JOURNAL OF DENTISTRY FOR CHILDREN最新文献

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.

Purpose: To assess the setting of premixed mineral trioxide aggregate (NuSmile NeoPUTTY) when used as a pulpotomy agent in primary molars, restored in a single visit, and to compare the effect of overlying materials, including zinc oxide eugenol (ZOE), resin-modified glass ionomer cement (RMGIC) and stainless steel crowns (SSC), on the microhardness of the NeoPUTTY.
Methods: Forty-eight extracted primary molars were prepared with the standard pulpotomy technique. Approximately three mm of NeoPUTTY were placed on the pulpal floor of each tooth. The teeth were divided into four groups according to restorative material: (1) control group-none; (2) RMGIC; (3) ZOE; and (4) ZOE and SSC. Groups 2, 3 and 4 specimens were placed in artificially simulated oral cavity conditions. After 24 hours, all teeth were sectioned mesiodistally and polished. Microhardness was then measured in Knoop scales (HK) at one mm, two mm and three mm away from the NeoPUTTY-overlying material interface following the application of a 25-gf load force for 30 seconds at each site. One-way analysis of variance was used to compare the NeoPUTTY microhardness values between groups at each depth as well as between the three different depths within each group (P <0.05).
Results: No statistically significant differences in mean HK values (57.9 to 62.3 range) were found between groups at each depth, or between depths within each group (Group 1,P =0.328; Group 2, P =0.74; Group 3, P =0.293; Group 4, P =0.788).
Conclusion: The setting reaction of NeoPUTTY, as a function of microhardness, was not affected by the presence or type of overlying material used in a single-visit pulpotomy. This in vitro study found no evidence against the immediate restoration of primary molar pulpotomies done with NeoPUTTY.

Purpose: To evaluate the association between attention-deficit/hyperactivity disorder (ADHD) symptoms reported by parents and the variables sleep problems, possible sleep bruxism, possible awake bruxism and dental trauma (DT), and its mode of occurrence in children and adolescents.
Methods: A cross-sectional study was conducted with the parents of 144 four- to 16-year-old subjects through a questionnaire on demographics, subjects' sleep, self-reported bruxism and DT mode of occurrence. The Swanson, Nolan and Pelham scale IV was used to assess ADHD signs and subtypes. Bivariate and multivariate analysis were performed (P <0.05).
Results: The subjects' mean age was 7.9 years (±2.8 years) and 50.7 percent were boys. DT was reported in 80 percent of those with the hyperactive/impulsive subtype (ADHD-HI) and 72.7 percent of those with the combined subtype (ADHD-C). DT was caused solely by falls in the ADHD-C and inattention subtypes (ADHD-I). ADHD-C was associated with somniloquy (prevalence ratio [PR]=1.075; P =0.010). ADHD-HI was associated with bad sleep quality (PR=1.194; P =0.005), possible sleep bruxism (PR=1.088, 95% confidence interval=1.006 to 1.176; P =0.034), possible awake bruxism (PR=1.146; P =0.024) and sleep duration (PR=0.88; P =0.02).
Conclusion: ADHD-C and -HI subtypes were associated with sleep characteristics. Possible sleep and awake bruxism were associated with symptoms of ADHD-HI. Despite no significant association, DT was present in most ADHD subjects, mostly due to falls.

Purpose: To compare the effective dose (E) of the Tru-Image® rectangular collimator and the universal round collimator of a Planmeca® wall-mounted radiograph unit for two bitewing radiographs (right and left) on a pediatric phantom.
Methods: Absorbed doses utilizing the Tru-Image ®rectangular collimator and universal round collimator were acquired using an anthropomorphic 10-year-old child phantom. Each set of 24 dosimeters was exposed to two bitewing exposures with the manufacturer's child settings. Fifty clinical exposures were completed for each set and three sets were exposed for each collimator. The average E per exposure was calculated.
Results: The overall E for the Tru-Image ®rectangular collimator and the universal round collimator were 6.3 microsieverts (μSv) and 25.3 μSv, respectively. This difference was statistically significant (P <0.001). The highest equivalent dose for both collimators was delivered to the oral mucosa. When compared to the universal round collimator, the Tru-Image ® rectangular collimator had significant dose reduction at all locations (P <0.05). When normalized and adjusted to the same source-to-end distance, there was an overall 65 percent dose reduction with the rectangular collimator.
Conclusion: The average effective dose was significantly reduced with the use of the Tru-Image ®rectangular collimator. Clinical use of this rectangular collimator should be considered in the pediatric population.

Purpose: To evaluate the efficacy in dental biofilm (DB) removal between electric toothbrushes versus manual toothbrushes in primary dentition using an Image Analysis System (IAS) of digital photographs.
Methods: A prospective, randomized, controlled, blind, crossover clinical trial was conducted for 12 weeks with children between four to six years of age. The amount of DB was evaluated at zero, four, eight and 12 weeks. The degree of acceptance of the type of toothbrush used by the child was assessed at week 12.
Results: Twenty-two children participated and 176 photographs were taken, with 1,408 images of primary incisors being digitally analyzed by IAS. DB was significantly reduced by both types of toothbrushes on day zero (manual=7.44±1.83 percent; electric= 9.80±2.03 percent) and at week four (manual=8.57±2.23 percent; electric= 5.85±2.10 percent). However, there was no statistically significant difference in DB reduction when both types were compared. After week four, when compared prospectively, there was a statistically significant reduction (P <0.05) of DB for the electric toothbrush only. Electric toothbrushes had a significantly greater acceptance by the participants (P <0.01).
Conclusion: Electric toothbrushes eliminated DB better and were more accepted by the children than manual toothbrushes.

The purpose of this paper is to discuss the avulsion of a primary maxillary first molar in a 22-month-old child, which occurred while she had a training cup in her mouth. The parents noticed bleeding in the mouth and a missing tooth, and brought the child to a pediatric emergency department. A clinical assessment by the pediatric dental team confirmed the avulsion and since the tooth could not be located, a radiograph of the chest was obtained to rule out aspiration. The chest radiograph showed the tooth to be in the proximal jejunum.

Langerhans cell histiocytosis (LCH) is a rare proliferative disease of myeloid cells that can affect multiple organs and present with diverse clinical manifestations. The skeleton, skin and lymph nodes are commonly affected sites, while oral involvement is rare. LCH is currently classified by disease extent into single system and multisystem forms, and further categorized by risk organs. The purpose of this report is to describe the case of a six-month-old girl who presented with a chief complaint of feeding difficulties, premature eruption of the primary left maxillary second molar, expansion of the maxillary alveolar ridges and ulceration of the posterior maxillary oral mucosa. The diverse presentations of pediatric LCH in the literature are reviewed and the role of pediatric dentists and oral surgeons in helping to diagnose LCH is highlighted.