JOURNAL OF DENTISTRY FOR CHILDREN最新文献

Purpose: To assess the fracture resistance of prefabricated esthetic crowns for primary molars. Methods: Seventy-two human mandibular second primary molars were divided into three groups: preveneered stainless steel crowns (VSS), prefabricated zirconia crowns (PZ) and BioFlx crowns (BF). Crowns were cemented with glass ionomer cement; for each group, 12 samples were tested for fracture resistance and 12 samples underwent 5,000 thermocycles before testing. The fracture mode was assessed for all the samples. Differences in the fracture resistance values between the groups were tested using analysis of variance (ANOVA), followed by Tukey's post hoc test, while the distribution of fracture modes was tested using Fisher's exact test. Statistical significance was set at P =0.05 and analyses were conducted using SPSS version 25.0 software. Results: ANOVA tests indicated a significant difference in fracture resistance among the test groups (P <0.001). The groups were ranked as follows: before thermocycling- (1) PZ group (3,327±1497), (2) BF group (1,694±163) and (3) VSS group (536±12); and after thermocycling-(1) PZ group (3,308±162), (2) BF group (1,579±77) and (3) VSS group (413±16). Tukey's post hoc analysis indicated that the PZ group exhibited a significantly higher fracture resistance than the BF and VSS groups (P <0.001). The VSS group showed a predominance of minimal cracks (5.6 percent) and loss of less than half of the crown (11.1 percent). Conclusions: PZ yielded the highest resistance, followed by BF crowns. VSS may require caution in high-stress areas due to their susceptibility to esthetic component failure, although the underlying crown remains functional.

Purpose: To measure the fluoride release and enamel fluoride uptake from a new dimethicone-based fluoride varnish (Profisil) and Duraphat fluoride varnish, and determine if the varnishes occlude dentin tubules. Methods: The fluoride release of both varnishes was measured from specimens with a constant surface area to volume ratio in a water bath. The fluoride uptake of demineralized enamel cores treated with both varnishes was studied over 24 hours using ion-specific electrodes to determine fluoride content and atomic absorption spectroscopy to determine calcium content. Scanning electron microscopy (SEM) was used to examine the occlusion of dentin tubules and the surface of enamel after treatment with varnish. Results: Duraphat varnish released 68±7.1 ppm of fluoride per gram of varnish after 24 hours. Profisil varnish released 65±6.3 ppm of fluoride per gram of varnish after 24 hours. Duraphat varnish specimens had a fluoride content of 2.5±1.8 mg F/g enamel before application of the varnish, which increased to 285±62 mg F/g enamel after 24 hours. Profisil varnish specimens had a fluoride content of 2.4±2.1 mg F/genamel before application of the varnish, which increased to 272±74 mg F/g enamel after 24 hours. SEM images depicted that both varnishes occluded open dentin tubules and left mineral deposits on the surface of the enamel. Conclusions: Both varnishes released significant amounts of fluoride and significantly increased the fluoride uptake of demineralized enamel. Moreover, the new varnish induced occlusion of the tubules and induced mineral growth on the surface of the enamel.

This case describes an emergency situation with a 10-month-old infant who presented with a sizable, smooth-surfaced, dome-shaped oral lesion. Upon examination, the pediatric dentist discovered a piece of a toy, embedded in the alveolar ridge. The purpose of this case report is to raise awareness about intraoral foreign body embedment in infants, highlighting the potential risks associated with popular toys that can break, adhere to the alveolar ridge and pose choking hazards. Pediatric dentists should advise parents to prevent infants from chewing on toys due to safety concerns.

The purpose of this report is to describe a seven year-old boy diagnosed with hypohidrotic ectodermal dysplasia who was rehabilitated with dental implants and partial removal prosthesis. The patient had only three dental elements: primary maxillary right first molar and primary maxillary right and left canines. The patient underwent treatment under general anesthesia in a hospital setting. Two dental implants were placed in the mandibular arch to support a dental prosthesis. Due to the COVID-19 pandemic, there was a prolonged period before continuing with the rehabilitative phase. Upon resumption, peri-implant mucositis was observed. Through professional and home plaque control measures, peri-implant tissue health was restored. A removable prosthesis was fabricated for the maxillary arch and O-ring attachments were used for the mandibular prosthesis. Given the patient's growth, prostheses may need to be replaced approximately every six months until growth is complete.

Purpose: To assess the direct and indirect effects of oral conditions, family income, child's sex, history of toothache and dental visits on oral health-related quality of life (OHRQoL) of children, according to parents. Methods: A cross-sectional study was conducted with 843 pairs of parents and children aged three to five years of age, in Campina Grande, Paraíba, Brazil. Parents answered a questionnaire with sociodemographic and socioeconomic questions, and their children's use of services and experience of toothache, as well as the Brazilian Scale of Impact on Oral Health in Early Childhood. Three researchers examined for the presence of dental caries, dental trauma and malocclusion. Descriptive and confirmatory factor analyses were conducted to validate the measurement models and constructs. The analysis accounted for confounding factors to ensure precise estimates of the relationships among variables. Structural equation modeling was employed to examine both direct and indirect associations between variables. Results: Absence of dental visits (β =-0.332; 95 percent confidence interval [95% CI]:- 0.471 to -0.193; P <0.001) and toothache (β =-0.748; 95% CI:0.588 to 0.883; P <0.001) directly impacted OHRQoL negatively. Family income (β =0.689; 95% CI: 0.518 to 0.859; P <0.001) and anterior open bite (β =-0.339; 95% CI:-0.613 to -0.184; P <0.001) had indirect effects mediated by dental caries (β =0.748; 95% CI: 0.748 to 0.883; P <0.001). Conclusion: Both direct and indirect factors affect the OHRQoL of preschoolers, emphasizing the importance of considering oral health conditions and socioeconomic factors to evaluate and improve their quality of life.

Purpose: The maxillary labial frenulum (MLF) has been implicated in clinical concerns, including breastfeeding difficulties, midline diastema and oral hygiene challenges. Despite multiple classification systems, a lack of consensus persists regarding the clinical significance of MLF variations and indications for surgical intervention. This review evaluates existing classification systems, diagnostic approaches and treatment considerations to provide an evidence-based framework for clinical decision-making. Methods: A literature search was conducted using PubMed, Scopus and EMBASE. Studies were screened through a multi-phase process and their quality was assessed using the Critical Appraisal Skills Program. Results: Sixteen studies met the inclusion criteria. Classification systems varied widely, with limited clinical applicability. Midline diastema often resolves naturally, questioning the necessity of early frenectomy. Surgical intervention is only advised when MLF impedes oral hygiene or contributes to orthodontic relapse. Conclusions: Variability in the classification and management of the MLF may contribute to inconsistent clinical decisions. Evidence-based guidelines are needed to support appropriate intervention and reduce the risk of unnecessary procedures.

Diamond-Blackfan anemia is a rare inherited bone marrow failure syndrome. It is part of a group of genetic disorders characterized by a decrease in red blood cells due to bone marrow malfunction. It affects five to seven live births per million per year. Pediatric patients are typically diagnosed within the first year of life; however, clinical manifestations can present at any age. Advances in molecular testing have increased the ability to identify Diamond-Blackfan anemia variants in adults. Patients with the disease have a wide range of features, including distinct physical characteristics; however, there is limited literature highlighting the dental manifestations and implications of the disease. Therefore, the purpose of this case report is to review the literature on Diamond-Blackfan anemia and highlight the unique challenges that dental practitioners may face in the delivery of dental care.

Purpose: To understand mandatory educational requirements for child abuse and neglect (CAN) recognition and mandated reporting for dentists to obtain and renew dental licensure in the United States (US).Methods: Publicly available state websites, dental board documents and the American Academy of Pediatric Dentistry's website outlining requirements for dental licensure in the US were reviewed for specifically designated mandated reporting or CAN educational requirements as prerequisites to obtain either initial or renewal of licensure to practice dentistry within the jurisdiction. For inclusion in the study, CAN education had to be listed as a requirement specific to obtaining and renewing dental licensure, not just a general mandated reporting education suggested or required by the state.Results: Four of 50 states (Illinois, Iowa, New York and Pennsylvania) and the District of Columbia require a mandatory educational course on CAN and reporting to obtain a dental license. Four states (Illinois, Iowa, Maryland and Pennsylvania) and the District of Columbia require a mandatory educational course on CAN to renew a license.Conclusions: This study suggests that more US states should implement a requirement for dental professionals to take a mandatory educational course on CAN recognition and reporting to obtain and renew dental licensure. This education should be specific to dentistry and dental practice settings to best prepare professionals to report suspected abuse and/or neglect.

Purpose: To assess the interrater agreement and reliability of pediatric airway assessments using the Brodsky and Mallampati classifications among pediatric dentistry residents, pediatric dentistry faculty and anesthesiologists. This study also aimed to determine the consistency of sedation decisions and the impact of clinical experience on classification reliability. Methods: A cross-sectional study was conducted with 50 participants who evaluated 17 pediatric airway videos, grading tonsillar obstruction using the Brodsky scale and oropharyngeal visibility using the Mallampati classification. Sedation decisions were recorded as binary outcomes. Assessments were completed twice, seven days apart, for intra-rater reliability. Interrater agreement was measured using Kendall's W and Fleiss' Kappa, while reliability was assessed using the intraclass correlation coefficient (ICC). Statistical differences between groups were analyzed using Kruskal-Wallis and Wilcoxon rank-sum tests. Results: The Brodsky scale demonstrated moderate to good interrater reliability, with anesthesiology faculty showing the highest agreement (ICC=0.627 to 0.612), followed by the dental faculty (ICC=0.654). Residents maintained moderate reliability (ICC=0.578 to 0.536). The Mallampati classification showed lower reliability, with anesthesiology faculty declining from moderate agreement (ICC=0.365) to poor agreement (ICC=0.209) between surveys. Sedation decisions had moderate agreement, with Fleiss' Kappa values of 0.467 for anesthesiology faculty, 0.407 for dental faculty and 0.371 for residents. Conclusions: The Brodsky scale was more reliable than the Mallampati classification, especially among experienced clinicians. The Mallampati classification showed greater variability. Structured training and clear protocols are necessary to improve airway assessment consistency and sedation safety.

Dental replantation is the treatment of choice for tooth avulsion; however, complications such as root canal obliteration, pulp necrosis and tooth resorption can arise, influenced by factors like extra-alveolar time and the storage medium in which the tooth was maintained. This case report discusses a seven-year-old child who experienced a traumatic avulsion of a permanent maxillary right central incisor with incomplete root formation. While the tooth was successfully replanted and both pulp vitality and complete root formation (apexogenesis) were initially maintained, the tooth later developed root canal obliteration and ankylosis, followed by external replacement root resorption. The tooth was extracted after six years due to advanced root resorption, leading to the placement of a space maintainer during childhood. Subsequently, an osseointegrated dental implant with a ceramic crown was placed. A 10-year follow-up post-implant installation demonstrated successful oral rehabilitation 20 years after the trauma. This case highlights the importance of long-term follow-up and a multidisciplinary approach in treating severely traumatized permanent teeth.