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Objective: The evidence base for the use of space maintainers is relatively sparce despite being used for decades after the premature loss of primary molars. This study aims to increase the dental evidence base via investigating retrospectively the success rates of prefabricated fixed and removable space maintainers inserted from 2019 to 2021 and followed up until February 2023 at a specialized university clinic and to identify reasons for any reported minor and major failure. The authors hypothesized that there is no significant difference in failure rates between fixed and removable space maintainers inserted after the premature loss of a single primary molar per quadrant. Method and materials: Patients' digital records were searched yielding 645 space maintainers. After the application of inclusion criteria, 157 (67%) fixed prefabricated space maintainers in 112 children and 77 (33%) removable space maintainers in 61 children were analyzed for an average of 18.4 ± 9.5 months. Results: Kaplan-Meier survival analysis with Mantel-Cox statistics showed an overall cumulative survival time of 31.6 months (SE = 1.15, 95% CI = 29.4 to 33.9). Major failure occurred significantly more in removable maintainers (n = 40/67, 59.7%), mostly due to loss of the appliance, compared to fixed space maintainers (n = 27/67, 40.3%; P < .001). The present study indicates that space maintainers were mainly placed in young children with high caries experience, where treatment was mostly possible using advanced behavior management. Conclusions: Fixed space maintainers had a significantly lower failure rate than their removable counterpart. However, both require continual repairs, preservation, or even replacement till the eruption of the permanent tooth. [ABSTRACT FROM AUTHOR]

Objectives: Treatment of carious primary molars is always indicated, especially on young children; however, there are no clear guidelines that precisely explain the best treatment approach for Class II carious molars with marginal breakdown (International Caries Detection and Assessment System [IC-DAS] 5). The objective of this prospective observational clinical study was to assess the efficacy of three restorative techniques in treating ICDAS 5 Class II lesions in primary molars: compomerfillings (CF), preformed metal crowns (PMC), and pulpotomy and conventional preformed metal crowns (PMC+P). The secondary goal was to evaluate the impact of some cofactors on the course of treatment. Method and materials: Overall, 92 children (female, n = 50, 54.3%; male, n = 42, 45.7%) aged 2 to 9 years old (mean age = 5.9 ± 1.9 years) with 166 treated teeth were included. The average number of decayed, missing, or filled teeth (d3mft) of the whole sample was 8.0 ± 3.4. The distribution of the sample according to type of treatment was CF = 53 (31.9%), PMC = 64 (38.6%), and PMC+P = 49 (29.5%). Paired ttest, nonparametric Friedman ANOVA test, and decision tree analysis were used as the basis for the statistics. Results: After 12 months, data from 75.8% (72/95) treated patients, corresponding to 62.0% (103/166) of the treated teeth (CF = 42/53, 79.2%; PMC = 38/64,59.4%; PMC+P = 23/49,46.9%) were available for analysis. The mean patients age was 6.8 ± 1.8years; 32 (47.1%) boys and 36 (52.9%) girls. The mean d3mft of the remaining sample was 7.8±3.35. PMC and PMC+P arms showed the highest success rates (> 91%) as compared to the CF arm, which showed the lowest success rates (61.9%), with 9/42 teeth of the CF group (21.4%) presenting with minor failures, and 7/42 teeth (16.7%) with major failures (P< .0001). Conclusion: Accordingtothe decision tree analysis, PMC and PMC+P had a success rate of 99%, whereas CF had a success rate of only 69%. Some cofactors (treatment decision, Approximal Plaque Index, and tooth number) had a higher impact on the decision tree analysis than others (age, dmfs, and dmft values), especially when the treatment selection was CF. In future studies it is necessary to examine the impact of other cofactors on the outcomes of conventional fillings using a larger sample size. [ABSTRACT FROM AUTHOR]

Background: Radiotherapy is a treatment modality used for head and neck cancer patients. It has a negative influence on bonding strength of adhesives. Little information is available about the effect of radiotherapy on bonding strength of adhesives in primary teeth. Therefore, this in vitro study aimed to detect the best adhesive system and ideal time to apply restorations in primary irradiated teeth regarding adhesive shear bond strength. Methods: Dentin samples from primary teeth were randomly assigned to four groups based on restoration application time and radiation exposure, (G1: control, G2: preradiation, G3: 24 h postradiation, and G4: 6 months postradiation) with 20 samples per group. These groups were further divided into 2 subgroups according to the adhesive system used, with 10 samples per subgroup. (1) 3M™ Single Bond Universal Adhesive (SB), (2) 3M AdperSingle Bond 2 (AS). Samples were exposed to gamma radiation from a cobalt-60 machine. One shot of 60 Gy of radiation was delivered. Then samples were subjected to a shear bond strength test. The load was applied until failure and the maximum load was recorded. Numerical data are presented as mean and standard deviation values, then distributed according to Shapiro–Wilk test or Levene's test and analyzed via two-way ANOVA. The significance level was set at p < 0.05 for all tests. Statistical analysis was performed with R statistical analysis software version 4.4.1 for Windows (Team RC, R: A language and environment for statistical computing. R foundation for statistical computing, 2023). Results: Compared with the AS subgroup, the SB subgroup presented significantly greater values (p < 0.001). For SB, there was no significant difference among the G1 and G4 groups (p > 0.001). However, there was a significant difference between G1, G2, and G3 (p < 0.001, P = 0.025, P = 0.265 ns respectively), and G3 presented the lowest values. For AS, there was no significant difference between groups G1 and G4 (p = < 0.001). Compared with the other groups, G3 presented a significant difference (p = 0.265 ns) and the lowest results. Conclusion: Restorations performed 24 h after radiation had lower bond strength than those performed six months after radiation. Regardless of the adhesive system used, SB performed better than AS in terms of the shear bond strength. [ABSTRACT FROM AUTHOR]

The article focuses on the molecular analysis of two-and-a-half-year-old twins diagnosed with odontohypophosphatasia due to a missense mutation in the alkaline phosphatase biomineralization associated (ALPL) gene. Topics discussed include the clinical presentation and diagnosis, identification of a novel heterozygous missense mutation (c.224G>A) in ALPL, and its predicted impact on tissue-nonspecific alkaline phosphatase (TNSALP) function.

Objectives: Naturally exfoliated primary teeth are being increasingly collected in child development studies. Most of these odontological collections and tooth biobanks use parent‐reported information from questionnaires or tooth checklists to collect data on offspring teeth. To the best of the authors' knowledge, no studies have assessed parental engagement in tooth checklists, nor parental accuracy in identifying their child's baby tooth. This study aimed to evaluate these dimensions by analysing data from the about this tooth checklist returned with donated primary teeth in a natural experimental study called STRONG (the Stories Teeth Record of Newborn Growth). Methods: Parental self‐reported information were analysed on checklists returned with 825 primary teeth belonging to 199 children. The percentage of blank answers was calculated for each question. The accuracy of parents‐reported tooth identification was evaluated by comparing parental ratings to researchers' ratings. Reliability of researchers' tooth identification was first evaluated by calculating intra‐observer and inter‐observer agreements, as well as Cohen's Kappa values. The percentage of accuracy of parents' tooth identification (relative to researcher's) was then calculated, and logistic regressions were used to evaluate if time elapsed between when exfoliation occurred and the checklist was completed associated with parental accuracy in tooth identification. Results: Parents returned 98.4% of the checklists and completed 74.9% to 97.7% of the questions. Excellent reliability was demonstrated for researchers' intra‐ and inter‐rater tooth identification (agreement percentages >90%; Cohen's Kappa values >.83). Moderate accuracy of parents‐reported tooth identifications was found, with parents correctly identifying 49.5% of the donated tooth. Better parental accuracies were highlighted for partial identifications (87.1% of correct jaw, 75.6% of correct tooth type, and 65.8% of correct lateralization). Logistic regressions showed the odds of correct parental identifications decreased on average by 1.8% every 30 days of distance between tooth exfoliation and checklist completion. Conclusions: While parental engagement is high, parents‐reported tooth identifications have moderate accuracy, which decreases over time. High accuracy is however found for partial identifications. Parent‐reported information on the accompanying questionnaire of naturally exfoliated primary teeth collection or tooth biobanks, even when filled in a long time after exfoliation took place, should be encouraged. However, expert identifications of teeth should remain best practice. [ABSTRACT FROM AUTHOR]

Background: Dental caries is a major, multifactorial oral condition that causes the demineralization of tooth enamel and impacts approximately half of the world's child population. This study aimed to determine the prevalence of dental caries among school-going children aged 7 to 13 years in Kabul city. Methods: This descriptive cross-sectional study was conducted with 491 students aged 7 to 13 years in Kabul during the first half of 2019. A multistage cluster sampling method was used, in which educational zones, schools, and classes were selected. The data were collected using pre-structured questionnaires through face-to-face interviews and oral examinations of students using dental probes and mouth mirrors while adhering to infection control protocols. The collected data were analyzed using Statistical Package for Social Science version 21.0, and a p-value < 0.005 was considered as statistically significant. Results: The average age of the study participants was 9.9 ± 1.8 years. Boys made up approximately 45% of the participants, while 54.8% were girls. The overall prevalence of dental caries was 78.8%, with 62.1% in deciduous teeth and 42.8% in permanent teeth. Among students who did not brush their teeth, the prevalence of dental caries was 84.8%, compared to 81.7% for those who brushed once daily, 78.7% for those brushing twice daily, and 67.4% for those brushing three times daily (p = 0.022). About 10% of students had dental calculus, with a prevalence of 17.0% among those aged eleven and older, 10.0% among students aged nine to ten years, and 5.9% among students aged eight and younger (p = 0.006). Poor oral hygiene affected nearly one-third of the students, with 34.2% among boys and 30.9% among girls. Poor oral hygiene was more prevalent in students aged eight and younger (38.8%) compared to those aged eleven and older (25.9%) (p = 0.023). Conclusions: The prevalence of dental caries among students aged 7 to 13 years in Kabul schools was similar to that in most developing countries. The prevalence of dental calculus was greater among students aged eleven years and older. Over 99% of the students surveyed had not undergone any dental treatment. [ABSTRACT FROM AUTHOR]

The present study aimed to compare the effect of photobiomodulation with different energy densities on the angiogenic differentiation of human periodontal ligament stem cells (hPDLSCs) and stem cells from human exfoliated deciduous teeth (SHED). Photobiomodulation therapy with a 660 nm diode laser (2.4 J/cm2 and 3.9 J/cm2) on two consecutive days post-culture was applied to two types of stem cells (hPDLSCs and SHED). The Quantitative Real-time Polymerase Chain Reaction (RT-qPCR) test was undertaken to investigate Vascular Endothelial Growth Factor-A (VEGF-A) and Angiopoietin I (ANG-I) genes on days 1, 3, 5, 7, and 10 after the first session of laser application. The 4′,6-diamidino-2-phenylindole (DAPI) staining and Methyl Thiazolyl Tetrazolium (MTT) test were conducted on days 1, 3, and 5 after the first session of laser application, to assess the cell viability. The Two-way ANOVA with Tukey post hoc test was used to analyze the outcomes of the MTT and RT-qPCR tests. The results of the MTT and DAPI convergently illustrated that the groups receiving photobiomodulation with 2.4 J/cm2 had higher cell viability compared to 3.9 J/cm2. All experimental groups showed an upregulation of VEGF-A and ANG-I gene expression from day 1 to 5, followed by a downregulation from day 5 to 10. The groups with cultured hPDLSCs and SHED receiving photobiomodulation using 2.4 J/cm2 had the most amounts of VEGF-A and ANG-I gene expression on day 5, respectively. In conclusion, the 660 nm mediated photobiomodulation therapy of cultured SHED and hPDLSCs with 2.4 J/cm2 energy density may be associated with higher angiogenic differentiation (the expression of VEGF-A and ANG-I) as well as higher cell viability compared to the photobiomodulation therapy with 3.9 J/cm2. [ABSTRACT FROM AUTHOR]

Background/Objectives: Tooth agenesis (TA) is among the most common malformations in humans. Although several causative mutations have been described, the genetic cause often remains elusive. Here, we test whether whole genome sequencing (WGS) could bridge this diagnostic gap. Methods: In four families with TA, we assessed the dental phenotype using the Tooth Agenesis Code after intraoral examination and radiographic and photographic documentation. We performed WGS of index patients and subsequent segregation analysis. Results: We identified two variants of uncertain significance (a potential splice variant in PTH1R, and a 2.1 kb deletion abrogating a non‐coding element in FGF7) and three pathogenic variants: a novel frameshift in the final exon of PITX2, a novel deletion in PAX9, and a known nonsense variant in WNT10A. Notably, the FGF7 variant was found in the patient, also featuring the WNT10A variant. While mutations in PITX2 are known to cause Axenfeld‐Rieger syndrome 1 (ARS1) predominantly featuring ocular findings, accompanied by dental malformations, we found the PITX2 frameshift in a family with predominantly dental and varying ocular findings. Conclusion: Severe TA predicts a genetic cause identifiable by WGS. Final exon PITX2 frameshifts can cause a predominantly dental form of ARS1. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Dental caries are among the most common oral and dental diseases affecting adults and children. To prevent caries, either the factors that cause caries should be reduced or the host resistance should be increased. Several compounds, such as bioglass, chitosan, and silver diamine fluoride (SDF), can enhance enamel remineralization. Purpose: This study was conducted to investigate the effects of chitosan, bioglass, chitosan-bioglass, and SDF compounds on remineralizing primary enamel lesions. Materials and Method: In this in vitro study, seventy-two primary canine teeth were collected. The teeth were exposed to a demineralization solution for 72 hours to create primary caries lesions. The primary Vickers microhardness test (VMT) was conducted to measure the initial values. The samples were randomly divided into six groups (n=12): Group 1: bioglass-chitosan solution; Group 2: chitosan; Group 3: bioglass solution; Group 4: SDF; Group 5: remineralization solution; Group 6: distilled water. The solutions of Groups 1, 2, and 3 were applied to the samples for 7 days, while the SDF solution was applied only once. The samples were immersed in an artificial saliva solution, which was refreshed daily. After the treatment, the final Vickers microhardness test (VMT) values were recorded. The data were analyzed statistically using a two-way ANOVA and Tukey's test (p< 0.05). Results: The results indicated a statistically significant effect of remineralizing compounds on both pre-treatment and post-treatment microhardness (p< 0.0001). However, no significant difference in microhardness was observed between the groups studied (p= 0.225). Conclusion: All the compounds utilized in this study demonstrated a significant remineralizing effect on enamel lesions caused by primary caries in primary teeth. The chitosan-bioglass and bioglass groups exhibited the highest levels of remineralization, respectively. However, the comparison between the groups yielded insignificant results due to the dispersion of the samples. Therefore, further studies with larger sample sizes are recommended. [ABSTRACT FROM AUTHOR]

Statement of the Problem: It is challenging to perform a pulpectomy procedure in primary tooth because of its physiological root resorption and variation in root morphology. Working length measurement is considered to be one of the critical steps, as it determines the extent of obturation and apical seal. Purpose: To compare the accuracy of electronic apex locator (EAL) and digital radiography (DR) for working length determination in primary teeth. Materials and Method: In this systematic review, electronic databases and grey literature were searched from 1st January 2005 to 1st January 2023 for randomized control trial, nonrandomized control trial, in vitro studies, ex vivo studies that compared accuracy of EAL and DR in primary teeth. Two reviewers independently identified studies, retrieved data, and assessed risk of bias using the revised and validated MINORS (methodological index for non-randomized studies) criteria. Results: Ten studies were included in qualitative analysis. Seven out of ten studies showed low risk of bias whereas other three studies showed high risk of bias. In view of methodological heterogeneity of the findings, a meta-analysis was not conducted. Conclusion: Available evidence suggests a moderate quality of evidence in this systematic review. Analyzing the ten studies included in this systematic review, the majority of studies showed statistically insignificant difference between EAL and DR. However, EAL was closer to actual WL as compared to DR. Based on the evidence that is currently available; EAL can be considered as an alternative for working length measurement in primary teeth. [ABSTRACT FROM AUTHOR]

Background: Finding the best treatment approach and suitable capping materials in primary molars with deep carious lesions remains unresolved. Aim: To compare the success rates of partial pulpotomy in deep caries lesions in primary molars treated with mineral trioxide aggregate (MTA), biodentine, or acemannan for 6–24 months. Design: A parallel‐design, non‐inferiority randomized controlled clinical trial was performed. Ninety mandibular primary molars from 65 children meeting the criteria, aged 3–8 years, were included. After inflamed pulp tissue removal and hemostasis, each tooth was randomly allocated into the MTA control group, or the biodentine or acemannan experimental group (N = 30 per group). All teeth were restored with a stainless steel crown. The outcomes were evaluated for 6–24 months. A generalized estimating equation model was used to compare the overall success rate in each group. Results: After 24 months, 58 children (83 teeth) were available for evaluation. The results indicated that the success rate in the MTA, biodentine, and acemannan groups was 83.3%, 76.9%, and 74.1%, respectively. No significant difference in success rates among groups, however, was observed at the 6‐ to 24‐month follow‐ups (at 24th month, p =.30). Conclusion: There was no statistically significant difference between MTA, biodentine, or acemannan in the partial pulpotomy success after 24 months. [ABSTRACT FROM AUTHOR]

Background: Pulpectomy is used to treat primary teeth with irreversibly inflamed or necrotic pulp tissue. There is, however, a lack of consensus on clinical protocols for teaching pulpectomy at dental schools. Aim: To determine what faculty members at Brazilian dental schools are teaching about pulpectomy in primary teeth. Design: A cross‐sectional, observational study was conducted using a 39‐question survey available via the Google Forms® platform. A snowball sampling strategy was used for recruitment. Invitations to participate were sent via e‐mail, WhatsApp® and Instagram®. The data were analysed descriptively. Results: A total of 177 (58.4%) responses were obtained. Most faculty members recommended the use of Kerr hand files (66.1%), and 1% sodium hypochlorite was the most common choice for the irrigating solution (35.3%). Iodoform pastes were the first choice of faculty members (41.6%), and 60.5% of the faculty members recommended composite resin as the definitive restoration. Conclusion: Similarities were found in the teaching of pulpectomy for primary teeth among faculty members at dental schools in Brazil. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study is to evaluate the remineralization potential of primary teeth enamel after being exposed to different laser diode therapies. Methods: Ninety-six vestibular primary teeth enamel samples were divided into eight groups (n = 12) with varying treatments: control (G1), CPP-ACP-fluoride varnish (G2), diode lasers at 980 nm (G3), 808 nm (G4), 450 nm (G5), 980 nm + CPP-ACP-fluoride varnish (G6), 808 nm + CPP-ACP-fluoride varnish (G7), and 450 nm + CPP-ACP-fluoride varnish (G8). Each sample was assessed using a DIAGNOdent® (KaVo Dental, Biberach, Germany), at baseline, post-treatment, and post-pH cycle remineralization. SEM imaging was performed before and after treatment and following the pH cycle. Results: The results indicated that the 980 nm and 808 nm diode lasers, both alone and in combination with CPP-ACP-fluoride varnish, either maintained or increased the calcium (Ca) weight percentage (Wt%) in the enamel. The 980 nm diode laser combined with CPP-ACP-fluoride varnish (G6) showed a significant increase in Ca Wt%, suggesting a strong remineralization effect. Similarly, the 808 nm diode laser alone (G4) also promoted a substantial increase in Ca Wt%. In contrast, the 450 nm diode laser, whether applied alone or in combination with CPP-ACP-fluoride varnish, resulted in a lower Ca Wt% and an increase in phosphorus (P) Wt%. Most groups, except for the CPP-ACP-fluoride varnish alone (G2), demonstrated an increase in P Wt%, indicating a complex interaction between laser therapy and enamel remineralization. Conclusions: The combined use of laser therapy with CPP-ACP-fluoride varnish significantly enhanced the remineralization of temporary teeth enamel. The 980 nm diode laser + CPP-ACP-fluoride varnish showed the most pronounced improvement in remineralization, while the 808 nm diode laser alone also effectively increased calcium solubility. These findings suggest that higher-wavelength diode lasers, particularly when combined with remineralizing agents, can effectively enhance the mineral content of primary teeth and promote enamel remineralization. [ABSTRACT FROM AUTHOR]

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Retentive strength data are critical to predicting the long-term clinical performance of zirconia crowns for primary teeth. Objectives: This research assessed the clinical outcome of prefabricated zirconia crowns (PZCs) cemented with either self-adhesive resin cement or pure glass ionomer cement in the primary teeth of children. Method: In the present research, a sample of 162 prefabricated zirconia crowns were collected through convenience sampling. A follow-up examination was conducted at 12 and 24 months to assess the clinical outcomes of PZCs post cementation. Results: Zirconia crowns cemented with self-adhesive resin showed high clinical outcomes at both 12 and 24 months, with 95.1% of crowns retained. In contrast, crowns cemented with glass ionomer cement had slightly lower clinical outcomes, with 91.4% retained at 12 months and 84.0% retained at 24 months, indicating a significant difference (p-value). Long-term follow-up is crucial for the optimal maintenance of crown stability. Conclusions: Self-adhesive resin cement is a viable option for cementing PZCs in pediatric dentistry, demonstrating satisfactory clinical performance over both 12 and 24 months. Future studies comparing different types of cement are recommended for further validation of these results. [ABSTRACT FROM AUTHOR]

Background: Periodontitis is a chronic inflammatory disease mediated by dysbiosis of the oral microflora, resulting in the destruction of periodontal tissue. Increasing evidence suggested that mesenchymal stem cell (MSCs) and exosomes derived from MSCs play a critical role in periodontal tissue regeneration. However, whether stem cells from exfoliated deciduous teeth (SHED)‐secreted exosomes can improve the therapeutic potential of periodontitis is largely unknown. Objective: Here, we aim to evaluate the effect of SHED‐exosomes on inflammation, apoptosis and osteogenic differentiation in periodontitis. Methods: The periodontitis cell model was constructed by stimulating periodontal ligament stem cells (PDLSCs) with lipopolysaccharide (LPS), and the periodontitis rats were established by ligation. Results: First, we isolated exosomes from the SHED, and we figured out that exosomes secreted by SHED were enriched in miR‐92a‐3p and the exosomes enhanced proliferation and osteogenic differentiation and reduced apoptosis and inflammatory responses in PDLSCs. In addition, we found that SHED‐exosomes alleviated inflammatory effect and elevated the expression of osteogenic‐related genes in periodontitis rat model. Moreover, miR‐92a‐3p targeted downstream Krüppel‐Like Transcription Factor 4 (KLF4) and regulated the PI3K/AKT pathway. Finally, our data indicated that upregulation of KLF4 or activation of PI3K/AKT by 740Y‐P counteracted the inhibitory effect of SHED‐exosomes on periodontitis progression. Conclusion: Taken together, our finding revealed that exosomal miR‐92a‐3p derived from SHED contributed to the alleviation of periodontitis development and progression through inactivating the KLF4/PI3K/AKT signaling pathway, which may provide a potential target for the treatment of periodontitis. [ABSTRACT FROM AUTHOR]

Background: Dental eruption is part of a set of children´s somatic growth phenomena. The worldwide accepted human dental eruption chronology is still based on a small sample of European children. However, evidence points to some population variations with the eruption at least two months later in low-income countries, and local standards may be useful. So, this study aimed to predict deciduous teeth eruption from 12 months of age in a Brazilian infant population. Methods: We developed a cross-sectional study nested in four prospective cohorts – the Brazilian Ribeirão Preto and São Luís Cohort Study (BRISA) – in a sample of 3,733 children aged 12 to 36 months old, corrected by gestational age. We made a reference curve with the number of teeth erupted by age using the Generalized Additive Models for location, scale, and shape (GAMLSS) technique. The explanatory variable was the corrected children´s age. The dependent variable was the number of erupted teeth, by gender, evaluated according to some different outcome distributional forms. The generalized Akaike information criterion (GAIC) and the model residuals were used as the model selection criterion. Results: The Box-Cox Power Exponential method was the GAMLSS model with better-fit indexes. Our estimation curve was able to predict the number of erupted deciduous teeth by age, similar to the real values, in addition to describing the evolution of children's development, with comparative patterns. There was no difference in the mean number of erupted teeth between the sexes. According to the reference curve, at 12 months old, 25% of children had four erupted teeth or less, while 75% had seven or fewer and 95% had 11 or fewer. At 24 months old, 5% had less than 12, and 75% had 18 or more. At 36 months old, around 50% of the population had deciduous dentition completed (20 teeth). Conclusion: The adjusted age was an important predictor of the number of erupted deciduous teeth. This outcome can be a variable incorporated into children's growth and development curves, such as weight and height curves for age to help dentists and physicians in the monitoring the children's health. [ABSTRACT FROM AUTHOR]

Background: Because of controversial results from clinical studies comparing different dental local anesthesia methods in children, the primary objective of this randomized, split‐mouth, crossover, controlled trial was to compare pain intensity during local anaesthesia (LA) performed with a computer‐controlled LA delivery system (C‐CLADS) versus a conventional syringe (CONV). Secondary objectives included comparisons during dental treatment. Methods: Participants (4–8 years) with tooth pair requiring similar treatment were recruited from five French hospitals. The right primary molar, which was treated at the first visit, was randomly allocated to one of the anaesthesia groups (either intraosseous with C‐CLADS or infiltration with CONV), whereas the contralateral molar (treated at the second visit) was assigned to the other group. Pain intensity and behaviour outcomes, assessed with the Faces Pain and Venham revised scales, respectively, were compared between groups using Proc mixed. Stratified analyses were performed on dentition and location. Results: Among 107 participants, the analysis revealed reduced pain perception during LA in the C‐CLADS group compared with the CONV group (−0.72, 95% CI: −1.43, −0.006), but not during dental treatment. Stratified analyses showed that this effect was observed only in primary dentition (p =.006) and mandibular molars (p =.005). Behavioural issues were fewer in the C‐CLADS group than in the CONV group (p =.05) only during injection. Conclusion: C‐CLADS emerged as the preferable system in primary dentition. [ABSTRACT FROM AUTHOR]

Background: Premature loss of primary teeth (PLPT) can be a rare presentation of systemic medical conditions. Premature loss of primary teeth may present a diagnostic dilemma to paediatric dentists. Aims: To identify systemic conditions associated with PLPT and develop a clinical aid. Design: OVID Medline, Embase and Web of Science were searched up to March 2023. Citation searching of review publications occurred. Exclusion occurred for conference abstracts, absence of PLPT and absence of English‐language full text. Results: Seven hundred and ninety‐one publications were identified via databases and 476 by citation searching of review articles. Removal of 390 duplicates occurred. Following the exclusion of 466 records on abstract review, 411 publications were sought for retrieval, of which 142 met inclusion criteria. Thirty‐one systemic conditions were identified. For 19 conditions, only one publication was identified. The majority of publications, 91% (n = 129), were case reports or series. Most publications, 44% (n = 62), were related to hypophosphatasia, and 25% (n = 35) were related to Papillon–Lefèvre. Diagnostic features were synthesised, and a clinical aid was produced by an iterative consensus approach. Conclusions: A diverse range of systemic diseases are associated with PLPT. Evidence quality, however, is low, with most diseases having a low number of supporting cases. This clinical aid supports paediatric dentists in differential diagnosis and onward referral. [ABSTRACT FROM AUTHOR]

Background: Although intraoral scanning is highly reliable, little is known about its accuracy in young children with limited mouth‐opening ability. Aim: To determine the accuracy of intraoral scans based on the degree of mouth opening. Design: To simulate mouth opening in children with primary dentition, three groups (n = 5 per group) were allocated by maximum mouth opening of 30, 37 and 40 mm. After the primary dentition model was connected to a dental phantom, intraoral scanning was performed using iTero and TRIOS4. The scanned files were digitally evaluated. Root mean square values were calculated to assess trueness and precision. Results: iTero showed deviations of three‐dimensional trueness of 0.067 ± 0.008, 0.063 ± 0.001 and 0.065 ± 0.005 mm, and TRIOS4 of 0.07 ± 0.002, 0.064 ± 0.003 and 0.066 ± 0.002 mm in the 30, 37 and 40 mm groups, respectively. There were no significant differences in either mouth opening (p >.017) or the intraoral scanners (p >.05). The same statistical results were obtained for precision, with the exception of the 30 mm of mouth opening. Conclusions: Within the limits of this study, limited mouth opening hardly influenced the accuracy of intraoral scanning. [ABSTRACT FROM AUTHOR]

The article describes the case of an eight-year-old girl who complained of multiple carious lesions, causing pain upon eating and teeth brushing. Topics discussed including findings on radiographic examination, treatment given to the patient, and the introduction of prefabricated zirconia crowns (PZCs) for first permanent molars (FPMs) after the success and wide acceptance of the PZCs for primary teeth.

Background: Identifying factors associated with the occurrence of primary tooth avulsion is essential to promote prevention strategies. Aim: To investigate the risk factors associated with primary incisor avulsion and variables associated with post‐avulsion sequelae in the permanent successor. Design: This case–control study comprised 407 children (cases) with primary incisor avulsion and 407 children (controls) with other traumatic dental injuries (TDI). The association between explanatory variables and avulsion was evaluated through logistic regression. Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated. Poisson regression analyses between potential explanatory variables and sequelae were run, from which relative risks (RR) and corresponding 95% CI were estimated. Results: TDI caused by moderate falls (OR = 2.20; 95% CI = 1.47 to 3.27), affecting lateral incisors (OR = 10.10; 95% CI = 3.89 to 26.54) and the lower arch (OR = 9.54; 95% CI = 3.15 to 28.85), were associated with primary incisor avulsion. Moreover, children with previous severe TDI, anterior open bite, and anterior crossbite had higher odds of primary incisor avulsion. Children who suffered from any primary tooth avulsion (RR = 2.68; 95% CI = 1.82 to 3.95) had a higher risk of sequelae in the permanent successors. The risk for sequelae in the permanent teeth was significantly greater for younger children under age 2 years than for children ages 3 to 5 years. Conclusion: Risk factors for primary incisor avulsion are related to the severity of the fall, tooth position, history of previous TDI, and malocclusion. Furthermore, avulsion increases the risk of sequelae in the permanent successors. [ABSTRACT FROM AUTHOR]

Background: Osteogenesis imperfecta (OI) is an inherited disorder characterized by bone fragility and skeletal alterations. The administration of bisphosphonates (BPs) to patients with OI reduces pain, thereby improving their quality of life. The main mechanism of action of BPs is the inhibition of osteoclast action. In the oral cavity of children with OI during growth and development, physiological processes that require the function of osteoclasts occur. The aim of this investigation was to study the dental development of premolars and the root resorption of primary molars in children with OI medicated with BPs according to age and sex. Methods: An observational and analytical study was designed. The study sample consisted of 26 6- to 12-year-old children with a confirmed diagnosis of OI treated with BPs with available panoramic radiographs. The control group consisted of 395 children with available panoramic radiographs. Both groups were divided into subgroups according to sex and age. The third quadrant was studied, focusing on the first left temporary molar (7.4), the second left temporary molar (7.5), the first left permanent premolar (3.4) and the second left permanent premolar (3.5). The Demirjian method was used to study the dental development of 3.4 and 3.5, and the Haavikko method was used to study the root resorption of 7.4 and 7.5. The Mann‒Whitney U test was used for comparisons, and p < 0.05 indicated statistical significance. Results: The mean chronological age of the 421 patients was 9.21 years (95% CI 9.05–9.37). The sample was reasonably balanced by sex, with 52.5% (221 patients) boys versus 47.5% (200 patients) girls. Delayed exfoliation and tooth development were described in children with OI (p = 0.05). According to sex, the root resorption of primary molars and tooth development were significantly lower in boys in both groups and in girls in the OI group, but the differences between the age groups were not significant. Conclusions: Children with OI treated with BPs exhibit delayed dental development of the premolars and delayed root resorption of the primary molars. Boys exhibited delays in both variables, but the differences by age subgroup were not significant. These clinical findings support the importance of clinically and radiographically monitoring the dental development and root resorption of primary teeth in children with OI treated with BPs to avoid alterations of the eruptive process. [ABSTRACT FROM AUTHOR]

Background: The acidic component of liquid medicinal syrups used by pediatric patients may cause erosion and partial demineralization. This study aimed to evaluate the effect of cheese and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on erosive lesions of primary teeth enamel following exposure to amoxicillin and ibuprofen syrups. Materials and Methods: In this in vitro study, 60 noncarious deciduous molars were used. After measuring the surface microhardness of the samples, they were randomly separated into two groups and immersed in either amoxicillin or ibuprofen for 1 min three times per day. CPP-ACP, cheese, and artificial saliva were then applied to each of the three subgroups (n = 10). After each immersion time, 10 min of therapy was given. Between treatment intervals, the samples were kept in artificial saliva. The microhardness was remeasured after 1 week. Data were analyzed using SPSS software through repeated-measures ANOVA (α = 0.05). Results: All samples' microhardness reduced considerably after immersion in liquid pharmaceuticals (amoxicillin [84.9 kgf/mm2] and ibuprofen [75.1 kgf/mm2]), but increased significantly following exposure to therapeutic solutions. There was no difference between the amoxicillin-cheese and amoxicillin-CPP-ACP subgroups (P = 0.975). A statistically insignificant difference was found between the ibuprofen group and the ibuprofen-CPP-ACP subgroup (P = 0.499). Conclusion: As a result, cheese and CPP-ACP can be utilized to remineralize erosive lesions caused by amoxicillin or ibuprofen exposure. [ABSTRACT FROM AUTHOR]

Background: Paediatric rotary file systems have recently been developed for primary teeth use. Aim: To study the cleaning efficacies of two paediatric rotary endodontic files, the Prime PedoTM, and the Kedo‐SG BlueTM against the standard H files. Design: This in vitro study included 54 freshly extracted primary molars, which were randomised into three groups (n = 18 each) and were prepared using either Kedo‐SG BlueTM, Prime PedoTM or hand H files after injecting methylene blue dye into the canals. Pre‐ and post‐operative cone beam computerised tomography (CBCT) was performed to assess change in root canal volumes. Methylene blue dye removal from canals was assessed using stereomicroscopy, and canal cleanliness was examined by scanning electron microscopy (SEM). Results: Both Prime PedoTM and Kedo‐SG BlueTM files reduced significantly less dentine when compared with conventional hand filing with Prime PedoTM removing the least amount of dentine. No significant difference was found in median SEM scores among the groups in the cervical, middle and apical thirds of the roots. Stereomicroscopic assessment of root canal cleanliness using dye removal technique shows a statistically significant difference existing between Kedo‐SG BlueTM and hand H files groups. Conclusion: Prime PedoTM removed the least amount of dentine. Kedo‐SG BlueTM performed significantly better than conventional hand filing with H files when the root canal cleanliness was assessed. [ABSTRACT FROM AUTHOR]

Background: Eccentric instruments have been proposed as more effective and less time‐consuming for endodontic instrumentation. Aim: To compare biomechanical outcomes of different instrumentation systems and time undertaken for instrumentation in resin prototypes. Design: Sixty standardized prototypes of mandibular second primary molars were instrumented according to the following systems: K‐files, ProTaper Next (PTN), XP‐endo Shaper (XPS), XP‐endo Finisher (XPF), XP–Clean (XPC), and Sequence Baby File (SBF; n = 10/each). Irrigation was performed with saline with simultaneous aspiration, and time spent was recorded. The prototypes were micro‐CT‐scanned before and after the instrumentation, and image sets were reconstructed and registered. Non‐instrumented areas, accumulated debris, removed root material volume, and canal transportation were quantified. Data were analyzed through ANOVA, the Kruskal–Wallis test, and the Wilcoxon signed‐rank test (α = 5%). Results: K‐files and SBF resulted in more instrumentation time (p <.05). SBF, XPC and PTN removed less root dentine (p <.05), but PTN left more untouched areas (p <.05). Accumulated debris were lower for XPC and SBF (p <.05). Canal transportation was similar among the groups. Conclusion: Rotary systems reduced instrumentation time, whereas SBF and XPC resulted in more conservative instrumentation, with less debris accumulation and non‐instrumented areas. A dedicated paediatric endodontic system (SBF) outperformed eccentric instruments in terms of effectiveness. [ABSTRACT FROM AUTHOR]

Background: Molar incisor hypomineralization (MIH) is prevalent worldwide and is a challenge for clinicians who provide oral care to children. Molar incisor hypomineralization has been considered a multifactorial disturbance that results from a combination of environmental and genetic factors. Aim: This scoping review followed the Joanna Briggs Institute protocol and aimed to identify the available evidence of the genetic influence on the etiology of MIH. Design: The search strategy was conducted in multiple databases, including PubMed, BVS, Embase, Web of Science, and Scopus. Two trained reviewers, requiring a third reviewer in case of disagreements, collected evidence. Results: Of 563 retrieved studies, 17 were included in the review. From 14 studies performed in humans, 10 investigated DNA polymorphisms, one analyzed DNA methylation, one aimed model of inheritance, and two focused on the phenotype in twins or in the family. Three animal studies were based on the null expression of genes. Conclusion: This scoping review, based on the studies that used different methodologies, reinforces the hypothesis of a genetic contribution to the multifactorial etiology of MIH. The available data are limited in terms of size and origin of the samples. Hence, further genetic studies are still required. [ABSTRACT FROM AUTHOR]

Background: This cross-sectional study aimed to identify the prevalence of Candida albicans and Malassezia globosa in children with severe early childhood caries and caries-free children in Hong Kong. Methods: This study first recruited a total of 80 children aged between 48 and 72 months old, 40 children with severe early childhood caries, and 40 caries-free children. The children were then further divided into four groups, with 20 children in each group: Group 1: Severe early childhood caries—C. albicans, Group 2: Severe early childhood caries—M. globosa, Group 3: Caries-free—C. albicans and Group 4: Caries-free—M. globosa. Saliva, plaque, and caries lesion samples were collected from participants with severe early childhood caries, while only saliva and plaque samples were collected from caries-free participants. Caries status of the primary molars was assessed using WHO's decayed, missing, and filled tooth index, and the severity of cavitated lesions was determined based on International Caries Diagnosis and Assessment System criteria as caries code 5 or 6. The samples were analyzed using an Internal Transcribed Space and Quantitative Real-Time Polymerase Chain Reaction. Results:C. albicans was more prevalent in saliva and plaque samples of severe early childhood caries than in the caries-free group. Proportion of C. albicans in both saliva and plaque samples differed significantly between severe early childhood caries and caries-free groups (p < 0.05). Within the severe early childhood caries group, the proportion of children with C. albicans varied between 6 and 46%. No significant difference in M. globosa load was found between plaque samples of the severe early childhood caries and caries-free groups (p = 0.159). Conversely, no significant difference in M. globosa load was observed between saliva samples of severe early childhood caries and caries-free groups (p = 0.051). Conclusions: This study demonstrated a strong association between C. albicans and severe early childhood caries. M. globosa was detected in both the caries-free and severe early childhood caries groups, albeit at low levels. [ABSTRACT FROM AUTHOR]

The present review was aimed to describe the prevalence and the regional distribution of malocclusion among preschool children worldwide. Two independent reviewers performed a systematic literature search to identify English publications from January 2010 to May 2024 using PubMed, ISI Web of Science and Embase. Search MeSH key words were "malocclusion", "primary dentition" and "child, preschool". The reporting quality was assessed by the modified Newcastle–Ottawa Quality Assessment Scale. We identified 2599 publications and recruited 47 articles. Fourteen of the included studies were conducted in Asia, four in Europe, twenty-eight in South America and one in Africa. The prevalence of malocclusion ranged from 28.4% to 83.9%, and half of the reported prevalences were higher than 50%. The highest percentage was in Asia (61.81%), followed by Europe (61.50%), South America (52.69%) and Africa (32.50%). Statistically significant differences existed in deep overbite, anterior open bite, posterior crossbite, edge-to-edge incisor relationship and distal step between continents (p < 0.05). Europe showed the highest prevalence (33.08%) of deep overbite. Africa showed the highest prevalence (18.60%) of anterior open bite. Europe showed the highest prevalence (15.38%) of posterior crossbite. The most common malocclusion traits were increased overjet and deep overbite. To conclude, malocclusion remained prevalent in the primary dentition and varied between countries. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to evaluate the effectiveness of dental caries segmentation on the panoramic radiographs taken from children in primary dentition, mixed dentition, and permanent dentition with Artificial Intelligence (AI) models developed using the deep learning method. Methods: This study used 6075 panoramic radiographs taken from children aged between 4 and 14 to develop the AI model. The radiographs included in the study were divided into three groups: primary dentition (n: 1857), mixed dentition (n: 1406), and permanent dentition (n: 2812). The U-Net model implemented with PyTorch library was used for the segmentation of caries lesions. A confusion matrix was used to evaluate model performance. Results: In the primary dentition group, the sensitivity, precision, and F1 scores calculated using the confusion matrix were found to be 0.8525, 0.9128, and 0.8816, respectively. In the mixed dentition group, the sensitivity, precision, and F1 scores calculated using the confusion matrix were found to be 0.7377, 0.9192, and 0.8185, respectively. In the permanent dentition group, the sensitivity, precision, and F1 scores calculated using the confusion matrix were found to be 0.8271, 0.9125, and 0.8677, respectively. In the total group including primary, mixed, and permanent dentition, the sensitivity, precision, and F1 scores calculated using the confusion matrix were 0.8269, 0.9123, and 0.8675, respectively. Conclusions: Deep learning-based AI models are promising tools for the detection and diagnosis of caries in panoramic radiographs taken from children with different dentition. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate and compare the risk of dental caries in between human immunodeficiency virus (HIV)‐infected and uninfected children and adolescents. An electronic search was performed on PubMed/MEDLINE, Web‐of‐Science, Scopus, LILACS, ProQuest, and ClinicalTrials.gov up to May 2022. The critical appraisal checklist developed by the Joanna Briggs Institute was used to evaluate the quality of the included studies. Meta‐analysis was performed using the RevMan 5.4. Sixteen studies were included. A total of 3231 participants were evaluated, including 1701 and 1530 HIV‐infected and uninfected children and adolescents, respectively. The meta‐analysis revealed a higher risk of dental caries for primary dentitions in HIV‐infected children and adolescents by decayed, missing, filled tooth (dmft) (SMD:0.34; p = 0.006) and decayed, missing, filled surface (dmfs) scores (SMD:0.37; p = 0.001). Similar results were observed for permanent dentition, with increased dental caries in HIV‐infected children and adolescents with DMFT (SMD:0.32; p = 0.003) and DMFS (SMD:1.78; p < 0.0001) scores. Regarding the quality assessment, most of the included studies were moderate or good quality. However, the certainty of the evidence of the outcomes was very low. This systematic review and meta‐analysis showed higher caries severity in permanent and deciduous teeth among HIV‐infected children and adolescents. [ABSTRACT FROM AUTHOR]

The purpose of this report is to discuss the case of a four-year-old African-American girl who presented with clinical and radiographic evidence of localized stage III grade C periodontitis. She had no history of systemic disease or caries. Treatment consisted of oral hygiene instructions, extraction of unsalvageable teeth, full-mouth debridement with the use of systemic antibiotics and subsequent periodontal maintenance care. The patient underwent a two-year follow-up, during which the disease was stabilized and no space loss was detected. Although this condition is uncommon, the pediatric dentist must be able to diagnose and treat periodontitis in the primary dentition early, together with a multidisciplinary team, to prevent a recurrence of this disease in the permanent dentition. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the efficacy of the American Academy of Pediatric Dentistry (AAPD) best practice recommendations for the diagnosis and management of deep carious lesions in primary teeth. Methods: Primary molars from four to eight-year-old children were selected for diagnosis and treatment planning independently by a pediatric dental resident using the AAPD recommendations and a pediatric dentist using his clinical expertise and experience. The analysis of the two evaluators was performed for sensitivity, specifi- city, positive predictive value, negative predictive values, and agreement scores. Results: A total of 365 primary molars from 185 children were used. Diagnosis and treatment planning by the resident demonstrated a higher sensitivity score of 92.7 percent (95 percent confidence interval [95% CI]=80.1 to 98.5) and specificity score of 96.6 percent (95% CI=94 to 98.3) for treatment planning compared to a diagnosis having sensitivity and specificity scores of 74 percent (95% CI=59.7 to 85.4) and 89.8 percent (95% CI=86 to 92.9), respectively. Lower agreement scores between the resident and the pediatric dentist were found for the diagnosis of asymptomatic irreversible pulpitis and the use of lesion sterilization and tissue repair as a treatment modality. Conclusions: The AAPD best practice recommendations showed a better consistency for treatment planning than the diagnosis of carious primary molars. [ABSTRACT FROM AUTHOR]

Background: Few extended studies have explored oscillating–rotating (O–R) toothbrush efficacy in young children. Aim: To compare the efficacy between O–R and manual toothbrushes in reducing plaque and gingivitis after 4 weeks in children. Design: This was a randomized, parallel‐group, examiner‐blind, clinical trial. In two 50‐subject cohorts (3–6 years, primary dentition, parental brushing; 7–10 years, mixed dentition, self‐brushing), subjects used Oral‐B Kids O–R toothbrush per manufacturer's instructions or Paro Junior manual toothbrush in a customary manner. Plaque and Modified Gingival Index (MGI; primary variable) scores were assessed at baseline and Week 4 for all subjects and within each age group. Results: Both toothbrushes significantly reduced whole mouth and posterior plaque and MGI versus baseline (p <.001). Combined groups: O–R showed greater plaque and MGI reductions versus manual for all measures (p ≤.003). Three‐ to 6‐year‐olds: O–R demonstrated significantly (p <.032) greater whole‐mouth (55.7%) and posterior (34.3%) plaque reductions at Week 4 versus manual. Seven‐ to 10‐year‐olds: O–R showed significantly (p <.001) greater whole‐mouth (94.5%) and posterior (108.4%) plaque reductions and greater (p ≤.016) whole‐mouth (14.1%) and posterior (18.8%) MGI reductions versus manual. There were no adverse events. Conclusion: The O–R toothbrush, used per manufacturer's instructions, reduced plaque and gingivitis better than a manual toothbrush used in a customary manner among children. [ABSTRACT FROM AUTHOR]

Background: Mineralization‐promoting peptide‐3 (MPP3) is a new biomimetic remineralization agent. Aim: To assess the remineralization efficiency of MPP3, either alone or in combination with fluoride gel. Design: The samples were divided into four groups: control, 1.23% fluoride gel, 10% MPP3 gel, and 1.23% fluoride gel + 10% MPP3. Following the application of remineralization agents (4 min), the samples remained in a pH‐cycling model (37°C, 4 weeks). Microhardness, microcomputed tomography (micro‐CT), polarized light microscopy (PLM), and field emission scanning electron microscopy (FE‐SEM) analysis were conducted. RM‐ANOVA, one‐way ANOVA, and intraclass correlation coefficient (ICC) were used for statistical analysis, and a significance level of p <.05 was employed. Results: Mineralization‐promoting peptide 3 and fluoride gel + MPP3 increased the microhardness of the enamel compared with initial values in each group (p <.05). Mineralization‐promoting peptide 3 successfully maintained the mineral density of enamel, although the cariogenic pH‐cycling and PLM results indicated that the lesion depth (μm) was significantly lower in the fluoride gel + MPP3 group (27.0336 ± 12.53650) than in the control group (37.3907 ± 12.76002, p <.05). Conclusion: The combined use of MPP3 with fluoride gel enhanced the caries‐protective and mineralization‐promoting effects of fluoride. Mineralization‐promoting peptide 3 may be a potential agent that can be employed to improve the physical properties of enamel. [ABSTRACT FROM AUTHOR]

Aim: This systematic review and meta-analysis aimed to evaluate the success rates of pulpotomy treatment for irreversible pulpitis in primary teeth. Methods: This study was registered and conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. Relevant studies published between January 1980 and April 2023 were identified across eight online databases and two paediatric dentistry textbooks. Study selection, data extraction, and quality assessment were conducted by multiple investigators independently. Data analysis involved single-arm and two-arm meta-analyses, leave-one-out sensitivity analysis, meta-regression, and assessment of publication bias. The risks of bias were evaluated using the Cochrane Collaboration's assessment tools. The levels of evidence were determined using the Oxford Centre for Evidence-Based Medicine (OCEBM) tool. Results: Five primary studies were included. The weighted mean overall success rates at 6-month and 12-month follow-ups were 97.2% and 94.4%, respectively. Two-arm meta-analysis revealed no significant difference (p > 0.05) between the use of mineral trioxide aggregate (MTA) and non-MTA bioceramic-based materials as pulpotomy medicaments. The sample size of each study did not affect the degree of data heterogeneity. Egger's test revealed no significant publication bias. Conclusions: Pulpotomy may be regarded as an alternative modality for treating primary teeth with irreversible pulpitis. Nevertheless, future well-designed trials and extended follow-up periods are warranted. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effects of zinc oxide-eugenol, calcium hydroxide, and mineral trioxide aggregate as base materials on the clinical and radiographic success of ferric sulfate pulpotomies in primary molars. Method and materials: Following hemostasis with 15.5% ferric sulfate, 105 teeth were randomly allocated to three groups: Group 1, zinc oxide-eugenol; Group 2, calcium hydroxide; and Group 3, mineral trioxide aggregate. All teeth were restored with stainless-steel crowns. Clinical and radiographic examinations were conducted at 6, 12, 18, and 24 months. Results: After 24 months, clinical success rates for Groups 1 to 3 were 97.1% (34/35 teeth), 94.2% (33/35 teeth), and 97.1% (34/35 teeth), respectively (P > .05). Radiographic success rates were 65.7% (23/35 teeth), 65.7% (23/35 teeth), and 77.1% (27/35 teeth), respectively (P > .05). Internal resorption was the most observed radiographic finding (15/105 teeth). Conclusions: The choice of zinc oxide-eugenol, calcium hydroxide, and mineral trioxide aggregate, as base materials, did not affect the clinical and radiographic success of ferric sulfate pulpotomies in primary teeth. [ABSTRACT FROM AUTHOR]

Objective: To systematically evaluate and meta-analyze the short-and long-term clinical and radiologic failure rates of Biodentine versus formocresol as pulpotomy medicaments in primary teeth. Data sources: Relevant medical databases were searched until May 2021 for randomized controlled trials that used Biodentine and formocresol as pulpotomy medicaments in primary teeth with deep caries. Primary outcomes included clinical and radiologic failure rates at 12 months. Secondary outcomes were clinical and radiologic failure rates at 3, 6, 9, 13 to 24, and 25 to 48 months. Results: Nine randomized controlled trials (N = 626) with low risk of bias were included. Pooled analysis showed that compared to formocresol, Bioden tine had significantly lower clinical failure rates (relative risk [RR] 0.16; 95% confidence interval (CI) 0.03 to 0.87; six randomized controlled trials; N = 394; GRADE, low) and radiologic failure rates (RR 0.19; 95% CI 0.08 to 0.49; six randomized controlled trials; N = 393; GRADE, low) at 12 months. Radiologic failure rates at 6 and 9 months were significantly lower in the Biodentine group compared to the formocresol group. Conclusion: Compared to formocresol, Biodentine may be a superior medicament when used for pulpotomy in primary teeth. Adequately powered randomized controlled trials are needed to substantiate this evidence. [ABSTRACT FROM AUTHOR]

Background: Current evidence in cariology teaching is not consistently reflected in paediatric dentistry in the United Kingdom (UK). Many dental schools are not consistently teaching biological approaches to caries management, with outdated or complex methods being taught outwith the purview of general dental practitioners. This scoping review aimed to map current guidelines on the management of caries in children and young people. This is part of a work package to inform the consensus and development of a UK-wide caries management curriculum for paediatric dentistry. Methods: A search of electronic databases for peer reviewed literature was performed using Cochrane Library, MEDLINE via PubMed, TRIP Medical Database and Web of Science. Hand searching was undertaken for grey literature (citations of sources of evidence, websites of global organisations and Google Web Search™ (Google LLC, California, USA). Results from databases were screened independently, concurrently by two reviewers. Full texts were obtained, and reviewers met to discuss any disagreement for both database and hand searching. Results: This review identified 16 guidelines suitable for inclusion. After quality appraisal, eight were selected for synthesis and interpretation. Key themes included the shift towards selective caries removal and avoidance of complete caries removal unless in specific circumstances in anterior teeth. For "early lesions" in primary and permanent teeth with and without cavitation, several guidelines recommend biological management including site specific prevention and fissure sealants. Conclusions: This review mapping current cariology guidelines for children and young people found gaps in the literature including classification of early carious lesions and management of early cavitated lesions. Areas identified for further exploration include integration of biological caries management into treatment planning, selective caries removal and whether pulpotomy is specialist-level treatment, requiring referral. These results will inform consensus recommendations in the UK, using Delphi methods. [ABSTRACT FROM AUTHOR]

Objectives: The trial aimed to compare the clinical performance and radiographic success of ACTIVA BioACTIVE versus Compomer in restoring class-II cavities of primary molars. Materials and methods: A non-inferior split-mouth design was considered. A pre-calculated sample size of 96 molars (48 per group) with class-2 cavities of twenty-one children whose ages ranged from 5 to 10 years were randomly included in the trial. Pre-operative Plaque Index (PI), DMFT/dmft scores and the time required to fill the cavity were recorded. Over 24 months, the teeth were clinically evaluated every six months and radiographically every 12 months by two calibrated and blinded evaluators using the United States public health service (USPHS)-Ryge criteria. The two-sided 95% confidence interval (CI) for the difference in success rate was considered to assess non-inferiority, and the margin was set at -18%. The linear mixed model and Firth's logistic regression model were used for data analysis (P < 0.05). Results: After 24 months, 86 teeth (43 per group) were evaluated. The mean PI score was 1.1(± 0.9), while DMFT/dmft was 0.35 (± 0.74) and 6.55 (± 2.25) respectively. The clinical and radiographic success rate of Dyract vs. ACTIVA was 95.3% and 88.3% vs. 93% and 86%, respectively. The two-sided 95% CI for the difference in success rate (-2.3%) was − 3.2 to 1.3% and didn't reach the predetermined margin of -18% which had been anticipated as the non-inferiority margin. Clinically, ACTIVA had a significantly better colour match (P = 0.002) but worse marginal discolouration (P = 0.0143). There were no significant differences regarding other clinical or radiographic criteria (P > 0.05). ACTIVA took significantly less placement time than Dyract, with a mean difference of 2.37 (± 0.63) minutes (P < 0.001). Conclusion: The performance of ACTIVA was not inferior to Dyract and both materials had a comparable high clinical and radiographic performance in children with high-caries experience. ACTIVA had a significantly better colour match but more marginal discolouration. It took significantly less time to be placed in the oral cavity. Trial registration: The study was registered at ClinicalTrials.gov on 4 May 2018 (#NCT03516838). [ABSTRACT FROM AUTHOR]

Background: This systematic review aims to analyze the spontaneous dentoalveolar changes in the mandibular arch after maxillary expansion in growing patients obtained with different expansion protocols: Rapid Maxillary Expansion (RME), Slow Maxillary Expansion (SME), and Leaf Expander. Methods: The study adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Eligibility criteria were established in the PICO format, involving patients who underwent slow, rapid, or leaf maxillary expansion during the mixed or early permanent dentitions. A comprehensive search of electronic databases and manual searches was conducted up to December 2023. The outcome measures included inter-mandibular first permanent molar width, inter-deciduous molar and canine width, arch perimeter, and arch length; both short- and long-term results were considered. The articles that met the inclusion criteria were included in this systematic review and were qualitatively evaluated using a methodological quality scoring system with a 13-point scale. To assess the inter-examiner agreement concerning the article selection and the qualitative assessment of the included studies, Kappa statistics were computed. Results: A total of 1184 articles were identified through electronic and manual searches. After the removal of duplicates and the initial examination of the titles and abstracts, 57 articles were considered for the full text analysis, and according to the eligibility and exclusion criteria, 22 studies were finally selected, composed of 8 randomized controlled trials (RCTs) and 14 retrospective/case-control studies. The qualitative assessment of the included studies showed the following scores: 6 papers have high research quality, 5 have moderate quality, and 11 have low quality. SME demonstrated negligible mandibular changes, with less than 1 mm variation on average (range 0.46–2.00 mm) in the selected parameters and relapses observed in the long term. RME induced more significant increases, particularly in intermolar width greater than 1 mm, which ranged between 0.93 and 3.3 mm, and good stability over the long term. Leaf Expander exhibited promising short-term lower intermolar width increases greater than 1 mm and ranged from 0.5 to 1.69 mm, but long-term stability was not thoroughly evaluated. Conclusions: SME results in negligible short- and long-term effects, while RME, especially with Haas-type appliances, exhibits significant intermolar width increases that remain stable over the years. Leaf Expander shows short-term lower intermolar width increases, requiring further investigation into long-term stability. [ABSTRACT FROM AUTHOR]

Background: Orphan children represent a category of children who lost their family support. Their health status is poorer when compared to their parented counterparts. As the most prevalent disease in the world, dental caries is expected to affect orphans greatly. Being vulnerable, health status of orphan children must be monitored and studied; so that health improvement plans would be formulated. Therefore, this systematic review focuses on the extent of the dental caries problem among institutionalized orphan children and its determinants. Methods: The review has two outcomes: comparing caries experience of institutionalized children to their parented counterparts, and reviewing the determinants of caries in the exposure group. Two systematic searches (one for each outcome) were run on MedLine via PubMed, Cochrane library, LILACS, Egyptian knowledge bank (EKB) and Google Scholar; beside hand search and searching grey literature. Results: The searches yielded 17,760, followed by 16,242 records for the first and second outcomes respectively. The full text was screened for 33 and 103 records for the two outcomes respectively; after translating non-English reports. Finally, the review included 9 records to address the first outcome and 21 records for the second. The pooled results showed that the exposure group may show slightly poorer caries experience regarding permanent teeth (pooled mean difference of DMF = 0.09 (-0.36, 0.55)); but they have a much poorer caries experience regarding primary teeth health (pooled mean difference of dmf = (0.64 (-0.74, 2.01)). Meta-analysis of the caries determinants showed that institutionalization increases the risk of caries by 19%. Gender showed slight effect on caries risk with males being more affected; while primary teeth revealed higher risk of caries when compared to permanent teeth. Conclusion: Limited by the heterogeneity and risk of bias of the included studies, meta-analyses concluded that institutionalized orphan children have higher risk of caries. Yet, the institutionalization circumstances were not well-documented in all the included studies. So, the complete picture of the children's condition was not possibly sketched. Trial registration: Protocol has been registered online on the PROSPERO database with an ID CRD42023443582 on 24/07/2023. [ABSTRACT FROM AUTHOR]

Background: This animal study sought to evaluate two novel nanomaterials for pulpotomy of primary teeth and assess the short-term pulpal response and hard tissue formation in dogs. The results were compared with mineral trioxide aggregate (MTA). Methods: This in vivo animal study on dogs evaluated 48 primary premolar teeth of 4 mongrel female dogs the age of 6–8 weeks, randomly divided into four groups (n = 12). The teeth underwent complete pulpotomy under general anesthesia. The pulp tissue was capped with MCM-48, MCM-48/Hydroxyapatite (HA), MTA (positive control), and gutta-percha (negative control), and the teeth were restored with intermediate restorative material (IRM) paste and amalgam. After 4–6 weeks, the teeth were extracted and histologically analyzed to assess the pulpal response to the pulpotomy agent. Results: The data were analyzed using the Kruskal‒Wallis, Fisher's exact, Spearman's, and Mann‒Whitney tests. The four groups were not significantly different regarding the severity of inflammation (P = 0.53), extent of inflammation (P = 0.72), necrosis (P = 0.361), severity of edema (P = 0.52), extent of edema (P = 0.06), or connective tissue formation (P = 0.064). A significant correlation was noted between the severity and extent of inflammation (r = 0.954, P < 0.001). The four groups were significantly different regarding the frequency of bone formation (P = 0.012), extent of connective tissue formation (P = 0.047), severity of congestion (P = 0.02), and extent of congestion (P = 0.01). No bone formation was noted in the gutta-percha group. The type of newly formed bone was not significantly different among the three experimental groups (P = 0.320). Conclusion: MCM-48 and MCM-48/HA are bioactive nanomaterials that may serve as alternatives for pulpotomy of primary teeth due to their ability to induce hard tissue formation. The MCM-48 and MCM-48/HA mesoporous silica nanomaterials have the potential to induce osteogenesis and tertiary (reparative) dentin formation. [ABSTRACT FROM AUTHOR]

Background: Dental caries is the most common oral disease worldwide, and it is estimated to affect 2.3 billion people, with at least 530 million of them being schoolchildren with decayed primary teeth. This condition can rapidly evolve into irreversible pulp inflammation and pulp necrosis and thus requiring endodontic intervention. Photodynamic therapy (PDT) is a supplementary method to conventional pulpectomy and is used to improve the protocol used for disinfection. Aim: The main objective of this study was to evaluate through a systematic review the efficacy of supplementary PDT on the pulpectomy of primary teeth. This review was registered a priori on the PROSPERO database (CRD42022310581). Design: Two independent and blinded reviewers carried out a comprehensive search in five databases: PubMed, Cochrane, Scopus, Embase, and Web of Science. Eligible studies were randomized and nonrandomized clinical trials that evaluated in vivo microbiological load or clinical outcomes after using supplementary PDT in infected primary teeth. Results: After the selection process, four studies met the inclusion criteria and were included in this study. Data regarding the sample characteristics and PDT protocols were retrieved. All included trials used phenothiazinium salts as photosensitizer agents. Only one study observed a significant difference in the in vivo microbiological load reduction outcome when performing PDT on primary teeth. The remaining studies all discussed the possible benefits of this intervention; however, none observed a significant difference in this outcome. Conclusion: In this systematic review, moderate‐to‐low certainty of the available evidence was observed, and thus, no significant conclusions can be drawn from the findings. [ABSTRACT FROM AUTHOR]

An observational study was carried out in a teaching hospital in Saudi Arabia to determine the occurrence of dental anomalies among Arabian children. The study included children of Saudi nationality with primary teeth. The study assessed the prevalence of dental anomalies in their primary dentition. The assessment and data collection were conducted by a single examiner, utilizing clinical examination and intra-oral radiographs. A comparative analysis was conducted to examine dental anomalies in relation to gender (boys and girls) and arch type (maxillary and mandibular). In addition, the study explored the occurrence of gender-specific dental anomalies depending on arch type. The data analysis was conducted using IBM Statistics (version 21.0) with a significance level of p < 0.05. In total, there were 245 children included in the final analysis. The study population consisted of boys (66%) and girls (34%), with an average age of 4.87 ± 0.9 years. Taurodontism was the most prevalent dental abnormality, occurring in 2.8% of the individuals in the study sample. The study sample exhibited hypodontia in 2%, supernumerary teeth in 2.4%, double teeth in 2%, and microdontia in 1.2%. Talon cusp and macrodontia have a relatively low incidence of 0.4%. Boys exhibit supernumerary teeth, microdontia, macrodontia, talon cusp, and taurodontism, whereas hypodontia and double teeth were more frequent in girls. [ABSTRACT FROM AUTHOR]

Background: The presence of treatment-resistant microorganisms is known as the main cause of pulpectomy failure in the endodontic treatment of deciduous teeth. The usage of lasers can contribute to reducing these microorganisms. This study aimed to compare the effect of three disinfection methods for deciduous teeth canals using laser diode 810 nm, photodynamic therapy with laser 660 nm and methylene blue, and sodium hypochlorite. Materials and Methods: In this experimental study, 58 single-root deciduous teeth with no root resorption were investigated in four groups, including one control group of 10 and three intervention groups of 16. Preparation of the samples was done using manual files up to three numbers after the initial file. After sterilizing the samples in an autoclave, Enterococcus faecalis bacteria were cultured in the canals. In the first group, irrigating with hypochlorite 2.5% was done; in the second group, photodynamic therapy was performed using a laser diode and 0.1 mg/mL methylene solution; and in the third group, high-intensity laser 810 nm direct radiation was done into the canal. Next, samples were taken from all canals. The colony formation unit (CFU) of the bacteria was counted in the blood agar culture medium. The data were analyzed using Kruskal--Wallis and negative binomial regression test (α =0.05). Results: The mean CFU differed significantly between the four groups. The rate of incidence of E. faecalis colonies showed a reduction in all three intervention groups compared to the negative control. In the high-intensity laser 810 nm group, there was 68.4%; in the photodynamic therapy with diode 660 nm and methylene blue, there was 88%; and in the hypochlorite group, 98.3% reduction was observed compared to the negative control group. Conclusion: Based on the results of this study, to compare three disinfection methods of the deciduous teeth canals without preparation of canals, sodium hypochlorite had greater efficiency. All three groups of laser, photodynamic therapy, and sodium hypochlorite showed reductions of E. faecalis bacterial colony compared to the control group. The reductive effects of CFU were greater in the hypochlorite sodium group, followed by photodynamic and direct laser radiation groups. [ABSTRACT FROM AUTHOR]

Background: The aim of this study is to evaluate the stress distributions of a primary molar tooth restored with a stainless steel crown (SSC) using resin and glass ionomer luting cements by Finite Element Analysis (FEA). Methods: Original DICOM data of a primary molar was used to create a 3D model. One model was prepared as a tooth model with SSC. A 30 μm cement layer was used in model. Two different luting cements were tested in the study: self-cure adhesive resin cement, and glass ionomer cement. Vertical and oblique loads of 330 N were applied to simulate maximum bite force and lateral forces in the occlusal contact areas of the models. Maximum von Mises stress values in the models were evaluated as MPa. Results: The maximum von Mises stress value was observed in the force application and general occlusal contact areas for all models. The maximum von Mises stress values were higher in the tooth model with SSC using self-cure adhesive resin cement (478.09 MPa and 214.62 MPa) than in the tooth model with SSC using glass ionomer cement (220.06 MPa and 198.72 MPa) in both vertical and oblique loading, respectively. Conclusions: Depending on the magnitude of the bite force on the SSC, fracture of the luting cement materials could occur if the stress exceeds the endurance limit of the luting cement. Cementation with glass ionomer cement may help to reduce stress levels in SSC restorations of primary molars in children. [ABSTRACT FROM AUTHOR]

(1) Introduction. An analysis was made of posterior crossbites in deciduous dentition and their relation to the type of feeding received by the child, with the objective of determining the influence of the way in which the child is fed in the early stages of life on the development of posterior crossbites. (2) Material and methods. A total of 1401 preschool children between 3 and 6 years of age from Seville (Spain) were included in the study. An intraoral exploration was carried out to assess the presence of crossbites (uni- or bilateral, and functional or not). The study was completed with a parent or legal guardian questionnaire exploring the type of feeding received by the child in the first stages of life, as well as the presence of bad oral habits and their duration. (3) Results. A total of 276 children (19.7%) presented posterior crossbite in occlusion. Uponn centering the midlines, 197 were maintained, indicating that 79 were due to premature contacts (functional crossbites). There were no significant differences in crossbites among the children who had received breastfeeding, though bottle-feeding was seen to favor crossbite. (4) Conclusions. No statistically significant relationship was found between posterior crossbites and breastfeeding, though an association between posterior crossbites and bottle-feeding was observed, with the number of crossbites increasing with the duration of bottle-feeding. [ABSTRACT FROM AUTHOR]

Background: Nasoalveolar molding (NAM) is a presurgical orthopedic technique used in the management of cleft lip and palate deformities. Despite the widespread use of NAM therapy, there is a need for further investigation to assess its specific effects on arch dimensions and malocclusion characteristics. Aim: To evaluate the effects of NAM therapy on maxillary arch dimensions and malocclusion characteristics in patients with unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP). Design: Patients in primary dentition were referred to the Institutional Department of Orthodontics. The NAM group consisted of 21 patients with UCLP (mean age 4.7 ± 0.7 years) and 12 patients with BCLP (mean age 4.8 ± 0.7 years). Sixteen patients with UCLP (mean age 4.9 ± 0.9 years) and five patients with BCLP (mean age 5.4 ± 1.1 years) were included in the non‐NAM group. The plaster models of all patients were digitized. Dental arch dimensions and malocclusion characteristics were analyzed via digital software. One‐way ANOVA with Bonferroni correction was used for statistical analysis. Results: Intercanine and intermolar widths showed statistically significant differences according to the cleft type (p <.01). There was no statistically significant effect of NAM therapy on maxillary arch parameters and malocclusion characteristics (p >.05). The prevalence of anterior crossbite was 12.1% in the NAM group and 23.8% in the non‐NAM group. Conclusion: NAM therapy did not affect the maxillary arch dimensions and malocclusion characteristics in patients with UCLP and BCLP. The cleft type was the main factor, leading to a significant difference in maxillary widths. [ABSTRACT FROM AUTHOR]

Background: The decayed, missing, and filled teeth (DMFT/dmft) index recommended by the World Health Organization (WHO), which measures the prevalence of caries based on the presence of cavitated caries lesions, is the most used dental caries index in epidemiological studies. Early diagnosis of noncavitated carious lesions enables preventive measures, which has the potential to prevent dental caries‐related morbidity and reduce the financial burden associated with restorative or rehabilitative dental care. The International Caries Detection and Assessment System (ICDAS II) incorporates both the cavitated and noncavitated carious lesions with acceptable reliability. Aim: To compare dental caries prevalence based on ICDAS II and WHO criteria. Design: A cross‐sectional study was conducted among 362 children visiting People's Dental College and Hospital, Nayabazar, Kathmandu, Nepal to study dental caries prevalence based on the ICDAS II and WHO criteria. Results: Among the study population, 290 (90.34%) and 169 (68.42%) children had dental caries in primary and permanent teeth according to the ICDAS II criteria, whereas according to WHO criteria, 267 (83.18%) and 107 (43.32%) had dental caries in primary and permanent teeth, respectively. The prevalence of dental caries was significantly higher (p <.001) according to ICDAS II criteria than the prevalence based on WHO criteria in both dentitions. Conclusion: This study showed a significant difference in dental caries prevalence between the ICDAS II and WHO methods of caries diagnosis. The presence of noncavitated carious lesions was alarming. To enable detection of early/noncavitated carious lesions, ICDAS II rather than WHO criteria of caries diagnosis may be a more a valuable tool. [ABSTRACT FROM AUTHOR]