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In diabetic patients, maintaining blood glucose levels as close to normal as possible is an objective in dental management especially in pediatric ones. Patients with poorly controlled diabetes are at greater risk of developing infections. Therefore, the prescription of antibiotics may be necessary for some dental procedures., Aim: The aim is to optimize the benefit and minimize the risk of antibiotics in dental treatments performed in diabetic children., Materials and Methods: A cross-sectional approach was conducted on 155 type 1 diabetic children (72 controlled and 83 uncontrolled). The types of dental acts held for the study were pulpotomies, pulpectomies, pediatric crowns, scaling, and extraction. For the balanced diabetic patients, no antibiotics were prescribed except for infected teeth. In the unbalanced diabetic group, for the acts causing bleeding, prophylactic antibiotics were administered. In presence of dental infection, antibiotics were administered for at least 5 days., Results: The analysis of data was carried out using Statistical Package for the Social Sciences Computer Software (SPSS 21.0, Inc., Chicago, Illinois, USA). A probability value of <0.05 was regarded as statistically significant. Around 126 acts in the balanced group and 145 in the unbalanced ones were performed. In balanced diabetic children, 125 successes and one failure were noted. In the unbalanced group, 142 successes and three failures were recorded. The comparison between variables did not show any statistical significance ( p -value = 0.382)., Conclusion: This study demonstrated that working with diabetic young patients is possible and safe as long as some measures are considered. It is crucial to identify the dental acts that necessitate antibiotics administration and to differentiate between balanced and unbalanced diabetic children for the same dental procedure., How to Cite This Article: Nassif N, Noueiri B. Antibiotic Prescription for Dental Procedures in Type 1 Diabetic Children. Int J Clin Pediatr Dent 2023;16(1):60-63., Competing Interests: Source of support: Nil Conflict of interest: None, (Copyright © 2023; The Author(s).)

Aim: This study aims to evaluate, over 12 months of clinical and radiographic follow-ups, the performance and outcomes of Biodentine™ pulpotomy in stage I primary molars., Materials and Methods: A total number of 20 stage I primary molars requiring pulpotomy were selected from eight healthy patients aged between 34 and 45 months. Patients presenting a negative attitude toward dental treatment on the dental chair were scheduled for dental treatments under general anesthesia.Pulpotomy with Biodentine™ as a pulp-dressing material was performed on all selected molars. The patients were called back at 1 and 3 months for clinical follow-ups, then at 6 and 12 months for clinical and radiographic follow-ups. Data were tabulated according to follow-up intervals and occurrence of any changes in root maturation, pulp canal obliteration (PCO), periodontal ligament space (PLS), and bone or root lesion., Results: No statistically significant differences were recorded at 1, 3, 6, and 12 months. There was a statistically significant increase in number of roots with closed apices from six roots at 6 months to 50 roots at 12 months ( p < 0.0005) and the PCO was present in all 50 roots at 12 months, after it was present in 36 roots only at 6 months ( p = 0.0001)., Conclusion: This is the first randomized clinical trial that evaluates the performance of Biodentine™ as a pulp-dressing agent in stage I primary molar pulpotomy over 12 months of follow-up. Contrary to previous studies, the present work highlights the continued root formation and apical closure (AC) in pulpotomized immature primary molars., How to Cite This Article: Nasrallah H, Noueiri BE. Biodentine™ Pulpotomy in Stage I primary Molars: A 12-month Follow-up. Int J Clin Pediatr Dent 2022;15(6):660-666., Competing Interests: Source of support: Nil Conflict of interest: None Patient consent statement: The author(s) have obtained written informed consent from the patient's parents/legal guardians for publication of the case report details and related images., (Copyright © 2022; The Author(s).)

Aim: To evaluate over a six-year period, the prevalence of the dental procedures in primary and mixed dentitions, in males and females., Materials and Methods: A retrospective descriptive study on dental treatments in primary and mixed dentitions was conducted in the Department of Pediatric Dentistry at the Faculty of Dental Medicine, Lebanese University, from 2015 to 2020. The total number of children was 1291. Data were classified and reviewed according to the dentition type, gender, and type of dental treatment., Results: The number of children decreased from 741 for the period 2015-2017 to 550 during the period 2018-2020 (279 males and 271 females). No significant association was found between the admission periods and the genders. A significant relationship was found between the number of treatments performed in both genders and the dentition types ( p value = 0,015). Males were slightly more likely than females to present for the treatment in mixed dentition (54.58% versus 45.2%, respectively). Results portrayed a significant relationship between surgical treatment and gender ( p value = 0.049). However, no significant relationship between gender and other treatment types was noted. The comparison between the 2 time frames and the types of treatments showed a significant association in composite fillings ( p value = 0.043), extractions ( p value < 0.0001), sealants ( p value = 0.039), preventive resin restoration ( p =0.011), pulp therapies ( p value < 0.0001), pediatric crowns ( p value < 0.0001), and surgical interventions ( p value = 0.013). A nonsignificant relationship was recorded for the appliances and composite crowns ( p value = 0.45 and 0.14, respectively)., Conclusion: The present study points out the implications of the COVID-19 outbreak and Lebanon's economic collapse on children's dental status, with the number of children receiving dental care dropping remarkably. A decrease in all types of dental procedures was noted in mixed dentition, whereas an increase in dental treatments related to aggravated carious lesions was reported in primary dentition. More medical and financial aids are required to encourage and support parents' attitude towards children dental care during unprecedented crises., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2022 Samia Aboujaoude and Balsam El Noueiri.)

Diabetic patients struggle to maintain their blood glucose near normal levels to avoid the occurrence of hypo- or hyperglycemia discomfort. Dental practitioners must foresee such complications as they can also take place during dental treatment., Aim and Objective: This study aims to evaluate the impact of the type and duration of dental treatment on the blood glucose level (BGL) fluctuation in type 1 unbalanced diabetic children [hemoglobin A 1c (HbA 1c ) >7]., Material and Methods: A cross-sectional approach was conducted on 83 type 1 unbalanced diabetic children (HbA 1c ) > 7%, aged between 7 years and 12 years, divided into 40 females and 43 males in the Department of Pediatric Dentistry at the Lebanese University in Beirut. For dental treatments, diabetic children were scheduled for morning sessions 60-90 minutes after breakfast intake and a habitual insulin shot. Only patients with a BGL between 70 mg/dL and 300 mg/dL underwent dental treatments. The type, the duration of the dental session, and the BGL at the baseline (T0), and at the end of the session (T1) were recorded. The dental acts were classified into simple (without local anesthesia) and unpleasant with a solution of 2% lignocaine with 1:200,000 epinephrine. Statistical analyses were performed., Results: Fifty of 83 showed a decrease in their BGLs after dental treatments, 20 an increase, and 13 no change. For both genders, in simple acts, a statistical significance was noted ( p = 0.0002) for the female and ( p = 0.0014) for the males., Conclusion: Treatment unbalanced diabetic children can be safely done by taking some precautions and measures to avoid a hypo- or hyperglycemia episode., How to Cite This Article: Noueiri B, Nassif N. Dental Treatment Effect on Blood Glucose Level Fluctuation in Type 1 Unbalanced Diabetic Children. Int J Clin Pediatr Dent 2021;14(4):497-501., Competing Interests: Source of support: Nil Conflict of interest: None, (Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.)

Introduction: Pediatric dentists, while treating diabetic patients, have a major concern about the occurrence of hypo- or hyperglycemia complications. So far, no dental care protocol is elaborated to help practitioners in creating a safe environment for their patients. This study aims to evaluate the blood glucose level (BGL) fluctuation in type 1 diabetic children according to the type of the delivered treatment and its duration, to outline guidance for predicting the occurrence of a hypo- or hyperglycemia complication., Materials and Methods: A cross-sectional approach was conducted on 70 balanced diabetic children aged between 7 years and 12 years old (32 females and 38 males) in the Department of Pediatric Dentistry at the Lebanese University in Beirut. Only the patients having a BGL between 70 mg/dL and 300 mg/dL could undergo dental treatment. The gender, the duration of the dental session (≤30 or >30 minutes), the BGLs at the baseline and the end of the session were noted. The types of the performed dental treatment were classified as simple, and unpleasant acts., Results: For the female group, only eight sessions lasted ≤30 minutes. The results of simple and unpleasant interventions >30 minutes showed that BGLs before and after treatment were almost identical ( p > 0.05). In the male group, for the simple acts >30 minutes, the BGL showed a significant fluctuation ( p = 0.02)., Conclusion: Dentists must be aware of signs of discomfort in balanced type 1 diabetic children to avoid severe complications. This study highlights a new range of BGLs (70-300 mg/dL) that allows safe dental treatment., How to Cite This Article: Nassif N, Noueiri B. Dental Treatment Effect on Blood Glucose Level Fluctuation in Type 1 Balanced Diabetic Children. Int J Clin Pediatr Dent 2021;14(2):212-216., Competing Interests: Source of support: Nil Conflict of interest: None, (Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.)

Introduction: The preservation of the integrity and health of primary teeth and their supporting tissues is of great importance in maintaining arch length space, mastication, speech, and esthetics. A pulpotomy is a common therapy performed on a primary tooth presenting reversible pulpitis or a traumatic pulp exposure, allowing its conservation on the arch until its loss., Aim: The study aims to clinically and radiographically evaluate the rates of success and efficacy of Biodentine™ as pulpotomy medicament exclusively on deciduous molars with complete roots formation (stage 2)., Materials and Methods: A total number of 75 primary molars in stage 2 of formation were selected to undergo pulpotomy treatment. All teeth were restored with a stainless-steel crown.The clinical success was evaluated at 1, 3, 6 and 12-month intervals. The radiographic follow-up evaluations were at 6 and 12 months. The resulting data were tabulated and statistically analyzed., Results: Among the 75 teeth treated with Biodentine™, one tooth revealed abnormal mobility and tenderness to percussion at the end of the 1st month. PLS widening and the bone lesion was not seen in any of the 74 remaining cases. Forty teeth (54.1%) showed pulp canal obliteration (PCO), and none of the cases developed a draining sinus or had increased mobility. At the end of the 1-year follow-up, the clinical and radiographic success rates were 98.7% and 100%, respectively., Conclusion: Pulpotomies performed with Biodentine™ on stage 2 primary molars were generally very satisfactory and fulfilled all requirements, covering all needs. This innovative bioactive medicament seems to be a "heroic" material. The excellent outcomes of the present study are indicative that Biodentine™ is a promising biomaterial to promote pulp repair after pulpotomy in clinical practice., How to Cite This Article: Nasrallah H, El Noueiri B, Pilipili C, Ayoub F. Clinical and Radiographic Evaluations of Biodentine™ Pulpotomies in Mature Primary Molars (Stage 2). Int J Clin Pediatr Dent 2018;11(6):496-504., Competing Interests: Source of support: Nil Conflict of interest: None

Introduction: Conservation of primary dentition is essential for maintenance of arch length, esthetic, mastication, speech and prevention of abnormal habits. The commonly supported treatment for retaining carious primary molars with affected pulp is pulpotomy., Aim: The study aims to evaluate clinically and radiographically the rates of success and efficacy of Biodentine™ as pulpotomy medicament exclusively on primary molars with physiological root resorption., Materials and Methods: A total number of 35 primary molars in stage three of formation were selected to undergo pulpotomy treatment. All teeth were restored with pediatric stainless-steel crowns.The clinical findings were evaluated at 1, 3, 6 and 12-month intervals and the radiographic follow-ups evaluations were done at 6 and 12 months. The resulting data were tabulated and statistically analyzed using IBM SPSS© for Windows version 20.0 (SPSS, Chicago, IL, USA). Mc Nemar test was conducted to evaluate the differences in results between months 6 and 12., Results: Periodontal ligament space (PLS) widening and alveolar bone lesion were not seen in any of the 35 cases, 9 teeth (25.7%) manifested pulp canal obliteration (PCO), and none of the cases showed signs of pathologic root resorption. The clinical and radiographic success rates in pulpotomy using Biodentine™ at 6 and 12 months were 100%., Conclusion: Pulpotomies performed with Biodentine™ were entirely successful. This dressing material appears to be a serious pulpotomy agent in primary molars with root resorption. How to cite this article: Nasseh HN, Noueiri BE, Pilipili C, Ayoub F. Evaluation of Biodentine Pulpotomies in Deciduous Molars with Physiological Root Resorption (Stage 3). Int J Clin Pediatr Dent., 2018;11(5):393-398., Competing Interests: Source of support: Nil Conflict of interest: None

Introduction: Diabetes mellitus type 1 (DM1) markedly alters the lives of individuals and their families. Family members can be affected by diabetes and its treatment, causing burden, distress, and reduced quality of life (QOL)., Objective: The aim of this research is to study the relationship between the diabetic child and the family members, to evaluate the stress and emotional issues between siblings, and to weigh in on the psychological, affective, and financial burden that parents have to deal with in their daily life., Materials and Methods: A total of 37 diabetic Lebanese families recruited from the Chronic Care Center (CCC) answered two questionnaires, one about general information and the other related to psychological and financial impact of DM1 and its oral complications on the families., Results: About 56.8% have monthly income below $1,000; 16.2% of parents have an educational upper limit of college degree; 83.8% of the mothers are housewives; 75.7% of parents feel guilty about their child's condition; 89.2% feel that their diabetic child is frustrated with their diet. For 78.4%, the siblings are jealous of the diabetic child; 13.5% of parents are well aware of the oral complications of diabetes and 86.5% think that treating the diabetic child's teeth is more important than the siblings' ones; 91.9% assist their diabetic child's toothbrushing, but 81.1% of family members do not visit the dentist regularly. A total of 100% allocate special budget for the diabetic child's diet and 59.4% have an additional budget dedicated to the diabetic child's treatment; 81.1% declared that their career is affected by their child's illness., Conclusion: The diabetic child expressed frustration with their diet. The child's siblings are jealous as they feel left behind. The parents experienced guilt feeling and psychological stress. They have social restriction and financial problems. The QOL of families living with a diabetic child is altered negatively. How to cite this article: Noueiri B, Nassif N. Impact of Diabetes Mellitus Type 1 on Lebanese Families' Quality of Life. Int J Clin Pediatr Dent 2018;11(2):61-65., Competing Interests: Source of support: Nil Conflict of interest: None

Introduction: Diabetes mellitus type I (DM1) has been increasing at an alarming rate worldwide. Children suffering from this chronic disease are subject to a high risk of systemic and oral complications, due to their young age and the lack of awareness of the relation between diabetes and oral health., Objective: The aim of this study is to evaluate the impact of oral and general complications of DM1 on the Lebanese children's quality of life. The goal was to assess the child's behavioral issues on the one hand and the oral issues on the other., Materials and Methods: About 37 diabetic Lebanese children aged between 6 and 12 years, recruited from the Chronic Care Center (CCC), answered two questionnaires, one related to the disease and the second related to the oral complications., Results: A majority of the participants (81.1%) are aware of their disease, 73% know the importance of their treatment and 54.1% are able to control their glycemia; 45.9% are not annoyed with constantly carrying a monitor and 67.5% are bothered by their restricted diet. Only 5.4% of children isolate themselves., Concerning the Oral Complications: About 83.8% of the children do not suffer from oral ulcers, 56.8% are caries-free, and 64.9% have completed their dental treatment; 89.2% do not complain while eating and 94.6% are not able to brush their teeth properly., Conclusion: Diabetic patients are found to have good knowledge of the disease and its systemic complications but a little on their increased risk for oral diseases. In order to ensure a good quality of life for the diabetic children and their families, optimal control of diabetes, appropriate oral hygiene, and regular visits to the dentist must be respected. How to cite this article: Noueiri B, Nassif N, Ollek A. Impact of General and Oral Complications of Diabetes Mellitus Type I on Lebanese Children's Quality of Life. Int J Clin Pediatr Dent 2018;11(1):40-45., Competing Interests: Source of support: Nil Conflict of interest: None

Aim: The aim of the study is to evaluate the behavior of Lebanese pediatricians regarding children's oral health., Materials and Methods: A cross sectional study including 100 Lebanese pediatricians was performed. They answered 11 questions. Three variables were taken into consideration: The number of years in practice, the place and the type of practice., Results: The answers were tabulated according to the latter three subdivisions. 97.7% of pediatricians who have been practicing for more than 5years reported inquiring about whether a child is taking a milk/juice bottle overnight as compared to 76.9% of pediatricians who have been practicing for less than five years. The majority of pediatricians working in cities/big villages (98.9%) and 76.9% in small villages do look for cavities during oral examination., Discussion: Independently of the years in practice, the majority of pediatricians look for cavities and check the mucosa/ tongue during the oral examination. The results regarding dental examination revealed a significant difference between the pediatricians working in cities/big villages (98.9%) and those in small villages (76.9%). Regarding the frequent diagnosis of ECC, there is also a significant difference between pediatricians working in cities/ big villages (74.7%) and those working in small villages (46.2%)., Conclusion: The behavior of the Lebanese pediatricians regarding children's oral health is not satisfactory. In their daily practice, pediatricians need to have more interaction with pediatric dentists and should take into consideration the AAP and AAPD recommendations. How to cite this article: Noueiri B, Nassif N, Bacho R. Behavior of Lebanese Pediatricians regarding Children's Oral Health. Int J Clin Pediatr Dent 2017;10(4):379-383., Competing Interests: Source of support: Nil Conflict of interest: None

Pediatricians have an important role in early identification and prevention of oral health, but they reported lack of knowledge in this field., Aim: the aim of the study is to evaluate the knowledge and attitudes of Lebanese pediatricians regarding children's oral health., Materials and Methods: A cross sectional study including 100 Lebanese pediatricians was performed. They answered 21 questions. Three variables were taken into consideration: The number of years in practice, the place and type of practice., Results: 73.6% of pediatricians with more than 5 years in practice, 63.5% of pediatricians with an exclusive private practice and 74.7% of pediatricians working in cities/big villages believe that a child is able to brush properly his teeth before the age of 5 years. Only 27.6% of pediatricians with more than 5 years in practice, or working in cities/big villages and 12.7% of those having an exclusive private practice admit that white and black spots are signs of affected teeth., Discussion: Majority of our pediatricians reported that bottle feeding is associated with early childhood caries. They do not believe that the maternal milk can harm the baby's teeth. Concerning the transmission from mother to child of the bacteria responsible for dental caries, the reported percentages were not statistically different in relation to pediatricians' years of experience, type and place of practice. Pediatricians who are academically affiliated were more likely to report that fluoride is safe compared to those practicing in the private sector (P = 0,012). The majority believe that there is a relation between systematic manifestation such as fever and eruption of primary teeth., Conclusion: The Lebanese pediatricians have an acceptable level of knowledge in children's oral health, but should be better informed and motivated toward dental and oral issues., How to Cite This Article: Nassif N, Noueiri B, Bacho R, Kassak K. Awareness of Lebanese Pediatricians regarding Children's Oral Health. Int J Clin Pediatr Dent 2017;10(1):82-88., Competing Interests: Source of support: Nil Conflict of interest: None

Aim: The aim of this study was to evaluate the effectiveness of a Pulpotec modified endodontic approach on primary molars presenting necrotic pulp and furcation bone loss in a cohort of healthy children., Materials and Methods: Forty primary necrotic molars in healthy children, aged between 4 and 6 years underwent clinical and radiological assessment. A chemomechanical removal of pulpal necrotic debris was performed with 1% sodium hypochlorite irrigation. The canals were dried and Pulpotec was inserted in the pulp chamber, and the teeth were then restored. Clinical evaluation, vertical and horizontal measurements of the bone radiolucency were performed for up to one year after the Pulpotec procedure., Statistical Analysis: Wilcoxon signed-rank test was applied for comparison of groups., Results: In this study 67.7% of patients showed healing of bone loss, and a significant difference in height and width of the lesion was observed (respectively 80.6%, 71%; p<0.05; p<0.025)., Conclusion: This technique can be used as an alternative to conventional endodontic treatment for primary necrotic teeth. This procedure may allow paedodontists the ability to postpone extraction of necrotic teeth in particular situations or until eruption of the first permanent molar. Necrotic primary molars presenting furcation bone lesion due to infection may be treated with this modified Pulpotec procedure. With certain caveats, this procedure will preserve the molar on the dental arch for a certain period of time. In our study this technique yielded significant clinical improvements, but the radiological improvement is considered moderate. Future investigations are warranted in order to determine the possible effects of Pulpotec on the succedaneous teeth as well as their path of eruption.