The latest medical research on Paediatric Dentistry

The research magnet gathers the latest research from around the web, based on your specialty area. Below you will find a sample of some of the most recent articles from reputable medical journals about paediatric dentistry gathered by our medical AI research bot.

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Three-dimensional evaluation of interproximal contacts of permanent dentition: a cone beam computed tomography study.

Eur Paed Dent

To assess the various patterns of the inter-proximal contact areas of the permanent dentition using the available cone beam computed tomography (CBCT) images.

A retrospective cross-sectional study was performed on existing CBCT images from a University hospital and teaching department. Three thousand two hundred and fifty inter-proximal contacts were assessed from 125 existing CBCT scans of patients (age range: 14 years 3 months-29 years 9 months) who had matched the eligibility criteria. The types of inter-proximal contacts of the permanent dentition were scored at occlusal, middle, and cervical thirds, according to the OXIS inter-proximal contacts classification. Chi-square test was used to assess the contacts and gender/arches.

The most prevalent contact was type I for the posterior teeth contacts, and types S1 and S2 for the anterior teeth contacts. Statistical significance was not observed between the contacts on the left and right sides (P > 0.05), while statistical significance was observed between the inter-proximal contacts of the maxilla and mandible (P < 0.05).

The CBCT-based three-dimensional assessment of the inter-proximal contact areas of the permanent dentition is representative of the OXIS classification. The occlusal level contact was predominantly representative of the overall type of the contact.

The ectopic mandibular canines can start tooth formation in three different locations: a case series study based on single orthopantomograms from 47 individuals.

Eur Paed Dent

A former study on orthopantomograms from young children with abnormal dental development (not canine ectopia) demonstrated that the tooth bud of the mandibular canine, compared to a stable longitudinal canine axis, could be located normally, anteriorly or posteriorly, with close relation to the first premolar.

The aim of the present study is to analyse on orthopantomograms if the canine axis can demonstrate where the ectopic mandibular canine started tooth formation.

Based on canine maturity, location of the canine axes and the interrelationships between the roots of the permanent canine and first premolar, the location from where the canine started tooth formation was determined. Canine maturity. Maturity stage below half root length and maturity stage above half root length revealed that 11 ectopic canines had less than half root length and 36 cases more than half root length. Canine axes. The canine axis, through the length of the primary canines Ax, is inserted on drawings of the orthopantomograms using the tracing programme Inkscape®. Interrelationship between roots. By visual inspection, the distance between the canine and first premolar was designated close distance, normal distance and extended distance.

The results are divided into 3 groups. Group 1: The initial site of the permanent ectopic canine is located within the canine axis (6 cases). Group 2: The initial site of the permanent ectopic canine is located posterior to the canine axis (36 cases). Group 3: The initial site of the permanent ectopic canine is located anterior to the canine axis (5 cases).

The study explained that the canine axis could divide cases of ectopic canines into three groups according to the location from where tooth formation starts. For getting closer to the pattern of the ectopic canine eruption, it is necessary to analyse series of orthopantomograms taken from the same individual over several years.

Comparative evaluation of cervical pulpotomy and pulpectomy for primary molars with irreversible pulpitis: a multicentre randomised controlled trial.

Eur Paed Dent

The objective of this multicentre randomised controlled trial was to compare the clinical/radiographic outcomes of cervical pulpotomy using calcium-enriched mixture cement (PCEM) and pulpectomy using Metapex (PM) in primary molars with irreversible pulpitis (IP).

A total of 134 primary molars from 94 children were randomly assigned to two intervention groups: the PCEM group (n = 74) and the PM group (n = 60). Baseline characteristics including age/gender/molar type/tooth type/jaw were recorded. The primary outcome measures were clinical/radiographic success rates assessed at the first and second follow-up appointments. Secondary outcomes included reasons for clinical/radiographic failures. Multiple logistic regression analysis was performed to determine the impact of various factors on the success rates.

The mean age of the participants in both groups was similar (PCEM group: 5.4 years, PM group: 5.5 years). Gender distribution, molar type, tooth type, jaw, and number of practitioners were comparable between the groups. The clinical success rate at the first follow-up was 98.6% in the PCEM group and 96.4% in the PM group. At the second follow-up, the clinical success rate was 97.1% in the PCEM group and 91.1% in the PM group. The radiographic success rates at the first and second follow-up were 98.6% and 96.4% in the PCEM group and 96.4% and 91.1% in the PM group, respectively. Multiple logistic regression analysis did not reveal any significant association between the success rates and age/gender/molar type/jaw, or treatment groups (P > 0.05).

In primary molars with IP, both simple/conservative cervical pulpotomy using calcium-enriched mixture cement and pulpectomy using Metapex demonstrated high clinical/radiographic success rates. No significant differences were observed between the two treatment modalities. These findings suggest that both techniques can be considered effective treatment options for managing primary molars with IP.

Trial registration number: IRCT20201226049838N1, retrospectively registered on 12 January 2021.

Clinical effectiveness of pit and fissure sealants in primary and permanent teeth of children and adolescents: an umbrella review.

Eur Paed Dent

This umbrella review aimed to critically appraise the evidence published in systematic reviews (SRs) on the clinical effectiveness of sealants compared with each other/the non-use in primary/permanent teeth of children and adolescents with at least 12-month follow-up.

A systematic literature search on 4 electronic databases was conducted up to January 18th, 2023. Following handsearching, two review authors independently screened retrieved articles, extracted data, and assessed the risk of bias (RoB) using the risk of bias in systematic reviews (ROBIS) tool. Based on a citation matrix, the overlap was interpreted by the corrected covered area (CCA).

Of 239 retrieved records, 7 SRs met the eligibility criteria with a moderate overlap among them (CCA = 7.4%). For primary molars, in 1120 1.5- to 8-year-old children, data on the clinical effectiveness of sealants were inconclusive. For permanent molars, 3 SRs found a significant caries risk reduction for sealants versus non-use (≤ 36-month follow-up). There was insufficient evidence to proof superiority of sealants over fluoride varnish for caries prevention (3 SRs), and to rank sealant materials according to the best clinical effectiveness in permanent molars. One study was rated at low and 6 at high RoB, which did not allow for a valid quantitative synthesis.

Considering the limitations of this umbrella review, sealants are more effective for caries prevention in children's permanent molars compared to no treatment. Future well-implemented RCTs are needed to draw reliable conclusions on the clinical effectiveness of sealants in primary and permanent teeth of children and adolescents.

Gingival thickness and gingival width in children: a cross-sectional study utilizing ultrasonography.

Eur Paed Dent

To measure the gingival phenotype-related features, gingival thickness (GT) and gingival width (GW), in healthy children and to investigate their association between them, with age, gender, tooth-type and arch.

The gingival sites of 1029 teeth were included from 64 children (36 males and 28 females), with primary and mixed dentition, attending the paediatric dental clinic of Aristotle University, Thessaloniki. GT and GW were measured ultrasonically and with a periodontal probe, respectively. Mixed effects linear regression models were used to evaluate the association of gingival thickness and gingival width with the under-investigation parameters. Spearman's correlation coefficient was used to evaluate correlation between GT and GW.

Significantly thicker gingiva is found in posterior teeth compared to anterior teeth, in permanent teeth versus primary teeth and in maxillary teeth in comparison to mandibular teeth (p value < 0.001). Regarding GW, significantly wider gingiva is noted in posterior regions (p value = 0.022) and the maxilla (p value < 0.001). Gender-wise and concerning age GT and GW are not significantly affected. A weak and positive correlation between GT and GW is noted (rho 0.30, p < 0.001).

GT and GW present significant associations with arch and tooth-type. Findings from this study fulfil the further understanding of GT and GW of paediatric patients that are investigated sparsely throughout the literature and demonstrate an accurate, painless and simple method to map the gingiva.

Oral findings in paediatric patients with severe heart, liver, and kidney failure prior to organ transplantation.

Eur Paed Dent

Organ transplantation is an effective treatment for children with severe heart, liver, and kidney diseases. These patient groups may have more oral and dental diseases than healthy controls. It is important to eliminate oral infection foci before transplantation and to maintain good oral health to avoid potential post-transplant complications. The aim of this study was to describe and compare oral health in Finnish paediatric heart, liver, and kidney transplant recipients prior to organ transplantation.

Eighty-six children who received a heart (n = 21), liver (n = 19), or kidney (n = 46) transplant in Finland during the years 2014-2018 were included in this study. The inclusion criterion was a pre-transplantation oral examination. Oral hygiene, enamel anomalies, and the number of decayed, missing, and filled teeth (dmft/DMFT) were analyzed retrospectively from medical and dental records and compared between the three patient groups.

Children with liver (p = 0.043) or heart (p = 0.047) disease had higher combined primary and permanent dentition dmft/DMFT scores compared to children with kidney disease. A higher combined dmft/DMFT score was associated with poor oral hygiene (p = 0.005). No significant differences in oral hygiene between the patient groups were found. Furthermore, all patient groups had a high prevalence of developmental dental defects.

Children with liver or heart disease seem to have a higher combined dmft/DMFT score, indicating a higher prevalence of caries compared to children with kidney disease. Prevention of dental caries, along with promoting a good oral hygiene routine and regular check-ups, is suggested in these patient groups.

Comparative evaluation of volumetric changes following rotary and hand files' canal preparation of primary maxillary canine: an in vitro nano-CT analysis.

Eur Paed Dent

To evaluate the volumetric changes of two recently introduced paediatric rotary file systems in comparison with conventional hand file systems in primary maxillary canines using an ultra-high-resolution nano-computed tomography.

This in vitro study was performed in extracted primary maxillary canines based on certain inclusion and exclusion criteria. Samples were prepared, and working length was determined after the pre-operative scan using a high-resolution nano-CT device (SkyScan 2214, Bruker, Kontich, Belgium). A single well-experienced paediatric dentist prepared the canals using three file systems: Kedo-S plus, Kedo-SG blue and hand K-files. All samples were subjected to post-operative scans performed similar to pre-operative scans. Image reconstruction was performed with NRecon software for 3D volumetric visualisation and analysis of the root canals.

Kedo-SG blue file systems had the highest mean difference in the canal volume (4.05%). Hand K-files had the least difference at (3.71%) of canal volume. Kedo-S plus file system had a moderate mean canal volume difference (3.82%) which is closer to hand K-files. Intergroup comparison between the three groups showed that the mean difference in canal volume was statistically significant between all three file systems (p = 0.000).

Within the limitations of the current study, rotary file systems produced a significant enlargement of canals as compared to hand files. Kedo-SG blue created a uniform preparation of the canal cervico-apically. Kedo-S plus files were prepared more coronally with minimal preparation apically as close to the preparation of hand files.

Trial registration number: IHEC/SDC/PEDO-2103/22/651, Date of registration: 2022.

Comparative evaluation of hand and rotary file systems on dentinal microcrack formation during pulpectomy procedure in primary teeth: an in vitro study.

Eur Paed Dent

Pulpectomy can be used for the management of deep dentinal carious lesions in primary teeth which can be restored. Mechanical preparation of root canals can be performed using hand or NiTi rotary files. However, this may cause dentinal stress and consequently dentinal microcracks. Hence, the aim was comparative evaluation of hand and rotary file systems on dentinal microcrack formation during pulpectomy procedure in primary teeth.

60 extracted primary molar teeth were selected comprising of 80 root canals. Simple random sampling was used to divide root canals into four groups (n = 20): Group A-Hedstrom file, Group B-Pro AF Baby Gold rotary, Group C-ProTaper Next rotary, and Group D-unprepared group. Assessment was conducted on presence or absence of microcracks using Chi square test (p < 0.05).

The total number of microcracks in Group A: one (5%), Group B: four (20%), Group C: nine (45%) and Group D: zero (0%) which was statistically significant (p = 0.002). At cervical third, the number of microcracks seen with Group A: one (5%), Group B: zero (0%), Group C: five (25%) and Group D: zero (0%) (p = 0.005). At the middle third, the number of microcracks seen in Group A: zero (0%), Group B: four (20%), Group C: four (20%) and Group D: zero (0%) (p = 0.029).

The study concluded that dentinal microcracks are formed with both hand and rotary file systems in primary teeth. ProTaper Next showed significantly higher number of microcracks, followed by ProAF Baby Gold and H files.

Difficulties experienced by dentists and orthodontists regarding ethical issues when announcing the diagnosis of a rare oral disease: a qualitative study in Marseille, France.

Eur Paed Dent

It is traditionally considered that breaking bad news to patients does not represent a cause for concern for dental professionals. However, there are situations where they will be confronted with this task, as in the case of rare dental diseases. Little information is available regarding the feelings of healthcare professionals on this subject. There are no qualitative studies that explore how a diagnosis of oligodontia is announced to patients by dentists and orthodontists. The aim of our study is to explore the difficulties and ethical issues experienced by dental health professionals when they have to announce a diagnosis of oligodontia to a patient and their family.

This study relied on a qualitative research method using focus groups of dentists and orthodontists and a thematic analysis procedure.

The difficulties experienced could be summarised within five topics: organisational difficulties, difficulties with the management of dental treatment and with the administrative management associated with this anomaly, difficulties with the content of the announcement, and relational difficulties. These could be grouped in two categories: practical difficulties and ethical difficulties.

This survey allowed us to understand the difficulties encountered by dentists and orthodontists when announcing oligodontia. The participants felt uncomfortable with this task and were under stress. They reported difficulties in delivering the medical information and in adapting to the message. It is essential that dental professionals develop skills in medical communication.

The effect of xylitol chewing gums and candies on caries occurrence in children: a systematic review with special reference to caries level at study baseline.

Eur Paed Dent

A systematic review of published data was carried out to assess the caries-preventive effects of xylitol chewing gums and candies in children.

Electronic and hand searches were performed to find clinical studies on the effects of xylitol chewing gums and candies on dental caries in children (≤ 18 years). Prospective randomised or controlled clinical trials published before 2023 were included in the review.

The initial search identified 365 titles to be evaluated. After applying inclusion and exclusion criteria, 15 articles with either fair or low quality were reviewed. Nine articles studied chewing gums, five candies, and one both of them. In the ten evaluated xylitol chewing gum studies xylitol consumption significantly reduced caries occurrence when compared with no treatment or a placebo polyol gum. The effect was clinically significant in studies with high or moderate caries level at study baseline. The results also suggested that the caries-reducing effect of xylitol gums may differ from sorbitol/polyol gums. In five of the six heterogenous xylitol candy studies, no caries-reducing effect was found independent of caries level. In addition to caries level, also the daily xylitol dose was a confounding factor.

The present findings suggest that the caries-reducing effect of adding xylitol chewing gum to the daily diet has been well demonstrated in children and adolescents with high or moderate caries level at study baseline. Xylitol gum use could benefit subjects with active incipient caries lesions on smooth tooth surfaces.

Biodentine™ as a temporary filling in deep carious lesions in permanent teeth: a prospective observational 33-month follow-up study.

Eur Paed Dent

The study aimed to evaluate temporary fillings using Biodentine™ in asymptomatic deep carious lesions after 12, 24, and 36 months in school children from the remote village of Kerung, Nepal.

From November 2018 to November 2019, 91 temporary fillings were placed using Biodentine™ (a hydraulic calcium silicate cement) in permanent molars with deep carious lesions of schoolchildren in the remote district of Kerung, Nepal. These restorations were performed after selective caries removal in a non-dental setting with hand instruments and cotton roll isolation, as electric motors and saliva ejection systems were unavailable. In total, 78 single-surface and 13 multi-surface fillings were placed. Clinical and radiographic follow-up periods encompassed 12, 21, and 33 months, respectively.

After 12 months, all single-surface fillings (100%) survived, whilst all multi-surface fillings were partially or entirely lost. The survival rate of single-surface restorations after 21 and 33 months was 67.6% and 50%, respectively. Radiographically, no pathology was observed.

This study showed that Biodentine could be used in deep carious lesions as a temporary filling in single-surface lesions for at least up to 1 year and in a substantial number of cases for up to 21 and 33 months.

Caries experience in children with molar-incisor hypomineralisation in Fujairah, United Arab Emirates and its association with hypomineralised teeth number.

Eur Paed Dent

Molar-incisor hypomineralisation (MIH) has been found associated with an increase in dental caries. Studies utilising the recent MIH diagnosis and calibration criteria recommended by the EAPD in 2021 are very scarce. Additionally, the available data in literature about the relationship between the hypomineralised teeth number (HTN) and caries come from only one study.

To assess the relationship between MIH and caries experience among children in the city of Fujairah, UAE, utilising the recent criteria recommended by the European Academy of Paediatric Dentistry (EAPD) in 2021, and to assess the relationship between the number of teeth affected with MIH, and dental caries.

One hundred and sixty-two children were included in this cross-sectional study, aged 7-9 years old. Children were examined for MIH according to Ghanim et al. (Eur Arch Paediatr Dent 16:235-246, 2015. 10.1007/s40368-015-0178-8) criteria and Ghanim et al. (Eur Arch Paediatr Dent 18:225-242. 10.1007/s40368-017-0293-92017) training manual. Caries experience was assessed with decayed, missing, filled (dmft, DMFT) scoring system.

dmft mean was 6.56 (SD ± 3.78) and DMFT mean was 0.91 (SD ± 1.23). Children with MIH had significantly higher dmft (p = 0.003) scores. Children with higher HTN had significantly higher dmft (p = 0.008) scores.

Children in Fujairah have extremely high caries scores. Children with MIH have more decayed, missing and filled teeth. Hypomineralised teeth number was positively associated with caries experience.