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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]

Introduction: The objective of this study was to assess an original learning intervention to train students and paediatric dentistry teachers in radiographic diagnostic accuracy of pulpo‐periodontal complications in primary molars. Materials and Methods: The learning intervention was based on 250 different randomly ordered radiographs of primary molars within three quizzes (A, B and C) for 5 sessions (S): quiz A (50 X‐rays), B and C (100 X‐rays) were, respectively, completed in S1 to assess the extent of agreement with 5 experts' diagnoses, in S2 and S3 (B at days 8 and 23) and in S4 and S5 (C at days 90 and 105). During S1 and at the end of S3 and S5, the participants (48 students and 16 teachers) were informed of correct diagnoses. A satisfaction questionnaire was completed by all the students. Alongside the descriptive analyses, generalised linear mixed model (GLMM) analyses assessed the odds of participants' correct diagnosis over the study duration. Results: At S1, the odds of diagnostic accuracy among students were significantly lower than those among the teachers. After receiving feedback at S1, GLMM analyses showed that among all the participants, accuracy improved over time with the odds of correct diagnoses higher in S2‐5 than in S1; and there were similar increases across sessions between teachers and students, except in S3, where the improvement among teachers tended to be greater than that among the students. All students were satisfied though one‐third reported that quizzes with 100 radiographs felt too long. Conclusion: The online case‐based learning was a good training format for dental education. [ABSTRACT FROM AUTHOR]

Purpose: To identify the most effective methods of toothbrushing in children, assessed according to their ability to remove dental plaque. Materials and Methods: After electronic research, randomised clinical studies in children which compared different toothbrushing techniques or different frequencies with the same technique were included. The evaluation criterion was plaque index. Results: Six of 534 identified articles were included. Because the protocols differed, regrouping of data was not possible. The level of evidence was moderate due to imprecise methods. The horizontal technique was found to be the most effective up to 6 to 7 years of age. For older children, there was no statistical difference between the techniques. No randomised clinical trial assessed different frequencies of toothbrushing. Conclusion: Based on current knowledge, it would appear prudent to propose that, at the stage of the late mixed dentition, the technique adopted by the child be modified to improve brushing quality without favouring a particular technique. In younger children, the horizontal technique should be advised. The recommendations published via the Internet by national and international associations should be reconsidered. [ABSTRACT FROM AUTHOR]

The study aimed to compare the efficacy of three caries removal techniques—complete caries removal (CCR), selective caries removal (SCR), and stepwise caries removal (SWR)—for deep carious lesions in vital temporary teeth by conducting a systematic review and meta‐analysis of randomized controlled trials (RCTs). Electronic databases (PubMed [MEDLINE], Cochrane Library, EMBASE) were searched for corresponding references up to 31 May 2019. Possible outcomes were pulp exposure, pulpo‐periodontal complications, or restorative failures. Three reviewers independently selected studies, extracted data, and assessed the risk of bias using RoB 2. Meta‐analyses for intention‐to‐treat and per‐protocol scenarios were performed using Revman5. Of 1374 potentially eligible articles, ten relevant references corresponding to eight studies were included. Pooled results showed decreased risk of pulp exposure after SCR (OR: 0.10, 95% CI [0.04, 0.25]) or SWR (OR: 0.20, 95% CI [0.09, 0.44]), compared with CCR. There was a higher risk of composite restorative failure (OR: 2.61, 95% CI [1.05, 6.49]) using USPHS criteria, after SCR compared with CCR only in intention‐to‐treat analysis. Risk of clinical or radiographic failure of pulpo‐periodontal complications was unchanged when compared with SCR and CCR or SWR. SCR and SWR may result in lower pulp exposure risk than CCR. RCTs with lower risk of bias, higher power, and longer follow‐up are required to choose between these three caries removal techniques for deep carious lesions in vital temporary teeth. [ABSTRACT FROM AUTHOR]

A split-mouth randomized clinical trial was carried out to assess the effectiveness of sealants in preventing carious ICDAS (International Caries Detection and Assessment System) 3-6 lesions within a 2-year follow-up. We evaluated the effectiveness of 2 types of resin-based sealants, with and without fluoride, their retention rates, and the caries risk factors related to their outcomes. The study included 663 tooth pairs in 400 children (aged 5-15 years) considered to be at high individual caries risk (ICR) and presenting permanent molars free of caries or affected by ICDAS 1-2 lesions. In the first randomization, molars were either randomized to the treatment group receiving a dental sealant or the control group (nontreatment), and in the second randomization the sealant material to be used in the intervention group was selected. Uni- and multivariate Cox proportional hazard models were employed. At the 2-year follow-up, 483 tooth pairs were assessed: sealed molars had 83% (adjusted HR = 0.17; 95% CI: 0.15-0.20) less risk of developing ICDAS 3-6 lesions than molars without sealant. The magnitude of the protective effect was lower among teeth with ICDAS 1-2 lesions or with occlusal deep fissures than without. If the total retention rate of sealants was 70% at 2 years, sealant loss was not associated with the risk of caries (HR = 1.29, 95% CI: 0.92-1.79, p = 0.14). Sealants allow the prevention of new ICDAS 3-6 lesions or progression of noncavitated carious lesions in children at high ICR, and the effect of the sealant was similar regardless of whether it contained fluoride or not. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this cross-sectional study was to describe corresponding procedures for irreversible hydrocolloid and silicone impressions taught and used in European Union dental schools. Materials and Methods: A self-administered questionnaire requesting information about rinsing and disinfection methods was sent to each of the 373 heads of prosthodontic, pedodontic, and orthodontic departments in the 131 European Union dental schools. Response rate was 94%. Statistical analysis included chi-square or Fisher exact tests, and ANOVA or Kruskall-Wallis tests. Results: Of the responding departments, 92% systematically rinsed their impressions. Fifteen percent of the departments, mostly orthodontics, never disinfected irreversible hydrocolloid impressions, and 11% never disinfected silicone impressions. The immersion method was used by 65% for irreversible hydrocolloid impressions (73% for silicone), with a disinfection time of 10.3 ± 6.3 minutes (11.8 ± 7.4 for silicone). The disinfected impressions were not rinsed by 16% for irreversible hydrocolloid and 14% for silicone. Most departments used brand-name products. Conclusion: The same disinfection procedure for both irreversible hydrocolloid and silicone impressions was used by 78% of departments. There was great diversity, however, between departments in the procedure used for each impression material. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to assess the microleakage of a pit-and-fissure sealant after classical enamel preparations (prophylaxis followed by acid etching alone and mechanical widening with bur) and after air abrasion. Materials and Methods: Ninety noncarious freshly extracted third molars were randomly assigned to three groups of 30. In each group, the mesial halves of the fissures were treated with air abrasion and conditioned with acid etching for 15 s. In group 1, the distal halves were treated with acid etching alone. In group 2, the distal halves of the fissures were widened mechanically with a bur and etched for 15 s. In group 3, the distal halves were prepared with air abrasion alone. Then the sealant (Clinpro) was applied on the occlusal fissures of all teeth, according to the manufacturer's recommendations. The teeth were thermocycled and the samples placed in a 1% methylene blue dye solution. The teeth showing microleakage and the means of infiltration were assessed with an image analysis system. Results: The microleakage of sealants prepared with air abrasion alone displayed significantly greater microleakage (80%) (p < 0.0001) than the ones placed after prophylaxis and etching (13.33%), bur and etching (20%), or air abrasion and etching (22.2%). The samples prepared with air abrasion alone also showed the highest mean microleakage (1.14 ± 1.4 mm) when compared to samples receiving prophylaxis and acid etching (0.12 ± 0.41), bur and acid etching (0.08 ± 0.26), or air abrasion and acid etching (0.09 ± 0.4) (p < 0.05). No significant difference was noted between the three types of enamel preparation when etching was performed. Conclusion: Air-abrasion treatment does not eliminate the need for etching the enamel surface before applying the sealant. [ABSTRACT FROM AUTHOR]