JOURNAL OF DENTISTRY FOR CHILDREN最新文献

Purpose: To evaluate the prevalence of teething problems throughout the period of primary tooth eruption. Methods: This birth cohort study was conducted in two phases: Phase one (evaluation of teething symptoms among newly recruited infants) and Phase two (evaluation of teething symptoms among newly recruited infants and follow-up evaluation among infants recruited in Phase one). The study included an evaluation of infants born in a tertiary health care hospital using a hybrid design of telephonic conversation/video calling and clinical examination. The data were collected by one trained and calibrated evaluator and recorded in a self-designed form with validated measures of teething problems. Results: A total of 525 infants and parents participated. Teething problems were most prevalent at nine months of age (67.1 percent), followed by 12 months (50.1 percent)and 15 months (43.6 percent). Finger-sucking was the most common teething problem at six months (14 percent), nine months (81 percent), and 12 months (61.1 percent)of age. Incisor eruption was most associated with teething problems (72.5 percent), followed by canines (39.4 percent), first molars (36.9 percent) and second molars (24.9 percent). A significant correlation was seen between maternal education and maternal occupation and the parent-reported prevalence of teething problems (P<0.05). Conclusions: Almost two-thirds of the parents reported one or more teething problems at nine months coinciding with incisor eruption, whereas half also reported teething problems at 12 months. A significant correlation was seen between maternal education, maternal occupation and the prevalence of teething problems.

Maxillary frenectomies are invasive surgical procedures that are increasingly being performed in dental clinics to address functional and esthetic concerns. The purpose of this case report is to describe a 16-month-old boy who presented with oral bleeding lasting over 12 hours following a laser maxillary labial frenectomy, which eventually led to a diagnosis of severe hemophilia A. This case highlights the importance of thorough patient assessment, including the need to rule out systemic conditions, such as coagulopathies, prior to frenectomies. This report also raises concerns about the number of frenectomies being performed despite insufficient evidence to support their routine use.

Purpose: To assess antibiotic-prescribing practices at a university-based pediatric dental clinic, evaluating adherence to the American Academy of Pediatric Dentistry (AAPD) best practice recommendations. It aimed to determine the appropriateness of antibiotic selection, dosing, frequency and duration, and identify factors associated with inappropriate prescriptions. Methods: A retrospective cross-sectional study of electronic health records was conducted for patients aged zero to 17 years who received antibiotics for odontogenic infections or related dental conditions over 27 months, including a three-month COVID-19-related clinic closure. Data on patient demographics, clinical diagnoses, prescribed antibiotic type, dosage, administration frequency and duration were analyzed. Adherence to the AAPD prescribing recommendations was assessed and statistical analyses, including chi-square tests and logistic regression models, identified factors linked to inappropriate prescribing. Cohen's kappa statistics determined intra- and inter-examiner reliability. Results: Among 279 patient records, adherence to AAPD guidelines was 61.6 percent. Inappropriate prescriptions were significantly more frequent in younger children aged zero to seven years and medically compromised patients, with the latter twice as likely to receive an inappropriate prescription (P=0.0033, odds ratio [OR]=2.15). Infections involving permanent teeth were associated with a higher likelihood of prescribing errors (P=0.0353, OR=1.95). Weight-based dosing errors occurred in 6.5 percent of cases, mostly due to underdosing. The COVID-19 pandemic reduced overall prescriptions, but the proportion of inappropriate prescriptions remained unchanged. Conclusions: Antibiotic prescribing in pediatric dentistry showed moderate adherence to AAPD guidelines, with inappropriate prescriptions influenced by patient age, medical status and tooth type. Strengthening antibiotic stewardship and provider education is necessary to improve prescribing practices.

There is a scarcity of reports regarding the application of digital technology in pediatric dental prostheses after full-mouth dental rehabilitation. The purpose of this report is to describe a case involving the dental rehabilitation process of a six-year-old boy with sickle cell disease (SCD) who received multiple dental extractions under general anesthesia. The authors employed an innovative approach to prosthetic rehabilitation using digital fabrication of removable partial dentures and compared it with dentures fabricated using the conventional method. The digital workflow facilitated a straightforward fabrication process for denture-making as the child grew, enhanced the esthetics by customizing the teeth, improved the fit and decreased chairside time. In this context, the application of digital technology offers a potential solution for improving the oral health and quality of life of pediatric patients with SCD.

Purpose: To evaluate the influence of commonly used restorative materials, including zinc oxide eugenol (ZOE), resin-modified glass ionomer cement (RMGIC) and stainless steel crowns (SSC), on the setting reaction (measured by microhardness) of Endo-Cem Premix Mineral Trioxide Aggregate (PMTA) when used as a pulpotomy agent. Methods: Fifty extracted primary molars had a pulpotomy with a three-millimeter layer of EndoCem PMTA applied to the pulpal floor. Specimens were divided into five groups: group one (control), EndoCem with a moistened cotton pellet; group two, EndoCem with RMGIC; group three, EndoCem with ZOE; group four, EndoCem with RMGIC and SSC; and group five, EndoCem with ZOE and SSC. Teeth were incubated at 37 degrees Celsius and 100 percent humidity for 24 hours. Microhardness was measured at depths of one, two and three millimeters using a Knoop hardness tester. Statistical analyses included analysis of variance and Tukey's post hoc tests (significance at P<0.05). Results: EndoCem PMTA demonstrated effective setting across all experimental groups, with an overall mean Knoop hardness number (KHN) of 65.71±9.98. Group four showed the highest mean KHN (72.66±6.34 at three mm), while the control had the lowest KHN (58.42±11.26 at one mm). Groups three and four had significantly higher KHN than the control group (P<0.01). Microhardness values remained consistent across depths, with the highest values observed at three millimeters. Conclusions: EndoCem PMTA sets reliably, regardless of the restorative material, supporting its application in single-visit pulpotomy procedures. The use of ZOE or RMGIC with SSC further enhanced its mechanical properties.

Purpose: Several studies have evaluated the effects of cancer-related chemo-radiation on developing teeth, leading to disturbances in the formation of enamel and dentin, affecting the crown and root. However, their impact on dental pulp has not been well explored. The purpose of this study was to evaluate dental pulp calcification among young cancer survivors. Methods: This was a cross-sectional observational study consisting of 240 participants, each among cases and controls. It comprised an evaluation of orthopantomograms of cancer survivors prescribed as part of the follow-up evaluation under the cancer survivorship program. Patients with a confirmed diagnosis of malignancy (with a baseline diagnosis at 21 years of age or younger) who completed cancer treatment, as well as a long-term survivor (i.e., they remained cancer-free for two years), were included. Similarly, controls included were free from dental caries or any other systemic condition that could affect the dental pulp calcification. Results: The prevalence of dental pulp calcification was 24.1 percent (95 percent confidence interval [95% CI=19.15 to 30) among young cancer survivors, whereas among controls it was 8.3 percent (95% CI=5.43 to 12.57), which was statistically significant (P< 0.01). The multivariate regression analysis revealed 2.54 odds of having dental pulp calcification among survivors with initiation of anticancer therapy at the age of five years or younger, and 2.08 odds among those who received chemotherapy and radiation compared to chemotherapy alone. Conclusion: There was an increased likelihood of dental pulp calcification among young cancer survivors, especially when radiation was combined with chemotherapy and initiated at a young age.

Peripheral odontogenic fibroma (POdF) is a rare and benign mesenchymal odontogenic tumor that stands out as a distinctive entity. It is predominantly found in the gingiva and can present as a diagnostic challenging lesion due to its potential resem- blance to reactive oral lesions. The purpose of this report is to describe a case of a POdF in a 10-year-old child and highlight the importance of recognizing this lesion in the pediatric population. This report also explores the essential diagnostic differentials that clinicians should consider when examining a palpable soft tissue nodule with a firm consistency. Radiographically, well-defined small radiopacities were visible within the lesion, which was indicative of calcified structures. A complete surgical excision was done and histopathological analysis was diagnostic of POdF. The presence of calcifications exhibiting an osteoid/cementoid appearance was confirmed within the lesion. There were no signs of recurrence noted during the 16-month postoperative follow-up period. This case underscores the significance of PodF, which may be included in the differential diagnosis of gingival lesions in pediatric patients.

Langerhans cell histiocytosis (LCH) is a rare disease marked by the proliferation of Langerhans cells and the destruction of tissue. LCH can be limited to the oral cavity where it can present with gingival bleeding, swelling, tooth mobility and bone loss. This case report describes a 13-year-old male with LCH who presented with a one-month history of painful jaw swelling. Clinical examination revealed a firm, ulcerated mass adjacent to the mandibular right second premolar. Biopsy and subsequent histopatho- logic examination confirmed LCH. The lesion resolved spontaneously post-biopsy and the patient remains disease-free. Recognizing oral manifestations of LCH in dental practice is crucial for prompt diagnosis, appropriate multidisciplinary management and improving the survival rates and future quality of life for children with LCH.

The chief complaint of an eight-year-old girl was swelling in the maxillary labial vestibule that had started three months earlier. A periapical lesion was suspected based on the history and clinical characteristics of the involved area. However, there was no history of dental trauma, dental caries, restorations, or any other developmental dental alteration. The radiographic findings were suggestive of a cyst of non-odontogenic origin. The lesion was excised under local anesthesia using a 980-nm diode laser with a surgical E4-4mm tip at 1.8 watts on continuous contact mode. The histopathological examination confirmed it to be a dermoid cyst. The patient has been asymptomatic without any recurrence for 18 months.

Purpose: To investigate associations between parent-reported children's taste prefer- ences, children's feeding practices and early childhood caries (ECC).

Methods: A convenience sample of children younger than 72 months was recruited from several clinics and a health center in Winnipeg, Manitoba, Canada, between April 2019 and July 2022. The parents of participants were guided through a ques- tionnaire assessing their children's taste preferences and feeding practices. Data were stored in REDCap and analyzed using NCSS 2022 and 2023 software. Statistical sig- nificance was defined by a P -value ≤0.05.

Results: Overall, 467 children with a mean age of 45.7±15.4 months were recruited, of which 49 percent were female and 60 percent had ECC. Children with ECC had a higher mean taste preferences score, indicating greater preferences toward sugary foodstuffs (caries-free [CF]=0.63±1.07, ECC=0.96±1.02; P <0.001), with a great pro- portion showing preferences toward candies, ice cream and sugary drinks. Children with ECC also displayed a higher mean snacking frequency (CF=2.57±1.20, ECC= 3.13±1.22; P <0.001) and a great percentage (CF=36 percent, ECC=56.8 percent; P <0.001) frequently snacked before going to bed. A great proportion of parents of children with ECC also reported adding sweeteners to their children's drinks.

Conclusions: Overall preferences toward sugary foods and individual preferences to- ward candies, ice cream and sugary drinks are associated with the presence of caries, as are unhealthy feeding patterns. Preferences toward a cariogenic diet may be a risk factor for developing ECC.