Journal of Clinical Pediatric Dentistry最新文献

This study evaluated the mandibular development induced by rapid maxillary expansion (RME) therapy in mixed dentition patients with different vertical growth patterns through long-term observation. The research utilized a retrospective design that included two cohorts: a control group consisting of pediatric subjects with individualized malocclusions, and an experimental group received RME therapy. A total of 60 subjects were included; 37 in the RME group (17 males and 20 females) and 23 in the control group (13 males and 10 females). Based on mandibular plane angles, 19 pertinent cephalometric variables were quantified with Dolphin Imaging software, and participants were subclassified into high-angle and normal-angle subgroups. Changes in the groups during the observation period were statistically analyzed with a t-test. Compared to the control group, both sagittal parameters tended to decrease after treatment in the RME group (p < 0.05), and none of the vertical correlations were statistically different (p > 0.05). Within the normal-angle experimental subgroup, sagittal parameters markedly decreased when contrasted with their normal-angle control group (p < 0.05). Notably, a substantive decrease in overjet was solely observable in the sagittal dimension among the high-angle expansion subgroup when compared to the high-angle control subgroup (p < 0.05). In the vertical dimension, neither the normal-angle nor high-angle subgroups exhibited any statistically significant differences from their respective control cohorts (p > 0.05). Based on long-term observation, RME therapy promotes mandible sagittal growth of the mandible in subjects with normal-angle vertical growth patterns. A similar tendency was not observed in subjects with high-angle vertical growth patterns. In addition, the mandibular plane angle did not increase after RME in children with high-angles.

Regenerative endodontic procedures (REPs) are frequently utilized to treat immature permanent teeth with necrotic or inflamed pulps. In most instances, these treatments successfully result in the resolution of apical periodontitis and continued root maturation. However, after reviewing over 180 REP cases treated in the Endodontics Department of Stomatology Hospital at Zhejiang University School of Medicine over the past seven years, we identified an unusual root development pattern in ten cases, characterized by root tips detached from the root body. We conducted a comprehensive analysis of the patients' demographic information, dental histories, and therapeutic efficacy, and identified five potential etiological factors for this rare phenomenon, including external force, prolonged extensive periapical inflammation, iatrogenic factors, traumatic history of primary teeth, and excessive tooth mobility. In our study, we observed that therapeutic failure was more likely in patients with initially separated root tips, while those with initially normal teeth demonstrated significantly better prognoses. We hypothesize that the initial root condition may exert a considerable influence on treatment outcomes.

Sleep bruxism is both masticatory muscle activities characterized by repeated or prolonged tooth contact as well as bracing or thrusting of the jaw. This meta-analysis evaluates the differences between sexes and which therapy is most effective in treating bruxism. A literature search was performed on PubMed, Lilacs, Web of Science and Scopus, and articles published from 2000 to 2022 were considered according to the keywords entered. The term "Bruxism" has been combined with "Children" using the boolean connector AND. At the end of the research, 1462 studies were identified from the search conducted on the three engines. Only four were chosen to draw up the present systematic study. The Forrest plot found that photo biomodulation therapy has a higher efficacy (Odds Ratio (OR) 0.10; 95% Confidence Interval (CI) from 0.03 to 0.43), followed by treatment with hydroxyzine (OR 0.19; 95% CI from 0.03 to 1.04). The average between girls and boys with bruxism is 18.5 for boys and 19.5 for girls. This meta-analysis showed that treatment by photobiomodulation has more significant effects on bruxism, followed by treatment with hydroxyisalazine. However, this meta-analysis has limitations due to the diversity of treatment evaluation methods.

Globally, early childhood caries (ECC) is a significant public health concern, necessitating effective prediction and prevention strategies. This study aimed to explore variations in the oral microbiome of saliva from pre-school Han and Uyghur children during ECC development and establish a predictive model based on temporal oral microbiome changes. Saliva samples were collected from a single kindergarten every three months over six months. Forty-four pre-school children provided 132 samples, categorized into six groups: (1) HEF (healthy pre-school Han children), (2) HEO (Han children with caries), (3) HEP (Han children with progressive caries), (4) WEF (healthy pre-school Uyghur children), (5) WEO (Uyghur children with caries), and (6) WEP (Uyghur children with progressive caries). Illumina Miseq sequencing identified oral microbiome differences between groups and time points. The Random Forest (RF) algorithm established ECC prediction models. The T1HEO group exhibited significantly higher Chaol index, observed species index, PD whole tree index, and Shannon index than the T2HEO group (p < 0.01). Similarly, the T1WEO group had significantly higher Chaol index, observed species index, and PD whole tree index than the T2WEO group (p < 0.05). The AUROC value for the ECC prediction model based on temporal oral flora changes was 0.517 (95% CI: 0.275-0.759) for pre-school Han children and 0.896 (95% CI: 0.78-1.00) for pre-school Uyghur children. In the onset of caries in pre-school Han children, bacterial species richness and community diversity in saliva declined, paralleled by a decrease in bacterial species richness in pre-school Uyghur children's oral saliva. The ECC prediction model grounded on temporal oral microflora changes exhibited robust predictive power, particularly for pre-school Uyghur children, potentially leading to more effective ECC prevention measures.

Nickel-titanium (NiTi) instruments offer many advantages during endodontic instrumentation; however, the fracture risk within the canal remains a concern. Manufacturers continuously develop and introduce instruments to the market with supposedly enhanced cyclic fatigue resistance and increased flexibility, achieved through different proprietary manufacturing processes, the details of which have not been made public. In recent years, two rotary systems specially designed for deciduous teeth have been commercially available, but information about their performance is lacking. This investigation aimed to identify which manufacturing process provides better cyclic fatigue resistance: the AF-H Wire technology used in the AF baby rotary files (AF-f) or the CM-Wire technology used in the i3 Gold deciduous teeth rotary files (i3G-f). Forty rotary International Organization for Standardization (ISO) 25/04 files were tested in artificial canals with a standard geometry of 60° angle and 2.5 mm radius until fracture. The number of cycles to fracture was calculated, and the length of the fragments was measured. A scanning electron microscope (SEM) was used to examine the fracture surfaces and fragments. Energy dispersive spectroscopy (EDS) was used to determine the percentage weight of NiTi in each file. The statistical analysis (Mann-Whitney test) showed that the cyclic fatigue resistance of the AF-f was significantly higher (p < 0.0001) than that of the i3G-f. Additionally, there was a significant difference (p = 0.0419) in the length of the fractured fragments. All instruments showed one or more types of manufacturing defects and presented similar NiTi percentages by weight. The manufacturing process is critical to cyclic fatigue resistance, and there seems to be responsible for the difference in cyclic fatigue resistance between these similar instruments.

In spite of the widespread use of functional appliances, broad variations were applied the treatment response. The aim of this study is to investigate the pre-treatment cephalometric predictors on the chin advancement of twin-block in growing Chinese patients with class II malocclusion. After screening, 90 patients treated by twin-block were included in the study. The treatment outcome was assessed by the alterations in the distance of skeletal pogonion (Pog) to the vertical reference plane perpendicular to the Frankfurt plane (ΔPog-VRP). Moreover, ΔPog-VRP was divided by the cranial growth indicated by the Nasion to Basion changes (ΔN-Ba) to minimize the growth discrepancy among individuals (adjΔPog-VRP). Patients with ΔPog-VRP/adjΔPog-VRP above the median value were categorized into good response group (GRG/adjGRG, N = 45), while the rest were poor response group (PRG/adjPRG, N = 45). Independent t-test was used to compare the pre-treatment cephalometric measurements between GRG/adjGRG and PRG/adjPRG. Stepwise multivariate regression models were used to determine the pre-treatment cephalometric predictors for the chin advancement. Generally, there were not any significant differences between GRG/adjGRG and PRG/adjPRG regarding age, gender and cervical stage before twin-block treatment. Patients from GRG had significantly reduced cephalometric measurements in the vertical dimensions, including ∠N-Go-Me, ∠Mandibular plane-Occlusal plane (∠MP-OP) and the sum of angles (p < 0.05) in comparison to PRG. When the individual growth was taken account, similar findings were observed. The patients from adjGRG had a significantly lower ∠Sella Nasion line-MP (∠SN-MP), ∠Ar-Go-Me and ∠N-Go-Me, as well as an increased Posterior facial height (PFH)/Anterior facial height (AFH) (p < 0.05) compared with their counterparts. ∠N-Go-Me variable was the independent predictor on Pog advancement with (β = -0.26, 95% CI: -0.06 to -0.01, p = 0.01) and without (β = -0.29, 95% CI: -0.06 to -0.01, p < 0.01) adjustments on individual growth. The results of this study showed that patients with a reduced N-Go-Me angle are more likely to experience a greater chin advancement following twin-block treatment.

Evaluation of micro tensile bond strength (μTBS) and marginal leakage of sodium fluoride (NaF) and nano-hydroxyapatite (n-HA) modified universal adhesives (UAs) bonded using etch-and-rinse (ER) and self-etch (SE) bonding technique to the carious affected dentin (CAD). One hundred and twenty primary molars were prepared for CAD on the occlusal surface. The occlusal CAD surface was flattened and underwent a polishing procedure. The specimens were divided into six groups using a random allocation method based on the UAs applied and the mode of etching used (n = 20) Group A1: UAs (ER), Group B1: UAs (SE), Group A2: UAs (NaF) + ER, Group B2: UAs (NaF) + SE, Group A3: UA (n-HA) + ER and Group B3: UAs (n-HA) + SE. Composite restoration was placed and samples were thermocycled. Microleakage, μTBS, and failure mode assessment were performed using a dye penetration test, universal testing equipment, and stereomicroscope respectively. The μTBS and microleakage results (mean ± SD) were examined using analysis of the variance (ANOVA) and Tukey post hoc tests. Group B1 (UAs + SE) demonstrated the maximum scores of microleakage (25.14 ± 9.12 nm) and minimum recorded value of μTBS (14.16 ± 0.55 MPa). In contrast, Group A3 (UAs (n-HA) + ER) displayed a minimum value of marginal leakage (12.32 ± 6.33 nm) and maximum μTBS scores (19.22 ± 0.92 MPa). The outcomes of the intergroup comparison analysis showed that Group A2 (UAs (NaF) + ER), Group B2 (UAs (NaF) + SE), Group A3 (UA (n-HA) + ER) and Group B3 (UAs (n-HA) + SE) presented comparable outcomes of marginal seal outcomes and μTBS scores (p > 0.05). NaF and n-HA-modified UAs displayed favorable bond strength and minimum marginal leakage to the deciduous affected dentin surface.

This study aims to retrospectively evaluate the differences in dental treatments rendered in general anesthesia (GA) for patients who did or did not receive application of silver diamine fluoride (SDF) prior to GA. 1559 patients (≤6 years) who completed treatment with GA for caries at University of California San Francisco (UCSF) between 2015 and 2019 were included in the study. At baseline patients' electronic health record was reviewed to collect planned treatment, complete dental treatment and demographics. Patients were identified as SDF group (N = 335, 21.49%) or comparison (N = 1224, 78.51%). Dental treatments rendered were compared between the SDF and comparison group with multi-variable regression, including variables for demographics and clinical findings at baseline. The initial analysis identified variations in gender, age, dental pain, pulp involvement, and initial treatment plans between the SDF and comparison groups at baseline. In an unadjusted analysis, the SDF group displayed a statistically significant increase in the number of crown procedures but a notable decrease in the number of pulp therapy and extraction treatments completed (p < 0.05). An adjusted multivariable model affirmed the inverse relationship between SDF application and completion of pulp therapy and extractions at the time of GA (p < 0.05). No significant association was identified with the total number of crowns needed and SDF. The model further indicated a positive correlation between the total count of pulp therapy and extractions completed with patient age and the wait-time for GA. In conclusion, pre-GA application of SDF to carious primary teeth is negatively correlated with completed pulp therapy and extraction. SDF application prior to dental treatment with GA may be a valuable tool to reduce invasive dental procedures in GA.

The Child Oral Impacts on Daily Performances (Child-OIDP) index was developed to assess children's oral health-related quality of life. This study aimed to culturally adapt the self-administered Child-OIDP index into Urdu, evaluate its psychometric properties, and provide an initial estimate of oral impacts among 11-12-year-old children in Lahore, Pakistan. The translation of the Child-OIDP index from English to Urdu was performed, and the content and face validity of the initial Urdu version were evaluated by experts and 11-12-year-old children, respectively. The psychometric properties of the Urdu Child-OIDP were assessed by administering the index to 264 children aged 11-12 from five schools in the Lahore district. Psychometric properties were evaluated using criterion and construct validity, internal consistency, test-retest reliability, and global self-rated oral items, followed by an oral examination. The standardized Cronbach's alpha was 0.77, and the weighted Kappa was 0.94 (intraclass correlation coefficient = 0.98). The index exhibited significant associations with subjective outcome measures, dental problem history, and dental caries status (p = 0.001). Children reporting poor oral health, lower satisfaction with oral health, and experiencing oral impacts demonstrated higher Child-OIDP scores. Additionally, children with dental caries and perceived treatment needs exhibited higher Child-OIDP scores, indicating poorer Oral Health-Related Quality of Life (OHRQoL). The prevalence of oral impacts was 88.3% (mean score = 17.8, standard deviation (SD) =14.7). Eating performance was the most affected while speaking was the performance least affected, while toothache and sensitive teeth were identified as the two most common causes of oral impacts. Toothache was the primary cause of condition-specific impacts, responsible for the majority of oral impacts. This study demonstrates that the self-administered Urdu Child-OIDP index is a valid and reliable tool for assessing OHRQoL among 11-12-year-old children in Lahore, Pakistan.

Disadvantaged schoolchildren from rural and low socioeconomic backgrounds face persistent oral health inequalities, specifically dental caries, and periodontal diseases. This protocol aims to review the effectiveness of promotive and preventive oral health interventions for improving the oral health of primary schoolchildren in these areas. We will search the PubMed, MEDLINE, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) via EBSCOhost, Cochrane Library, Web of Science, Dentistry and Oral Sciences databases for studies published from 2000-2023. The review includes randomised/nonrandomised controlled trials and community trials evaluating the effectiveness of promotive and preventive oral health interventions on at least one of these outcomes: changes in dental caries status, periodontal disease status, oral hygiene status/practices, sugar consumption, or smoking behaviours. Two reviewers will independently assess the searched articles, extract the data, and assess the risk of bias in the studies using the Cochrane Risk of Bias 2 (ROB 2) for randomised controlled trials and Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) for non-randomised controlled trials. Both narrative and quantitative analyses will be conducted. However, only narrative synthesis will be performed if the data are substantially heterogeneous. The synthesised evidence from this review can inform policymakers on evidence-based interventions to improve the oral health outcomes of schoolchildren from rural and low socioeconomic backgrounds. Systematic Review Registration PROSPERO (Registration number: CRD42022344898).