JOURNAL OF DENTISTRY FOR CHILDREN最新文献

The coronavirus responsible for the current global pandemic, coronavirus disease 2019 (COVID-19), is well-known for its respiratory symptoms. The scientific community and frontline health care providers have been documenting a number of systemic manifestations, including clinical findings in the oral cavity. Among these findings, oral ulcerative lesions are becoming more prevalent in COVID-19 infection, with differing severities and presentations. Health care professionals should, therefore, be aware of the possible implications that COVID-19 has on the oral cavity to judiciously document, monitor and refer patients with ulcerative lesions to the appropriate medical and dental specialists for management when necessary.

Purpose: Fetal alcohol syndrome (FAS) results from the teratogenic effects of alcohol on the fetus. Oral manifestations are commonly found in FAS and contribute to the diagnosis. The purpose of this study was to provide a review of the literature and describe two cases of FAS.
Methods: Electronic searches were conducted in August 2021 in multiple databases. The cases of two children with FAS are reported.
Results: One hundred sixty-six articles were included. The oral features frequently reported were micrognathia, cleft palate, high arched palate, maxillary hypoplasia, prognathia and crowding. The first patient had systemic and orofacial changes, such as delayed physical and cognitive development, micrognathia, tooth impaction, malocclusion and enamel hypoplasia. The second child had cognitive, and speech and behavioral deficits, but no oral and dental abnormalities.
Conclusion: Dentists should be aware of clinical findings since they may take part in the diagnosis and management of FAS.

Purpose: To discuss the transplantation of a maxillary premolar to replace a maxillary central incisor in a seven-year follow-up period.
Methods: An avulsed permanent maxillary central incisor was reimplanted by a pediatric dentist but it presented progressive external root resorption. Transplantation of the maxillary right first premolar was planned, as the patient presented a Class II malocclusion with increased overjet that would be treated with extractions of the maxillary premolars.
Results: The transplanted tooth did not present any negative symptoms other than discoloration, which was treated with bleaching for three years. At the end of a three- year follow-up period, a full ceramic restoration was done to improve translucency properties to provide better esthetics. The transplanted tooth presented healthy periapical and periodontal tissues in both clinical and radiographic examinations at the end of the seven-year follow-up period.
Conclusions: Autotransplantation of maxillary premolars can be a viable alternative to provide adequate physiologic and esthetic components for avulsed and reimplanted permanent incisors that presented unsuccessful results.

Purpose: To evaluate knowledge, perceptions and current practices regarding care-seeking behaviors and oral health in pregnant and non-pregnant adolescent and young adults, and to assess barriers to dental care during pregnancy.
Methods: An 18-question survey was distributed to patients in three tertiary hospital clinics in Columbus, Ohio, USA. Statistical analyses used chi-square and Fisher's exact tests, with significance at P <0.05.
Results: Of 227 respondents, 197 were female and about 30 percent were pregnant. The mean and median age was 17 years. Almost half were African American, 69 percent had public insurance and over 75 percent had one or two annual dental check-ups. Less than one percent indicated pregnant females should never go to the dentist, although 63 percent of pregnant respondents had not sought dental care while pregnant and less than five percent had been to the dentist in the six months prior to pregnancy. The most reported barrier to seek dental care was the patient being too busy.
Conclusions: Dental care among pregnant adolescents seems to be less utilized than their non-pregnant peers. The importance and safety of dental care during pregnancy are less understood among adolescents and young adults than in older, pregnant women. Most respondents, including males, stated that if a pregnant female has tooth pain, she should go to the dentist, but were unaware if materials used at the dentist were harmful to the baby. Interventions to improve knowledge and reduce barriers to dental care during pregnancy are needed for adolescents and young adults.

Purpose: To determine the effect of motivational interviewing (MI) to improve recall attendance after dental treatment under general anesthesia (GA).
Methods: The sample consisted of parents of randomly selected pediatric patients who had oral rehabilitation under GA at a children's hospital. An 18-item questionnaire that included demographics, education, language, country of birth and age was administered prior to the GA appointment. A five-minute MI phone call three months after the procedure and a second MI phone call after the first recall was conducted by a standardized interviewer. The primary outcomes were attendance at the six- and 12-month recall visits. Data were compared to a historical control group of participants who did not receive the MI phone call during the same date range.
Results: Of 100 patients, 72 participated in the first phone call and 51 participated in the second phone call. All children had public insurance. The estimated odds of a six-month recall visit for parents receiving a single motivational interview was 2.52 times (95 percent confidence interval [95% CI]=1.43 to 4.44, P =0.001) higher compared to the control. The estimated odds of a 12-month recall visit for parents receiving two motivational interviews was 2.40 times greater (95% CI=1.27 to 4.54, P =0.006) compared to the historical control.
Conclusion: A brief intervention using MI led to an improvement in attendance at both the six- and 12-month recall visits.

Purpose: To evaluate the impact of malocclusion and dental caries on oral health- related quality of life (OHRQoL) in adolescents and the differences between adoles- cents' self-reports and caregiver's proxy reports. Methods: A population-based cross-sectional study was conducted with 1,612 Brazil- ian adolescents and 1,168 caregivers. Adolescents completed the Child Perceptions Questionnaire and caregivers completed the Parental-Caregiver Perceptions Question- naire. Malocclusion (dental esthetic index) and dental caries (DMFT) were documented. Multiple Poisson regression was conducted. Results: A self-reported model demonstrated that adolescents with malocclusion had an impact on emotional (PR=1.14; 95 percent confidence interval [95% CI=1.03 to 1.26) and social domains (PR=1.35; 95% CI=1.20 to 1.50). Dental caries had an impact on the emotional domain (prevalence ratio [PR]=1.34; 95% CI=1.21 to 1.48). The caregiver model showed that malocclusion had an impact on oral symptoms (PR=1.12; 95% CI=1.03 to 1.21), functional limitations (PR=1.18; 95% CI= 1.05 to 1.33), and emotional (PR=1.23; 95% CI=1.10 to 1.54) and social domains (PR=1.22; 95% CI=1.02 to 1.45). Those with dental caries felt an impact on oral symptoms (PR=1.09; 95% CI=1.01 to 1.19), functional limitations (PR=1.18; 95% CI=1.05 to 1.33) and social domains (PR=1.24; 95% CI=1.04 to 1.45). Conclusions: Adolescents reported a negative impact on OHRQoL both in relation to dental caries and malocclusion. Caregivers observed the impact of oral conditions on more domains than the adolescents reported.

Purpose: To evaluate the factors associated with longitudinal changes in the caries activity profile of high caries risk children.
Methods: The sample consisted of clinical records of children who had undergone dental care in a public setting during a one-year period. Patients with active carious lesions (non-cavitated and/or cavitated) at the initial examination and who completed treatment were considered for the analysis. A caries-controlled profile was set as the main outcome based on arresting active carious lesions. Poisson regression was used to evaluate the association of patient- and treatment-related factors with the outcome ( P <0.05).
Results: The analysis included 130 caries-active children (7.8±2.4 [standard deviation - SD] years), with a mean missing and filled teeth index score of 8.3±4.4 SD. Patients with lower caries experience (prevalence ratio [PR]=0.93; 95 percent confidence interval [95% CI]=0.87 to 0.99) who received more appointments focused on oral health promotion based on dietary and oral hygiene instructions (PR=1.28; 95% CI= 1.03 to 1.58) had a greater rate of moving to caries-controlled status. The number of invasive treatments was not associated with a shift from caries-active to caries-controlled status (PR=0.98; 95% CI=0.87 to 1.11).
Conclusion: A preventive regimen focused on dental and diet guidance may play an important role in arresting active carious lesions in high caries risk children.

Purpose: To present a patient interaction teaching tool for synchronous teledentistry visits following concepts in critical thinking and report on the viability, assessment and implementation of the tool in an academic pediatric dentistry clinic.
Methods: A teaching tool was derived from interviews with pediatric dental residents and clinicians. The tool contained six main sections and 26 steps. The main sections included: greeting, medical, dental and behavioral histories; airway assessment; treatment recommendations; behavioral modalities of treatment; and follow-up. A faculty member assigned each interviewer dichotomous values of yes and no for implementation of each step of the teaching tool.
Results: Six pediatric dentistry residents participated in a tool use demonstration with 21 patients. The purpose of each interview was to gain information for procedural treatment at the first onsite visit. All pediatric dental residents completed over 90 percent of the steps in each section. The interview duration ranged from eight to 29 minutes (median: equals 18 minutes). Eighteen of the 21 patients were scheduled for follow-up visits.
Conclusions: The emulation model for provisional treatment planning is viable for teledentistry. Pilot results showed students consistently completed over 90 percent of skillset steps and that this teaching tool serves as a framework for teledentistry appointments.

Purpose: To investigate shear bond strength (SBS) of three restorative materials on primary dentin after silver diamine fluoride (SDF) application.
Methods: Thirty primary teeth were randomized into three groups of 10 teeth. Each tooth was split mesiodistally and randomized into experimental (artificial caries plus SDF) and control (sound dentine without SDF) groups. Glass ionomer cement (GIC), resin-modified bioactive resin (ACTIVA), and composite resin (CR) restorations were tested for SBS and mode of failure (MF).
Results: All SDF groups exhibited significantly lower SBS compared to the control (CR: P =0.001; ACTIVA: P =0.001; GIC: P =0.004). For the SDF group, the compa- rison of materials was statistically significant (P =0.006); posthoc tests showed significance only between CR and ACTIVA (P =0.009) and between ACTIVA and GIC (P =0.020). The lowest mean value was obtained for ACTIVA (1.4 MPa) and the highest mean value was obtained for CR (3.3 MPa). For the control group, Welch's F test was statistically significant (P =0.044), but all posthoc tests were not. For MF, SDF exhibited a significantly greater percentage of adhesive failures with ACTIVA and CR than with GIC. In the control group, a mixed MF was more dominant with no significant differences.
Conclusion : The SDF group had significantly lower SBS.

Purpose:To assess the impact of the Covid-19 pandemic on applicants for advanced education programs in pediatric dentistry in the United States and provide recom- mendations for virtual interviews (VI).
Methods:A cross-sectional survey was emailed to pediatric dentistry applicants in the 2020-2021 cycle.
Results:One hundred seventy-five applicants responded. Virtual interviews were the universal format during this timeframe. Forty-four percent admitted to applying to programs they were not initially strongly considering and 42 percent accepted inter- views they would have declined if they had to travel. Applicants found social events with residents only (80 percent), a program overview presentation (86 percent), a virtual tour (77 percent) and a question-and-answer session with residents (85 percent) to be helpful. One-on-one or paired faculty interviews were the most preferred inter- view method. More than half (55 percent) thought programs were not able to learn about them as effectively through virtual compared to an in-person format.
Conclusions: VI caused different applicant behavior due to the low time and financial investment. Applicants valued their time with residents to learn about programs, but were split in their preferences for virtual, in-person or hybrid interviews. Programs can use findings from this study to plan future recruitment cycles.