JOURNAL OF DENTISTRY FOR CHILDREN最新文献

The purpose of this article was to present the case of a 12-year-old patient with Pallister-Killian syndrome and 45, X/46, XY mosaicism. Dental clinical and radiographic findings and treatment are discussed. The patient presented multiple unerupted supernumerary teeth, ankylosed primary teeth, abnormal root formation of permanent teeth, possible odontomas, and talon cusps on permanent teeth. These unique findings can assist providers in treating patients with these medical conditions.

Foreign bodies in the nasal cavity are common in children, possibly due to their curiosity to explore body openings. The purpose of this report was to describe a case of an undetected nasal foreign body in a 10-year-old girl who presented to a pediatric dentistry clinic for a routine dental examination. A foreign body in the nasal cavity was discovered during a panoramic radiographic examination. A prompt referral to the otorhinolaryngologist was critical to confirm the diagnosis and successfully remove the foreign body. This case report demonstrates that dentists can play a significant role in the diagnosis of foreign objects in children.

Purpose: To evaluate the sensitivity and specificity of the near-infrared light transillumination caries detection method by using DEXIS CariVu (DCV) for imaging of interproximal primary molar surfaces (IPMS).
Methods: A retrospective evaluation of patient records at a university pediatric dentistry (PD) clinic identified 22 patients with unrestored IPMS, which had images of both bitewing radiography (BW) and DCV. A scoring system (no caries, incipient caries, dentinal caries) was developed for the study. Two investigators (pediatric dental faculty) identically scored 90 IPMS in both BW and DCV images, establishing benchmark IPMS scores. The 180 images were then compiled in a randomized order in a questionnaire, which was answered by 24 raters (PD residents and faculty) using the study caries scoring system. Data analysis included raters and experts' percent agreement, Vassar Stats for sensitivity and specificity, and Kendall's correlation coefficient for interrater reliability.
Results: The overall agreement between raters and experts for DCV images was 48 percent (54 percent for no caries, 23 percent for incipient caries, and 68 percent for dentinal caries). The DCV's sensitivity and specificity to detect any caries were, respectively, 0.72 and 0.54, 0.60 and 0.53 for incipient caries, and 0.82 and 0.53 for dentinal caries. The BW's sensitivity and specificity to detect any caries were respectively, 0.82 and 0.87, 0.98 and 0.86 for incipient caries, and 0.99 and 0.87 for dentinal caries. The overall interrater reliability was 0.48 (95 percent confidence interval equals 0.46 to 0.50).
Conclusion: The use of DCV as a stand-alone caries detection method for IPMS is limited.

Purpose: This cross-sectional study evaluated knowledge, practices, and beliefs of Ohio dentists treating school-aged children regarding school absenteeism in relation to compliance with dental appointments.
Methods: A 26-item questionnaire was distributed to 7,274 dentists licensed in the state of Ohio in 2019. Eligible participants were pediatric dentists (PDs) and general dentists (GDs) who treated individuals younger than 16 years of age.
Results: A return rate of 13.5 percent (958 total participants) provided a sample consisting of approximately 90 percent of GDs, a mean age of 48.5 years and primarily practicing in suburban locations. Respondents felt parental attitudes had changed over the past five years, with a significantly higher proportion of PDs reporting increased parental concerns about school absences than GDs (59.5 percent versus 31.5 percent; P <0.001). Length of excused absence increased with treatment complexity. PDs were more likely to permit longer absences than GDs and to allow parents to decide the length of absence, particularly for children with special health care needs. PDs were 6.6 times more likely to report that concerns about school absences often negatively affected oral health (P <0.001).
Conclusion: Dentists acknowledged that school absences and school policy affected parental choices regarding dental visits, with PDs consistently stating a greater effect than GDs.

Purpose: To identify compliance of special health care needs and healthy pediatric patients with preventive dental appointments after treatment under general anesthesia (GA).
Methods: Records of special health care needs (SHCN) patients treated under GA in 2015 and 2016 were reviewed. The control group consisted of randomly selected healthy patients also treated under GA in the same time period and hospital. Patient demographics were compared, and the number of preventive visits was recorded for 24 months after GA.
Results: The sample consisted of 141 SHCN patients and 142 healthy children. The average number of preventive visits post-GA appointment was 2.74 out of a recommended nine visits over two years for the study population. There was a statistically significant difference in the level of compliance based on age and referral source, but there was no difference based on health status.
Conclusion: Compliance with preventive dental visits after treatment under GA among all pediatric patients, regardless of health status, must be improved. Caregivers must be further educated to implement change and barriers to care must be explored.

Purpose: To determine the extent to which history of dental pain explains the impact of dental caries on oral health-related quality of life (OHRQoL) among pre-schoolers.
Methods: A population-based study was conducted with a random sample of 769 five-year-old children. Preschoolers self-completed the Brazilian version of the Scale of Oral Health Outcomes for Five-Year-Old Children (SOHO-5), and caregivers completed a questionnaire addressing sociodemographic characteristics. Children had a dental/oral examination done by dentists. The effect of cavitated caries lesions on OHRQoL explained by pain was estimated by the percentage variation of the prevalence ratio (PR) for the impact of cavitated lesions on OHRQoL (PRc), and this measure was adjusted by dental pain (PRct). PR was determined through multiple Poisson regression (P <0.05).
Results: The prevalence of cavitated lesions was 58.8 percent; among this cohort, 23.8 percent reported dental pain. The PRc was 1.063 and PRct was 1.039. Thirty-eight percent of the impact of dental caries on OHRQoL was due to dental pain.
Conclusion: History of dental pain explains 38 percent of the impact of dental caries on the OHRQoL of preschoolers.

Purpose: To describe the geographic distribution of pediatric dentists (PDs) in Florida and the sociodemographic characteristics of communities in which they are located compared with communities without a PD.
Methods: The ratio of PDs to children for each county in Florida and the distribution of PDs in Florida counties at the census tract (CT) level were calculated. Each CT was categorized as having or not having PDs to examine the geographic distribution of PDs, and the sociodemographic differences between CTs with and without a PD were tested by using t-tests. PDs' participation in Medicaid and acceptance of new patients were also investigated.
Results: Of the 67 counties in Florida, 31 had no PD. There were 4,181,677 children younger than 18 years served by 388 PDs, for a statewide ratio of 9.2 PDs per 100,000 population (range 0 to 34.9). Median household income, family income, and education were higher in CTs with PDs, and poverty level, unemployment rate, and percentage of African American population were higher in CTs with fewer PDs. Although 49 percent of PDs accepted Medicaid, only 32 percent accepted new patients.
Conclusion: There are regional and sociodemographic disparities in the distribution of PDs in Florida.

A myofibroma is a relatively rare neoplasm characterized by its spindle cell proliferation. This lesion can present as a unifocal mass (myofibroma) or multifocal growths (myofibromatosis) in the skin, soft tissue, bone, or internal organs. In the oral cavity, the tumor is commonly identified on the tongue, mucosa, lips, and mandible. Myofibroma classically occurs in infants and young children. Its fast-growing nature often mimics a sarcoma; however, it is a benign tumor. The purpose of this article is to report the case of an eight-year-old boy who presented with a localized, painless, nodular mass in the palate and gingiva. Through clinical, radiological, and immunohistochemical evaluation, the diagnosis of an atypical myofibroblastic tumor was made after resection of the mass. With interprofessional team management, the patient's quality of life was improved.

Severe dental trauma can often result in tooth loss at an early age. Orthodontic space closure and reshaping of the teeth are a conservative treatment approach. The purpose of this paper is to present a fast and predictable way to reshape teeth using the composite resin injection technique. A 10-year-old female presented for orthodontic treatment with a Class II malocclusion, lateral open bite and loss of the permanent maxillary left central incisor due to trauma. The treatment plan involved mesialization of the maxillary left teeth and reshaping of the maxillary left canine and lateral incisor to the shape of the lateral and the central incisor, respectively. At the end of the orthodontic treatment, an impression was made and a transparent silicone index was fabricated based on the diagnostic wax-up. Through the index, flow composite resin was injected at the site to form the direct composite resin restorations.

Purpose: To assess pediatric dentists' knowledge, attitudes, and factors associated with the use of the Hall technique (HT) in the United States.
Methods: An electronic questionnaire with a cover letter and consent form was sent to 6,277 active members of the American Academy of Pediatric Dentistry (AAPD) between April 15 and June 1, 2019. Descriptive and multivariate analyses were calculated.
Results: The response rate was 9.4 percent; 52 percent were males, 76 percent were white non-Hispanic, and 83 percent were in private practice. Ninety-seven percent were familiar with HT, and 39 percent had used it. Factors significantly associated with the use of HT were female dentists (P =0.01), patients with Medicaid insurance (P <0.001), rural locations (P =0.02), academic and community/public health clinics (P =0.004). Compared with AAPD members in the Western region, pediatric dentists in the North-Central region were more likely to use HT (odds ratio [OR] =2.50, 1.22 to 5.13, P =0.01) but pediatric dental residents in the North-Central region were less likely to use it (OR= 0.39,0.18 to 0.84, P =0.02).
Conclusion: Use of HT was considered a viable alternative in the management of dental caries. Despite the limitations of the technique, pediatric dentists' practice location and place of residency were significantly associated with its use.