JOURNAL OF DENTISTRY FOR CHILDREN最新文献

Infraocclusion is a local etiologic factor of malocclusion that can have deleterious effects on normal dental development. Therefore, early recognition and diagnosis are the two most important factors in the management of infraocclusion. The purpose of this case report is to describe the management of a patient who was diagnosed at seven years of age with an eruption disturbance, whose severe sequela could have been prevented had the infraocclusion been diagnosed early.

Purpose: To create and validate size guides for fitting Denovo^® plain molar bands and bands with tubes to 3M^™ ESPE^™ stainless steel crowned primary molars. Methods: Two size guides were created for fitting these bands to corresponding crown sizes, with an additional pre-existing guide available for comparison. Eight volunteer dentists chose their best-fit band sizes for stainless steel crowned typodont teeth, with each seeing a subset of clinical conditions as determined by a randomized factorial experiment. Comparisons of dentists' best fits and each guide individually were evaluated for over 96 fits for robustness of clinical condition in an analysis of variance and agreement using intraclass correlation. Savings in attempted fits using size guides were estimated. Results: No significant differences over clinical conditions were observed when evalua- ting size guides and dentists' best fits. Intraclass correlations between plain band, plain band with tubes, and the pre-existing plain band with tubes guides and observed fits were 0.997, 0.998 and 0.998, respectively, with corresponding expected savings of 1.1, 0.7 and 0.5 attempts per fit, respectively. Conclusion: Size guides created for fitting plain bands and bands with tubes to stainless steel crowned primary molars were validated by volunteer dentists and showed promise for decreasing waste and increasing efficiency during dental visits.).

Chemical burn of the oral mucosa can occur as a result of the inadvertent, intentional or iatrogenic use of chemicals. Self-treatment for toothache relief with nonpharma ceutical substances can result in a chemical burn. A detailed history is paramount in such cases to identify the etiologic agent to proceed with appropriate treatment. The purpose of this report is to describe the case of an eight-year-old with a complaint of toothache who rinsed his mouth with potassium aluminium sulfate solution to achieve pain relief. This caused ulceration of the attached gingiva and oral mucosa and necrosis of the alveolar bone surrounding the offending tooth, leading to its mobility. This case highlights the disastrous consequences of inappropriate self-treatment to achieve pain relief from toothache.

Purpose: To assess the effect of rapid maxillary expansion (RME) on the inflammatory and stress response of patients undergoing orthodontic treatment. Methods: Eighty salivary samples were collected from patients (n=16) during RME at five moments: before the expander placement (T1); 25 minutes after its first activa- tion (T2); seven days after placement, shortly after the patient arrived at the dental clinic (T3); 25 minutes after the appliance activation on day seven (T4) and one month after the last activation of the appliance (T5). Cortisol and nitric oxide levels were evaluated using an immunoassay kit and the Griess method, respectively. Friedman and Wilcoxon tests were used for statistical analysis (P <0.05). Results: Participants' mean age was 11.5 years. There was a significant change in cortisol levels over the study period in the total sample (P<0.01), for the Haas appliance (P=0.01), female sex (P=0.01), younger children (P=0.01), presence of large overbite (P=0.02), presence of posterior crossbite (P =0.006), Class I type occlusion (P=0.02) and mesofacial facial type (P =0.02). Regarding nitric oxide, there was a significant change over the study period in those who wore the Haas appliance (P =0.04). For nitric oxide levels, T1 was significantly higher than T3, T4 and T5 (P <0.05) for those who wore a Haas appliance. Conclusion: The period anticipating the consultation at the waiting reception area was more stressful than the dental procedure in patients undergoing RME. This procedure did not cause alterations in salivary biomarkers related to inflammation.

Ankyloglossia is a developmental anomaly characterized by a shortened lingual frenulum, which can range from cases with no clinical relevance to severe cases, where frenectomy may be indicated. In newborns, this indication has increased exponentially. The purpose of this report is to discuss obstruction of the sublingual caruncle, with a recurrent ranula, as a post-surgical complication of laser lingual frenectomy performed in a newborn. The treatment provided is also discussed (marsupialization and removal of the affected sublingual glands). Lingual frenectomy should be performed with great care, especially in newborns, because the sublingual caruncles can be affected and complications can occur.

Purpose: To examine the impact of dental operatory room color on the level of anxiety in committed youth at a juvenile correctional center. Methods: A randomized controlled trial was conducted at a juvenile correctional center using an approved continuous quality assurance survey. The dental assistant collected self-reported anxiety scores from 164 individuals alternating between two dental operatory rooms. One dental operatory room was painted with color while the other dental operatory room was unaltered (white). Repeated measures linear models were used to test for associations between visit type, visit number and operatory. Results: For 65 percent of visits, little to no anxiety was reported. Among the remaining visits, anxiety scores were on average 1.13 points higher across all appointment types in the non-colorful operatory room but were not statistically significant (P=0.1373, 95 percent confidence interval [95% CI] = -0.37 to 2.63). Anxiety scores were, on average, 1.7 points higher in the non-colorful room when selected for more anxiety- inducing restorative or emergency appointments (P=0.4371, 95% CI = -1.37 to -4.82), which indicated some clinical significance but was not statistically significant. Conclusion: The color of a dental operatory room did not have a statistically significant effect on lowering the level of anxiety in incarcerated youth but may have a clinically significant effect that should be further researched.

Purpose: To compare the accuracy and efficiency of both alginate and digital impression techniques in a method representative of a clinical setting. By evaluating the difference in fabrication time and accuracy for these techniques, it can be determined if using digital scanning is a viable alternative to alginate impressions to fabricate pediatric dental appliances.
Methods: Both the alginate and digital impressions were taken from the same pediatric typodont study model. The alginate impressions were handled and poured up, per product instructions, and digital impressions were 3D printed. A digital caliper was used to measure different landmarks on both the stone models and 3D printed models, and these measurements were compared to the pediatric typodont to determine accuracy. All steps in the process, including obtaining the impression, fabrication of the model and total time, were recorded to determine the efficiency of both methods.
Results: The alginate models had a significantly higher intercanine distance than the control. Measurements of anterior-posterior (AP) left, AP right, left central, and right central were larger than the control but did not show a significant difference in measurement. The alginate group had a significantly shorter impression time. Model fabrication time between the two groups was similar.
Conclusion: Alginate impressions require less chairside time and the digital technique was shown to be accurate in all measurements. Digital scanning may be a good alternative to alginate impressions for pediatric patients.

Regional odontodysplasia (ROD) is a rare developmental anomaly with distinctive clinical, radiographical and histological findings, affecting both primary and permanent dentitions. The teeth with ROD have an atypical morphology and are usually discolored, with either delayed eruption or complete failure to erupt. Radiographically, the affected teeth have a "ghostly" appearance, with marked radiolucency and decreased radiodensity, showing a thin outline of enamel and dentin, which appear hypomineralized histologically, with poorly structured dentinal tubules and enamel prisms. Calcifications are frequently found in the pulp chambers of the affected teeth. This case report discusses a three-year-old girl who presented with ROD in her mandible as well as the clinical and radiographical features, and treatment of the condition.

Bilateral dentigerous cysts (DC) associated with unerupted mandibular first molars in a non-syndromic pediatric individual are rare. Secondary infections may lead to complications, such as discomfort due to pain, disfigurement caused by enlargement of the cyst with cortical expansion of the jawbone, displacement of teeth and paraesthesia of the adjacent nerve. This case report describes the occurrence of bilateral DC in an eight-year-old patient. Marsupialization was the treatment of choice to preserve the permanent teeth and other adjacent tissues.

Odontogenic infections are preventable yet common in adults and children, and can progress to life-threatening levels if not definitively managed in a timely manner. Children with odontogenic infections often first present to the pediatric or general dental practice, making pediatric and general dentists key players in the management of odontogenic infections. While the pediatric or general dentist can definitively manage several types of infections, their critical role goes well beyond treatment to include timely and appropriate triage as well as facilitation of care when the severity of the infection exceeds the scope of their practice. Thorough and efficient triage allows the dentist to determine the most appropriate timing and setting of definitive care, thus preventing avoidable delays or inefficient use of health care resources. The purpose of this narrative review is to discuss key concepts in the overall management of odontogenic infections in children, with a focus on the clinical significance of each concept, in an algorithmic format.