JOURNAL OF DENTISTRY FOR CHILDREN最新文献

The quest for an esthetically pleasing smile is a key driver in seeking dental interventions aimed at achieving a more balanced and harmonious appearance. The purpose of this report is to discuss the restoration of conical lateral incisors in an 11-year-old patient. The treatment approach employed direct composite resin restorations associated with the Digital Smile Design (DSD) technology. The use of composite resins is the technique of choice for re-anatomizing conical teeth due to the material's versatility and low cost. In this case, the technique associated with the digital workflow resulted in the efficacy of esthetic restorations. DSD contributes to greater predictability of dental treatment, comfort, safety and efficiency.

Purpose: To investigate the oral health-related quality of life (OHRQoL) of young children in a randomized clinical trial (RCT) of silver diammine fluoride (SDF) and five percent sodium fluoride varnish (NaFV) to manage early childhood caries (ECC). Methods: Children younger than 72 months of age with active dentinal caries lesions (ICDAS 5 or 6) in primary teeth received two applications of 38 percent SDF and five percent NaFV as part of an RCT testing three different frequency regimes (one, four, and six months apart). The Early Childhood Oral Health Impact Scale (ECOHIS) questionnaire was completed at three study visits. Statistical analyses included descrip- tive and parametric methods. A P -value of ≤0.05 was significant. Results: Eighty-two children (58.5 percent male) were recruited with a mean age of 44.3±14.2 months. Significant improvement in total ECOHIS scores for all children was observed following treatment (baseline mean scores=4.52±4.77 versus third visit mean scores=3.19±3.78, P =0.01) and family impact scores for all children (base- line mean scores=3.00±2.98 versus third visit mean scores=1.68±2.01, P ≤0.001). However, no significant change in the mean child impact score was observed among all the children ( P =0.97). The parental distress and family function domains showed the most improvement with SDF treatment. No significant ECOHIS score differences were found among the three frequency groups across visits. Conclusions: Children showed better OHRQoL after applying 38 percent SDF and five percent NaFV. No significant differences were found between treatment groups. SDF is a viable non-restorative option for managing ECC as it has a positive effect on OHRQoL.

Purpose: To assess the effectiveness of Biodentine^™ (BD), mineral trioxide aggregate (MTA) and ferric sulfate (FS) as pulpotomy agents in primary molars and evaluate the impact of behavior guidance strategies on pulpotomy success.Methods: In this retrospective cross-sectional study, data from 374 cases (50.5 percent male, aged two to 10 years) undergoing 469 pulpotomies at a university pediatric clinic between April 1, 2016 and January 1, 2020 were analyzed. Clinical and radiographic outcomes were evaluated by two calibrated examiners using validated criteria. Statistical analysis included descriptive statistics, logistic regression (P <0.05), Kaplan-Meier survival curves and Cox proportional hazard models, with inter- and intra-examiner reliability confirmed by Cohen's Kappa. Results: Among the materials, BD and MTA showed the highest clinical (98.5 percent and 97.9 percent, respectively) and radiographic (95.2 percent and 93.6 percent, respectively) success, significantly outperforming FS (88.9 percent and 80.9 percent, respectively). Pulpotomy failures were notably higher with the use of protective stabilization (P =0.002), while treatment under general anesthesia and good patient cooperation were associated with better outcomes. Conclusions: BD and MTA demonstrated superior effectiveness over FS for primary molar pulpotomies. The success of pulpotomy is significantly influenced by behavior guidance techniques, with less restrictive methods correlating with improved outcomes.

Trichothiodystrophy (TTD) is a rare genetic disorder with a high mortality rate among pediatric patients, primarily as a result of related infections. Its defining clinical feature is brittle, dry hair, with broken hair shafts revealing "tiger-tail banding". Other common characteristics include photosensitivity, scaly skin and stunted growth. The disorder's rarity and variety of symptoms pose diagnostic challenges, yet early diagnosis and treatment can improve a patient's overall health and quality of life. The purpose of this report is to describe the case of an underweight five-year-old boy with brittle hair and scaly skin who presented to an emergency room with an active odontogenic infection and was incidentally diagnosed with TTD following genetic testing. This case illustrates the importance of evaluating patients comprehensively, while addressing their chief complaint. It also showcases the importance of involving providers across health professions in diagnosing and managing TTD and other genetic disorders in pediatric patients.

The management of molar-incisor hypomineralization is challenging as the clinical appearance and individual need for treatment vary widely, with a broad spectrum of treatment modalities available. The purpose of this report is to describe the treatment of an affected, carious permanent molar using glass ionomer cement (GIC) and an occlusal replica technique. An alginate impression of the mandibular arch was done and a partial diagnostic cast was fabricated, followed by diagnostic waxing and a silicone guide. Conventional GIC was used to fill the silicone impression, which was placed on the tooth. The excess material was removed and occlusion was checked. Twelve months after the procedure, the patient did not report any symptoms, the oral hygiene was adequate and restorative material was intact.

Knowledge of microbiology-related issues in dentistry is fundamental to clinical practice and patient care. The purpose of this literature review is to comprehensively describe the roles microbes play in pediatric dental practice, with a special focus on eight continuing and emerging microbiological issues related to waterline safety, dental material contamination, effects of oral bacteria on systemic health, antibiotic resistance, continuing COVID-19 findings and risks associated with animal-assisted therapies. Key points are highlighted on each topic, with current reports demonstrating microbial impacts on human health and clinical settings. Advice and risk management strategies related to patient care and clinical practice are provided.

Vitamin C deficiency, colloquially known as scurvy, has become rare in modern times due to the widespread availability of ascorbic acid-rich foods. Despite this, it continues to be a concern in certain at-risk populations. The purpose of this report is to describe the case of a two-year-old girl who initially presented to a pediatric dental clinic with the chief complaint of hypertrophic gingiva and bleeding. Suspecting a systemic cause, the dental team referred the patient to a hematology clinic for further evaluation. Subsequent assessments and laboratory work confirmed a diagnosis of diet-related vitamin C deficiency. Management with supplements led to the resolution of the oral manifestations and normalization of laboratory values. This report details the clinical presentation and pathophysiology of vitamin C deficiency to assist healthcare providers in recognizing signs and symptoms, ensuring timely referral and facilitating appropriate treatment. Additionally, it underscores the importance of pediatric dentists as potentially the first clinicians to encounter such cases and their role in the multidisciplinary management of these pediatric patients.