hoc test. The mean difference in volume after canal preparation and obturation was the highest in the Kedo-SG Blue group, followed by the ProTaper group and the least in the hand K group (p = 0.001). Inter-group comparison showed statistically significant differences between the hand K group and ProTaper group (p = 0.001), the ProTaper group and Kedo-SG Blue group (p = 0.001), and the hand-K group and Kedo-SG Blue group (p = 0.02). The volume of preparation and obturation was the highest using Kedo-SG Blue, followed by the ProTaper file systems.