Journal of Clinical Pediatric Dentistry最新文献

Bone age determination in individuals is important for the diagnosis and treatment of growing children. This study aimed to develop a deep-learning model for bone age estimation using lateral cephalometric radiographs (LCRs) and regions of interest (ROIs) in growing children and evaluate its performance. This retrospective study included 1050 patients aged 4-18 years who underwent LCR and hand-wrist radiography on the same day at Pusan National University Dental Hospital and Ulsan University Hospital between January 2014 and June 2023. Two pretrained convolutional neural networks, InceptionResNet-v2 and NasNet-Large, were employed to develop a deep-learning model for bone age estimation. The LCRs and ROIs, which were designated as the cervical vertebrae areas, were labeled according to the patient's bone age. Bone age was collected from the same patient's hand-wrist radiograph. Deep-learning models trained with five-fold cross-validation were tested using internal and external validations. The LCR-trained model outperformed the ROI-trained models. In addition, visualization of each deep learning model using the gradient-weighted regression activation mapping technique revealed a difference in focus in bone age estimation. The findings of this comparative study are significant because they demonstrate the feasibility of bone age estimation via deep learning with craniofacial bones and dentition, in addition to the cervical vertebrae on the LCR of growing children.

Glass ionomer cements (GICs) are the common materials employed in pediatric dentistry because of their specific applications in class I restorations and atraumatic restoration treatments (ART) of deciduous teeth in populations at high risk of caries. Studies show a limited clinical durability of these materials. Attempts have thus been made to incorporate nanoparticles (NPs) into the glass ionomer for improving resistance and make it like the tooth structure. An in vitro experimental study was conducted using the required samples dimensions and prepared based on the test being carried out on the three groups with or without the modification of light-cured glass ionomer. Samples were grouped as follows: control group (G1_C), 2% silver phosphate/hydroxyapatite NPs group (G2_SPH), and 2% titanium dioxide NPs group (G3_TiO₂). The physical tests regarding flexural strength (n = 10 per group), solubility (n = 10 per group), and radiopacity (n = 3 per group) were performed. The data were analyzed by Shapiro Wilks test, and one-way analysis of variance (one-way ANOVA), and multiple comparisons by post hoc Tukey's test. The p-value of < 0.05 was considered significant. No statistically significant difference was observed between the control group (G1_C) and (G2_SPH) (p = 0.704) in the flexural strength test, however differences were found between G2_SPH and G3_TiO₂ groups, ANOVA (p = 0.006); post hoc Tukey's test (p = 0.014). Pertaining to the solubility, G2_SPH obtained the lowest among the three groups, ANOVA (p = 0.010); post hoc Tukey's test (p = 0.009). The three study groups obtained an adequate radiopacity of >1 mm Al, respectively. The resin-modified glass ionomer cement (RMGIC) was further modified with 2% silver phosphate/hydroxyapatite NPs to improve the physical properties such as enhancing the solubility and sorption without compromising the flexural strength and radiopacity behavior of modified RMGIC. The incorporation of 2% titanium dioxide NPs did not improve the properties studied.

Poor oral health during childhood can lead to various oral diseases and have long-term implications for dental health. Innovative and engaging oral health educational approaches such as game-based teaching have emerged as a promising modality for health education. This systematic review examined the effectiveness of game-based teaching methods on the oral health of children (4-12 yrs). Scopus, Medline and Web of Science databases were searched according to specific inclusion and exclusion criteria. Inclusion criteria included randomised trials that compared traditional methods of oral health education with game-based interventions in preschoolers and school-age children. The quality of the data was determined using Cochrane risk-of-bias tool for randomized trials (ROB-2). A total of seven studies that examined 1097 children (4-12 yrs) were included in this systematic review with the association of game-based teaching of oral health. The findings indicated that the utilization of game-based methods significantly improved children's oral health outcomes when compared to traditional teaching approaches. Specifically, the game-based interventions demonstrated positive effects on various aspects of oral health, including enhanced oral health knowledge, improved oral hygiene scores, and reductions in debris and plaque scores. The game-based interventions were found to be more effective in promoting oral health when compared to conventional methods of teaching, such as verbal instructions or educational posters. Based on the limited evidence available, game-based teaching appears to be an effective approach for promoting oral health among children, consistently demonstrating positive outcomes, including improved oral health knowledge, enhanced oral hygiene scores, and reductions in debris and plaque scores. Further well-designed trials adhering to reporting guidelines and using objective measures are necessary before outlining universal guidelines for best practice.

This study aimed to perform clinical and radiographic investigations of the effect of regenerative endodontic procedures (REPs) with and without concentrated growth factor (CGF). Fifty-six non-vital and immature teeth from 56 patients were randomly categorized into two groups. Following chemical and mechanical preparation, REPs with and without CGF as a scaffold was induced in the blood clot (BLC) group and the CGF group. All patients were clinically and radiographically evaluated at 6-month and 12-month intervals to monitor their progress and treatment outcomes. When considering the total number of patients, the follow-up rate was 96.4% (54 out of 56 patients) over a 12-month period. Favorable clinical and radiographic outcomes were observed in 92.6% of patients (25 out of 27) in both the CGF and BLC groups; there were no significant differences between the two groups in these respects (p > 0.05). Notable differences were, however, observed in radiographic measurements relating to the development of root length and radiographic root area when compared between the CGF and BLC groups at both the 6-month and 12-month follow-up intervals (p < 0.05). REPs have been proven to represent a conservative and effective approach for promoting maturogenesis in non-vital and immature teeth. Furthermore, the incorporation of CGF as scaffolds holds promising potential for enhancing the desired biological outcomes of this regenerative technique. These findings highlight the clinical significance and potential benefits of CGF supplementation in REPs, further supporting its application in the field of endodontics.

The aim of this review was to evaluate the association between parental oral health literacy and children's oral health outcomes. A comprehensive search was conducted across four electronic databases to identify articles that were published up to October 2023. The articles that met our predetermined criteria were then screened and assessed for eligibility. Updated Arksey and O'Malley's scoping review framework was followed. After identifying 2964 references, duplicates were removed, leaving 1992 titles. Following the screening of article titles and abstracts, 19 full-text articles underwent a thorough examination. The scoping review included 19 relevant studies. In most of the studies included, the status of oral health of children is linked to the caregiver's oral health literacy. Children of caregivers with low oral health literacy were found to exhibit deleterious oral health habits, including inadequate teeth brushing and the use of bottles at night-time. Dental caries was found to be more common in children whose parents had low oral health literacy. Striving for optimal oral health literacy in the community is a valuable and worthwhile effort. Equipping parents with the skills and knowledge to make appropriate decisions about their children's oral health could positively prevent dental caries and promote better oral health outcomes.

This study evaluated 10-year secular changes in dental maturity and dental development among Korean children. A retrospective analysis of panoramic radiograph samples from Korean children (4-16 years old) taken in 2010 and 2020 was conducted. The 2010 group consisted of 3491 radiographs (1970 boys and 1521 girls), and the 2020 group included 5133 radiographs (2825 boys and 2308 girls). Using Demirjian's method, dental maturity scores and dental developmental stages were assessed. For intra-observer reliability, Weighted Cohen's kappa was used, and Mann-Whitney U tests were performed to compare the 2020 and 2010 groups. A slight acceleration in dental maturity was observed in both boys and girls, with the difference being more noticeable in boys at an earlier age. Statistically significant differences were noted at ages 4, 5 and 7 for boys, and at age 6 for girls. Despite these differences, the individual dental development stages of 2020 and 2010 showed inconsistent trends with limited differences. Generally, girls demonstrate more advanced dental maturity than boys. A slight acceleration in Korean children's dental maturity was observed over a 10-year period when comparing the 2020 groups to the 2010 groups.

This study aimed to assess the changes in interproximal contacts before and after orthodontic treatment using the OXIS classification. OXIS refers to the types of contacts that is open (O), point contact (X), straight contact (I), and curved contact (S), and thus the acronym "OXIS". Interproximal contact data of 30 orthodontic patients were obtained at three time points: T0, at the beginning of treatment; T1, at the end of fixed appliance treatment; and T2, one-year post-treatment. For the maxillary second molar-first molar contact, the most common contact at T0, was the "S" pattern (41.6%) which increased to 61.6% at T1 and reduced to 48.3% at T2. For the maxillary first molar-second premolar contact, maxillary second premolar-first premolar contact, and maxillary first premolar-canine contact, the most common contact at T0 was the "I" pattern (58.3%, 46.5% and 43.3%, respectively), which increased to 88.3%, 93.3% and 73.3%, respectively at T1 and decreased to 80%, 88.3% and 71.6%, respectively at T2. For the maxillary canine-lateral incisor contact and lateral-central incisor contact, the most common contact at T0 was the "O" pattern (45% and 33.3%) while it was the "X" pattern at T1 (63.3% and 80%) and T2 (58.3% and 80%). A similar observation was made for the posterior mandibular and anterior teeth. There was statistical significance for most of the changes in the mandibular contacts (p ˂ 0.05). Interproximal contacts change significantly from T0 to T1. Broader contacts were normal at T1 and T2 in the posterior segments. At T2, changes in the interproximal contacts were observed in the posterior segments, and substantial evidence was available, particularly for the mandibular arch.

Dental decay is a prevalent bacterial disease affecting a significant percentage of children globally. In paediatric dentistry, various materials are available for restoring deciduous teeth, addressing both functional and aesthetic concerns. However, paediatric dentists encounter challenges related to patient compliance, limited working time, and material handling. This study aims to observe the survival rate of bulk-fill composite restorations in paediatric patients over a five-year follow-up. A total of 198 patients aged 0 to 12 years underwent 673 class II restorations on deciduous first molars (1M) and second molars (2M). All restorations were conducted performed by 1 Pediatric DDS resident students from the Paediatric Dentistry Department (Padova University), utilizing using different isolation techniques. Bulk-fill composite restorations were evaluated over a five-year follow-up, and data were collected by a single investigator. After five years, 177 patients and 611 restorations were assessed. The retention rate was higher in primary second molars than in first molars, with fewer marginal dyschromies and less formation of secondary caries. The overall failure rate was higher in primary first molars and primary lower second molars. Bulk-fill composites demonstrated significantly positive performance in terms of retention, maintenance, and marginal dyschromies. Bulk-fill composites are promising materials of choice in paediatric dentistry due to their easy handling and favorable properties. Further research is necessary to compare high and low viscosity bulk-fill composites and assess the impact of different variables on restoration success.

Dental general anaesthesia provides a comfortable treatment modality for children with early childhood caries and children's dental anxiety, but US Food and Drug Administration safety warnings have raised concerns about the neurotoxicity of general anaesthetic drugs. Currently, anaesthetic drugs have been found to impair neurocognitive function in animals, with possible mechanisms including cell damage, cell loss and impaired neuronal network function. The outcomes of clinical studies on the neurocognitive effects of surgical general anaesthesia in children have been inconsistent. However, studies focusing on dental general anaesthesia in children suggest that it does not affect neurocognitive function. In general, a growing number of studies suggest that dental general anaesthesia does not affect neurocognitive development in children. Moreover, dental general anesthesia should be used as normal when other behavioural management is unavailable.

This study aimed to characterize the anatomical and physiological features of pits and fissures in primary and permanent molars by microtomographic (micro-CT) examination and three-dimensional (3D) printing. The occlusal surfaces of 84 primary molars and 60 permanent third molars were examined. The samples were scanned with micro-CT and the occlusal surface separated. The areas of the crown, its occlusal part, and fissures and pits were calculated. Digital impression of the occlusal surface was created and 3D printed. The frequency of different fissure types was determined by direct observation. Data were subjected to statistical analysis using Mann-Whitney U Test and chi-square test (p < 0.05). There was statistically significant difference between the ratio of occlusal surface and the crown area for the molars in primary and permanent dentitions (24.78% and 28.85% respectively, p < 0.05). In terms of the percentage ratio of the fissure area to the occlusal surface (24.24% and 22.30%) and the fissure area to the crown (6.02% and 6.52%), no significant difference was observed (p > 0.05). V-shaped fissures were predominant in both primary and permanent teeth, with a higher occurrence in primary dentition (59.48%, p < 0.05). Permanent molars exhibited a higher prevalence of I-type and U-type fissure configurations compared to primary molars (p < 0.05), with I-type fissures being the least common in primary molars. In both dentitions there was no statistically significant difference in the prevalence of IK-configuration (p > 0.05). The fissure depth was significantly greater in permanent molars than primary molars (p < 0.05). In conclusion, this study revealed remarkable diversity in fissure morphology among primary and permanent molars.