Department Of Pediatric Dentistry Research Articles

Bulk-flow composites in paediatric dentistry: long term survival of posterior restorations. A retrospective study.

Dental decay is a prevalent bacterial disease affecting a significant percentage of children globally. In paediatric dentistry, various materials are available for restoring deciduous teeth, addressing both functional and aesthetic concerns. However, paediatric dentists encounter challenges related to patient compliance, limited working time, and material handling. This study aims to observe the survival rate of bulk-fill composite restorations in paediatric patients over a five-year follow-up. A total of 198 patients aged 0 to 12 years underwent 673 class II restorations on deciduous first molars (1M) and second molars (2M). All restorations were conducted performed by 1 Pediatric DDS resident students from the Paediatric Dentistry Department (Padova University), utilizing using different isolation techniques. Bulk-fill composite restorations were evaluated over a five-year follow-up, and data were collected by a single investigator. After five years, 177 patients and 611 restorations were assessed. The retention rate was higher in primary second molars than in first molars, with fewer marginal dyschromies and less formation of secondary caries. The overall failure rate was higher in primary first molars and primary lower second molars. Bulk-fill composites demonstrated significantly positive performance in terms of retention, maintenance, and marginal dyschromies. Bulk-fill composites are promising materials of choice in paediatric dentistry due to their easy handling and favorable properties. Further research is necessary to compare high and low viscosity bulk-fill composites and assess the impact of different variables on restoration success.

Prevalence of OXIS Contacts between the Primary Molars in 3 to 9 Years Old Children: A Cross-sectional Study

Introduction: Interproximal contacts between primary teeth have traditionally been reported as broad and flat. A new system of classification for contacts called OXIS- O (open contact), X (point contact), I (straight contact), and S (curved contact) was introduced in 2018, based on the shapes observed occlusally. Understanding interproximal contacts in primary teeth is essential to comprehend the caries risk of the individual. Aim: To assess the prevalence of OXIS contact areas between non carious primary molars in 3 to 9 years old children and to determine the most common type of contact before and after the eruption of the first permanent molar. Materials and Methods: A cross-sectional study was conducted to determine the prevalence of the types of contacts between primary teeth through direct observation in a sample size of 260 contact areas. The study was carried out in the Department of Paediatric and Preventive Dentistry, Navi Mumbai, India, between August 2022 to February 2023. Ethical clearance from the university was obtained. A single calibrated examiner examined photographs of the interproximal contacts between primary molars. The contacts were assessed as O (open contact), X (point contact), I (straight contact), and S (curved contact) using the OXIS classification system. The prevalence of each contact type was recorded. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) 18.0 software. The prevalence of contact types was recorded in numbers and percentages. A comparison of contact types before and after the eruption of the first permanent molar was conducted using the Chi-square test. Result: The most common contact type was I (65.00%) both before and after the eruption of the first permanent molar. This was followed by S (19.62%), X (11.15%), and O (4.23%) in the primary dentition. After the eruption of the first permanent molars, I contact was the highest at 66.41%, followed by S (20.90%), X (12.68%), and O (0%). Conclusion: This study confirms the presence of O, X, I, and S types of interproximal contact areas in caries-free primary molars in 3 to 9 years old children.

Evaluation of Setting Time, Compressive Strength, Microleakage and Antibacterial Properties of Nano Hydroxyapatite Incorporated GIC: An In-vitro Study

Introduction: Glass Ionomer Cement (GIC) is widely used as a restorative material, but it still exhibits some limitations that pose significant drawbacks in clinical use. The composition of Hydroxyapatite (HA) mimics the inorganic fraction of mineralised tissues such as bones and teeth. HA possesses osteoconductive and bioactive properties, making it favourable for orthopaedic and dental applications. Aim: The aim of this study was to evaluate and compare the setting time, compressive strength, microleakage and antibacterial properties of nano-HA incorporated GIC (NHaGIC) at various concentrations with Type-II GIC. Materials and Methods: This in-vitro study was conducted in the Department of Paediatric and Preventive Dentistry at Sri Aurobindo College of Dentistry in Indore, Madhya Pradesh, India, for a duration of nine months, from May 2023 to January 2024. The study comprised five study groups as follows: Group-1- Type-II GIC (control), Group-2-NHA-GIC 4%, Group-3-NHA-GIC 8%, Group-4-NHA-GIC 10% and Group-5-NHA-GIC 15%. A total of 50 acrylic moulds containing the test material and TypeII GIC, with 10 in each group (n=10), were prepared to record the setting time, which was tested using a Gillmore needle. The compressive strength was checked using a Universal Testing Machine. Additionally, 50 primary molars were selected according to inclusion and exclusion criteria and randomly divided into five groups (n=10) to evaluate microleakage. Microleakage was assessed using the dye penetration method under a stereomicroscope. For antibacterial properties, 50 samples (n=10) were taken for each strain, i.e., Strain A: S. mutans and Strain B: L. fermentum and the disk diffusion method was employed. Thus, a total sample size of 250 was used. The preparation of GIC-NHAp was done by adding nano- HA to GIC at selected concentrations by weight/weight percentage (w/w%). The results were analysed using a one-way Analysis of Variance (ANOVA) test. Results: A statistically significant difference was observed (p<0.001) between Group-1 (GIC II) and Group-II (4% GICNHAp), III (8% GIC-NHAp), IV (10% GIC-NHAp) and V (15% GIC-NHAp) regarding setting time, compressive strength, microleakage and antibacterial properties. Conclusion: It can be concluded that adding NHAp crystals to GIC enhances its properties, such as compressive strength and antimicrobial efficiency, as the concentration increases. The microleakage property showed a consistent decrease with increasing concentration. However, the setting time increased with higher concentrations of NHAp in GIC.

Evaluation of Quality of Life of Parents and Growth Parameters of their Infants with Cleft Lip and Cleft Palate before and after Primary Surgery: An Observational Study

Introduction: Cleft Lip (CL) and Cleft Palate (CP) are associated with several complications that have a significant negative impact on the Quality of Life (QoL) of affected children and caregivers. Compared to their healthy counterparts, children with these conditions experience feeding difficulties, cosmetic abnormalities, and, most importantly, diminished physical and cognitive growth, especially during the first year of their lives. Aim: To evaluate the growth parameters in CL and/or CP infants and the QoL of parents with a CL and/or CP child before and after primary surgery. Materials and Methods: For this observational study, data was collected longitudinally from the same set of Cleft lip and cleft palate (CL/CP)/CL&CP infants and their parents before and after the primary surgery. The study was conducted at the Department of Paediatric and Preventive Dentistry, Guru Nanak Institute of Dental Sciences and Research, West Bengal, ABMSS Kolkata Comprehensive Cleft Care Centre, West Bengal, and IMA Vaccination Centre Barasat, West Bengal, India, from December 2020 to May 2022. In this study, 66 children and 64 parents were included in each study and control group. Growth parameters {weight, length, Head Circumference (HC)} were measured using a weight analogue machine, infantometer, and HC measuring tape, and compared with those of healthy infants. The QoL of parents with CL and/or CP infants was quantified using a questionnaire form of “Revised Impact on Family Scale (RIOFS)” filled out by parents before and after six months of primary surgery and compared with the QoL of same-age healthy infants. The responses to the RIOFS questionnaire were scored according to recommended guidelines. The Statistical Package for Social Sciences (SPSS) Statistics 23.0 was used for data analysis. Results: Among the study groups, statistically significant differences in mean height, weight, and HC were observed between the groups of all infants with CL, CP, and CL with CP before and after the primary surgery (p<0.001). The QoL of parents from the study group improved post-surgery. The difference in mean RIOFS score between study Group-3 and study Group-4 after the primary surgery was statistically significant (p<0.001). Conclusion: The growth of CL and/or CP infants and the QoL of their caregivers are compromised compared to healthy infants. After primary surgery, the growth of CL and/or CP infants and the QoL of their parents partially improved.

Efficacy of Two Paediatric Rotary Systems: Kedo-SG Blue™ and Prime Pedo™ Files in Primary Mandibular Molars: A Randomised Clinical Trial

Introduction: The success of root canal procedures depends on cleaning and shaping of canals. There are several instrumentation techniques available for root canal preparation. Recently, exclusive rotary file systems called Kedo-SG Blue and Prime-Pedo have been introduced for root canal preparation in primary teeth. The inherent flexibility of these files allows them to preserve the anatomy of curved canals in primary molars. Aim: To compare the instrumentation time, obturation time, and quality of obturation using two paediatric rotary file systems, KedoSG BlueTM and Prime-PedoTM, in mandibular primary molars. Materials and Methods: A randomised clinical trial was conducted in the outpatient Department of Paediatric and Preventive Dentistry, Narayana Dental College and Hospital, Nellore Andhra Pradesh, India, from February 1, 2019 to January 20, 2020. Fifty primary molars with necrotic pulp were included and randomly divided into two groups, with 25 teeth in each group. Group 1 and Group 2 were instrumented with Kedo-SG BlueTM and Prime-PedoTM, respectively. The time taken for instrumentation and obturation was noted in minutes, and the quality of root canal filling was recorded as optimal, underfilled, or overfilled. The data were statistically analysed using an independent Student’s t-test for time measurements and a Chi-square test for the quality of obturation. Results: There was a statistically significant difference in instrumentation time and obturation time between the two groups (p-value=0.009; 0.011). The Kedo-SG BlueTM rotary system showed a better quality of obturation compared to the Prime-PedoTM rotary system, although the difference was not statistically significant (p-value=0.22). Conclusion: The Kedo-SG BlueTM rotary system demonstrated shorter instrumentation and obturation times, as well as a higher number of optimally filled canals compared to the Prime-PedoTM rotary system. Therefore, the Kedo-SG BlueTM rotary system exhibited better clinical performance in primary molars than the Prime-PedoTM rotary system.

Comparative Efficacy of Smart Burs vs Conventional Burs in Removing Infected Dentin and Preserving Affected Dentin in Primary Teeth: A Randomised Control Study

Introduction: With the advent of time, the removal of caries has shifted from hand instruments to rotary instruments. A disadvantage of conventional burs is that they non selectively lead to over-preparation. A new polymer bur can be substituted to eliminate these undesirable effects. Aim: To compare and evaluate the efficacy of smart burs and conventional burs in removing infected dentine while preserving affected dentin in carious lesions in primary teeth. Materials and Methods: This was a double-blinded randomised controlled trial conducted in the Department of Paediatric and Preventive Dentistry at Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital, Nagpur, Maharashtra, India over a period of three months, from August 2023 to October 2023. A total of 40 children aged 6-12 years were selected and evaluated for caries removal efficacy using visual and tactile criteria, which were further confirmed by dye application and numerically scored. Group 1 included 20 children who underwent caries excavation with smart burs, while Group 2 included 20 children who underwent the procedure with diamond points. Statistical analysis was conducted using descriptive and inferential statistics, specifically the Chi-square test. Results: A total of 40 children aged 6-12 years were divided into two groups: Group 1 comprised 11 boys and 9 girls, whereas Group 2 included 10 boys and 10 girls. Of these, 12 cases (60%) showed complete caries removal after the first application of dye, regardless of which burs was used. However, 4 cases (20%) showed some residual caries when using smart burs, while 6 cases (30%) exhibited residual caries with diamond points at the base of the cavity preparation. Additionally, there were 4 cases (20%) with caries present at the base and/or in one wall of the cavity preparation when using smart burs, compared to 2 cases (10%) with conventional burs. Nonetheless, there was no statistically significant difference between the smart burs and the conventional diamond points regarding caries removal. Conclusion: It can be concluded that smart burs are equally effective in removing soft caries compared to conventional methods. Although the results were statistically insignificant, polymer burs were found to be more convenient and can be considered a viable alternative to conventional caries removal techniques.

Navigating into the Dental Management of a Child with Morphea: A Case Report

Morphea, a morphological variant of Localised Scleroderma (LoS) that typically occurs in children, is an inflammatory disease of connective tissue leading to skin and underlying tissue sclerosis due to increased deposition of collagen. The aetiology of morphea is quite elusive. Morphea, along with other regions also affects oral and perioral tissues; the most common affected implication being facial skin and tongue rigidity. The author reports a case of a 10-year-old female who reported to the Department of Paediatric and Preventive Dentistry for retained maxillary anterior deciduous teeth. The patient also presented with scarring on her face, chest, and arms. Her lips were thin, rigid and partially fixed producing microstomia with decreased mouth opening. Clinical examination, blood tests, Contrast-Enhanced Computed Tomography/High-Resolution Computed Tomography (CECT/ HRCT) of thorax, Antinuclear Antibody (ANA) test, Antineutrophilic Cytoplasmic Antibody (ANCA) Test, Anti-dsDNA Test, systemic sclerosis/myositis profile, and histopathological evaluation confirmed the diagnosis of morphea. The management of morphea is multidisciplinary. Hence, the role of a paediatric dental surgeon in recognising the development of disease progression in a patient and avoiding any oral complications is very important.

Evaluation of Antimicrobial Efficacy of 3.8% Silver Diamine Fluoride as a Root Canal Irrigant against Enterococcus Faecalis in Primary Teeth: A Randomised Clinical Trial

Introduction: During a pulpectomy, the infected or inflamed pulp tissues are removed, and the root canal is thoroughly cleaned with mechanical instrumentation and copious irrigation. Various endodontic irrigants are available, such as Sodium Hypochlorite (NaOCl), Chlorhexidine (CHX) gluconate, Ethylene Diamine Tetra Acetic Acid (EDTA), Mixture of doxycycline, citric acid, and a detergent (MTAD), etc. Among these, CHX gluconate is widely used as an endodontic irrigant and medicament due to its antibacterial effect and substantivity. Enterococcus faecalis is the most common bacterial species found in necrotic teeth, with high viability and antibiotic resistance. A 3.8% Silver Diamine Fluoride (SDF) has antimicrobial properties and has been shown to eliminate E. faecalis from the root canals of permanent teeth. However, there are no studies in the literature that have evaluated its efficacy as a root canal irrigant in primary teeth. Aim: To evaluate the antimicrobial efficacy of 3.8% SDF against E. faecalis in primary teeth. Materials and Methods: This was a in-vivo double-blinded randomised clinical trial conducted at Department of Paediatric and Preventive Dentistry, GSL Dental College and Hospital, Rajahmundry, Andhra Pradesh, India in children aged 3-8 years old. The study included 60 primary teeth that required pulpectomy. The teeth were divided into two groups and irrigated: 30 teeth with 3.8% SDF (Group I) and 30 teeth with 2% CHX (Group II). In all cases, two microbiological samples were taken using sterile absorbent paper points: the first after access opening and the second after the final irrigation. All samples were assessed using the agar plate method. The results were analysed statistically using a Student's paired t-test. Results: After analysing the pre- and postirrigation samples, there was a statistically significant reduction in Colony Forming Units (CFU)mL (p<0.05) in both groups. When comparing the two groups, no statistical difference was observed in the percentage reduction of bacterial colonies (p>0.05). Conclusion: The reduction in CFU/mL of E. faecalis was comparable in both groups. Thus, 3.8% SDF can be used as an alternative root canal irrigant to 2% CHX.

Maternal Perception and Attitude towards Television Food Advertisements Targeting Children: A Cross-sectional Questionnaire Study from Pune, India

Introduction: Television food advertisements targeting children are recognised as a significant health risk, influencing their dietary choices and contributing to the increasing prevalence of Non Communicable Diseases (NCDs) among children in Low and Middle-income Countries (LMICs). Understanding maternal perceptions and attitudes towards these advertisements is crucial for designing effective public health interventions. Aim: To evaluate maternal perceptions and attitudes toward television food advertisements targeting children, specifically among mothers of children aged 4-11 years. Materials and Methods: A cross-sectional study was conducted in the Department of Paediatric and Preventive Dentistry, Dr. D. Y. Patil Dental College and Hospital, Pune, Maharashtra, India, from My 2023 to November 2023. A total of 332 mothers of children aged 4-11 years were divided into two groups: Group 1 (mothers of children aged 4-7 years) with 159 participants, and group 2 (mothers of children aged 8-11 years) with 173 participants. A prevalidated, closed-ended questionnaire consisting of 24 questions was administered to the mothers. The reliability of the questionnaire was ensured through the preliminary exploratory study and expert reviews, achieving a Cronbach’s Alpha value of 0.84. Data analysis was performed using descriptive statistics and Chi-square tests to compare perceptions of mothers in both groups. Results: The study received 332 responses from mothers with children aged 4-11 years. Significant differences between the two age groups were observed. In group 1, 64 (52%) mothers mothers agreed, while 41 (57.7%) mothers in group 2 strongly agreed that their children show a keen interest in watching food advertisements. Additionally, 80 (55.9%) mothers in group 1 agreed, while 39 (44.8%) mothers in group 2 strongly agreed that their children do not understand the persuasive intent of food advertisements, with statistical significance (p-value=0.001). Most mothers, 75 (52.4%) in group 1 and 68 (47.6%) in group 2, agreed that reducing exposure to food advertisements would improve children’s eating behaviour (p-value=0.01). Moreover, 61 (64.9%) mothers in group 1 strongly agreed, and 77 (58.3%) mothers in group 2 agreed that seeing advertisements persuaded children to want unhealthy foods, highlighting significant differences between the age groups (p-value=0.004). Conclusion: Mothers recognise the negative impact of TV food advertisements on their children’s eating habits, particularly noting the use of cartoons and celebrities to promote unhealthy snacks and low-nutrition food that their children struggle to understand. The present study emphasises the urgent need for regulatory measures to protect young viewers and promote healthier dietary choices across different age groups.

Antimicrobial Efficacy of Tubulicid Red as a Cavity Disinfectant in Comparison with Chlor-X Gel against S. mutans in Primary Teeth: Randomised Split-mouth Clinical Study

Introduction: Microorganisms act as precursors to dental caries. Following cavity preparation, traces of resident bacteria in the smear layer may contribute to the recurrence of caries. Thus, eliminating the underlying causes improves the likelihood of treatment success. Disinfectants are adjuvant tools that should focus on removing microorganisms when combined with procedures that yield positive outcomes. Aim: To compare and evaluate the antimicrobial efficacy of Tubulicid Red (TR) Label as a cavity disinfectant with Chlor X gel (2% chlorhexidine) in primary teeth. Materials and Methods: The present randomised double-blind clinical trial was conducted at the Department of Paediatric and Preventive Dentistry, GSL Dental College and Hospital, YSRUHS, Rajahmundry, Andhra Pradesh, India from September 2021 to April 2022. The study assessed the antimicrobial efficacy of TR label against S. mutans in 60 primary carious teeth involving 1/3rd of the dentin. The teeth were divided into two groups, each consisting of 30 teeth. Group-I received TR Label, while Group-II received Chlor X. After excavating the infected dentine, the affected dentine was left in the cavity, and a dentinal sample was collected from the base of the cavity. The cavity was then disinfected with either TR or Chlor X gel, followed by rinsing with saline. A second sample was collected from the base of the same cavity. The collected samples were transferred to Eppendorf tubes and subjected to microbiological analysis to calculate the number of Colony-forming Units (CFU) of S. mutans on Mutans Sanguis (MS) agar medium. The obtained data were subjected to statistical analysis using the Wilcoxon’s’s signedrank test and Mann-Whitney test. Results: In the intragroup comparison (Wilcoxon’s signedrank test), both groups showed significant reductions in S. mutans count (p<0.001). The intergroup comparison showed no statistically significant difference (p>0.05) between the Tubulicid and Chlor X groups at baseline and post-treatment. Conclusion: The TR could be used as an alternative to Chlor X gel as a cavity disinfectant in primary teeth before restoration, potentially reducing the occurrence of secondary caries.

Knowledge and Awareness of Various Physical Restraints and Protective Stabilisation Methods: Parent’s Perception towards their Use in Children: A Multimedia Pre- and Post-test Quasi-experimental Study

Introduction: Physical restraints are often a debatable and misunderstood aspect of dental healthcare practice. They are frequently used in dental care settings to immobilise children and reduce the risk of injury during procedures. It is essential to assess parents' knowledge, awareness, and attitudes towards physical restraints and provide accurate information about them. This is important to ensure that they are used appropriately and ethically. Aim: To assess parents’ knowledge, awareness, and attitudes towards physical restraints in dental care settings before and after a multimedia intervention, and to provide precise information about the same. Materials and Methods: The study was conducted at the Department of Paediatric and Preventive Dentistry, Rajarajeswari Dental College and Hospital, Bengaluru, Karnataka, India using a pretest and post-test quasi-experimental study design on 400 parents whose children were between 3 and 16 years of age. The survey was conducted between December 2022 and March 2023. The data collection methods used in the present study consisted of a pre-education questionnaire and a post-education questionnaire administered after a multimedia educational intervention. The collected data were subjected to statistical analysis, including measures such as mean, Standard Deviation (SD), Chi-square goodness of fit test, Wilcoxon's signed-rank test, and Kruskal-Wallis tests. Results: When questioned about various stabilisation methods like direct and indirect methods, 379 (94.8%) of the study parents were unaware of them. However, after education, the majority of parents, 393 (98.3%), became aware that there were two types of stabilisation methods. Initially, 294 (73.5%) of parents refused to provide permission for doctors to treat their children using various stabilisation techniques. However, after being thoroughly educated about the various methods and their benefits, 383 (95.8%) agreed to let the dentist employ different stabilisation techniques when treating their children. This assurance helped alleviate concerns about potential harm to the child caused by using these stabilisation methods. Conclusion: The study suggests that there is a significant knowledge gap among parents. However, the implementation of multimedia educational intervention methods during dental visits by dentists played a crucial role in increasing their knowledge and resulted in a significant improvement in their attitude towards stabilisation methods.

Presence of radix entomolaris in primary mandibular first molars: A review of rare entity

Numerous developmental anomalies with respect to crown and root are commonly seen in permanent dentition and while rarely in the primary dentition. Radix entomolaris (RE), an extra root seen on the distolingual aspect of mandibular molars, is one such aberration found. The presence of extra root in primary mandibular first molars is of extreme rarity and such two reports its significance had been discussed. Two children of 5- and 7 years old reported to the pediatric and preventive dentistry department with a chief complaint of pain in the right and left mandibular back teeth region, respectively. A diagnosis of chronic irreversible pulpitis was made in both cases with the accidental appraisal of RE in both the primary first molars on intraoral periapical radiographs. Standard pulpectomy was performed in both cases. Pediatric dentists as well as clinicians should update regarding the abnormal morphologies of primary molars and its diagnostic including treatment strategies.

Trends in behavioral management techniques for dental treatment of patients with autism spectrum disorder: a 10-year retrospective analysis.

Patients with autism spectrum disorder (ASD) present challenges in dental treatment cooperation owing to deficits in communication skills and social interaction. Behavioral guidance, sedation, and general anesthesia may be employed to ensure the quality of dental care for individuals with ASD. This study aimed to examine the trends in dental treatment for patients with ASD who visited the Department of Pediatric Dentistry at Dankook University Jukjeon Dental Hospital, an oral health center for the disabled in the Gyeonggi region, over the past 10 years. This study utilized the order communication system to gather data on sex, age, cooperation level, number of quadrants treated, and administration of sedation or general anesthesia for patients with ASD who visited the Department of Pediatric Dentistry at Dankook University Jukjeon Dental Hospital between January 2013 and December 2022. The total number of patients with ASD increased annually, possibly due to an increase in ASD prevalence and the hospital's designation as a center for disabled oral health. General anesthesia was predominant before 2017, with a shift towards N2O-O2 sedation. The most common age group for sedation or general anesthesia was 6-9 years, with a higher prevalence in males than in females. Notably, N2O-O2 and midazolam sedation resulted in better cooperation and fewer treated teeth than general anesthesia. This study highlights the evolving trends in dental treatment for individuals with ASD, indicating a shift towards outpatient methods, particularly N2O-O2 sedation. The sex distribution aligns with national statistics, emphasizing a higher prevalence of ASD in males than in females. These findings underscore the need for further research to establish evidence-based guidelines for optimal dental care strategies tailored to the unique needs of individuals with ASD.

Preferences and Perceptions of Paediatric Dentists’ Attire among 4-12-year-old Children: A Cross-sectional Study

Introduction: Dentists’ attire includes their choice of clothes and Personal Protective Equipment (PPE) required to follow infection control measures. Investigating and understanding the paediatric patient’s preferences and perceptions towards the dentist’s attire can aid in establishing a more efficient and smoother relationship between them. Aim: To determine the children’s preferences and perceptions of their paediatric dentist’s attire and PPE among four to 12- year-old children. Materials and Methods: This cross-sectional study included four to 12-year-old Arabic-speaking children attending Department of Paediatric Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia for dental treatment with their parents/ guardians between February 2022 and April 2022. Data were collected from the participants using a validated Arabic electronic questionnaire to determine their preferences regarding different parts and types of the dentist’s attire and PPE, as well as their perceptions and feelings of comfort towards the dentist wearing the full standard PPE. Data were summarised as frequencies and percentages for categorical variables or means and standard deviations for continuous variables. The significance threshold was set at 0.05. Results: A total of 362 participants with a mean age of 8.4±2.3 years and their parents/guardians participated in the study. Female dentists were significantly more favoured by both male and female participants, with statistical significance among females (p<0.001) and younger participants (p<0.001). Both males and females (p=0.025) and older participants (p = 0.001) significantly favoured the traditional white coats over colourful paediatric coats. Furthermore, older participants significantly preferred surgical masks over paediatric masks (p<0.001), face shields as eye protection (p<0.001), and no head cover over colourful paediatric caps (p<0.001). Male participants showed significantly better acceptability towards the dentist wearing the full standard PPE. Conclusion: Both genders and younger children preferred female dentists. The traditional white coat is the most preferred attire by both genders and older children. Male and older children showed higher acceptability for the full standard PPE.

The effect of socio-economic status on children's dental health.

The aim of the present study was to record the oral health status of children from different socioeconomic backgrounds and correlate these findings with parent-associated factors. It comprised a cross-sectional study of healthy children, aged 6-12 years, attending either the Reception and Solidarity Center of the Municipality of Athens or the Postgraduate Paediatric Dentistry Department (NKUA) for dental care. Data regarding the demographics of both parents-guardians, as well as the children, and oral hygiene and dietary habits were collected through a structured questionnaire. This was followed by a thorough clinical examination evaluating oral hygiene status, gingival inflammation and caries experience. Analysis was based on the socioeconomic status (SES) of the parents which was according to the family income. Families with a monthly income of <1400 euros were considered as being of a low SES and families with incomes of >1400 euros as medium. Data were presented in frequency tables and significance of calculated differences was tested using chi-square and Fisher's exact tests. Multivariate regression analysis was used to detect possible risk factors for development of poor dental health. The sample consisted of 216 children (146 from a low and 70 from a medium SES) with a mean chronological age of 9.19 years. Parents from low SES were younger, of lower education, had lived abroad most of their lives and were unemployed or worked in the private sector. Children from low SES backgrounds reported infrequent dental visits, consumed more meals and had more sugary snacks. This was reflected in their worse dental health with significantly higher values for oral hygiene and caries indices. Despite the above differences, none of the parent-associated factors were significantly correlated to worse dental health. In conclusion, SES of parents is reflected in the oral health of children, although it is not a significant predictor of dental health.

Pediatric Oral Health Service Access in Racial/Ethnic Minority Neighborhoods: A Geospatial Analysis in Washington, D.C., USA.

Oral health plays a crucial role in overall well-being. One of the goals set by the US Department of Health and Human Service, Healthy People 2030 is to reducing dental caries in children and adolescents. The study aims to investigate the accessibility of pediatric dental care in neighborhoods with mixed-race and predominantly African American populations in the Washington District of Columbia (DC) area. Our objective is to uncover and highlight the disparities that exist in pediatric dental care within these communities. We have specifically examined the geographic and socio-demographic aspects of pediatric dental care facilities, utilizing geospatial tools such as modeling and mapping, as well as data from the clinical database at Howard University College of Dentistry. The detailed analysis of dental care access revealed significant disparities among various Wards in the region. Specifically, Wards 5, 7, and 8 stood out as having both the highest concentrations of African American residents and the lowest availability of pediatric dentistry providers when compared to the more affluent Wards 1, 2, and 3. Howard University College of Dentistry's pediatric dentistry department played a crucial role in providing dental care services to the community. Over the course of the year 2022, they recorded a total of 3,855 visits from residents of the DC area. Notably, a substantial portion of these visits, specifically 1,566 visits, were from individuals residing in Wards 5, 7 and 8. This data underscores the significant demand for pediatric dental services in these underserved communities and highlights the importance of addressing the disparities in access to care.

Dyskeratosis congenita: A report of two cases

Dyskeratosis congenita (DC) is the first genetic syndrome identified among telomeropathies. Its classical phenotype is characterized by mucocutaneous abnormalities, atrophy and pigmentation of the skin, oral leukoplakia, and nail dystrophy. Bone marrow failure and susceptibility to malignancy are rare, and DC is mostly an X-linked recessive, serious, multisystemic disease. This study aims to increase dentists’ awareness of this genetic disease, accompanied by oral findings. Two cases of DC are reported in this paper, along with a short review of the literature. Oral findings of the disease include dental caries, gingival recession, short roots, gingival bleeding, severe mobility of the teeth, and alveolar bone loss. DC is clinically seen mostly in males aged 5 to 12. This case report examines dermatological and oral findings consistent with the disease of two brothers diagnosed with DC who applied to the Gülhane Health Sciences University, Faculty of Dentistry, Pediatric Dentistry Department for dental caries complaints. DC is a rare disease, and dentists should pay attention to its systemic and oral symptoms during their examinations. Despite a positive prognosis of this disease, it is important to take into account any unexpected changes in hematological values and mucocutaneous malignant alterations. How to cite this article: Aydın Varol E, Kılıç G, Bal C, Atay İ. Dyskeratosis congenita: A report of two cases. Int Dent Res 2023;13(3):133-7. https://doi.org/10.5577/idr2023.460 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Evaluation of root development of mandibular first molar of children (6-12) years old visiting P.O.P. department College of Dentistry/ Hawler Medical University.

Background and objective: With FPMs between the ages of 6 and 12, the detection of open apex in some children at age 12 underlines the necessity for investigation prior to treating a deep carious lesion.Pulpal involvement was considered before the surgery began. The genesis of the roots is complete. Dentists are urged to conduct a comprehensive clinical examination, get diagnostic radiographs, and adhere to case-specific treatment protocols before attempting to treat FPMs in children, even those as young as 12 years old. This would reduce the likelihood of treatment mistakes, which might hinder the extraction of FPMs or cause unacceptable damage. Method: Dentists in the Paediatric Dentistry Department at Hawler Medical University saw all the children in the sample, and they were all in good health condition. This research evaluated the crown and root development stages of lower FPMs on both sides, as found by Demirjian et al. (1973). Information was collected in Excel 2017 for use in making charts and tables. Mean and standard deviation values. The T-test, either paired or unpaired, with a p-value of 0.05 serving as the threshold for statistical significance. Results: The findings showed that there was a total of 250 OPGs, with 130 belonging to females and 120 belonging to boys. The ages of the children that were considered for inclusion in the sample varied anywhere from six to twelve years old. In a sample of 12, the first molar in the mandibular region had the greatest percentage of AC (84.4%). Conclusions: The discovery of open apex in some children at 12 confirms the need for inquiry before treating a deep carious lesion in FPMs between the ages of 6 and 12. we evaluated the potential risk of pulpal involvement during this period. Before treating FPMs in children, even those as young as 12, the dentists were advised to do a thorough clinical examination, get diagnostic radiographs, and follow specific treatment procedures based on clinical instances. Keywords: tooth root, important tooth, root development, Demirjian technique.

REGRESSION MODELS OF THE AREA OF THE SOFT PALATE AND TONGUE IN YOUNG MEN AND YOUNG WOMEN WITH AN ORTHOGNATHIC BITE WITHOUT AND TAKING INTO ACCOUNT THE TYPE OF FACE DEPENDING ON TELEROENTGENOMETRIC INDICATORS OF THE UPPER RESPIRATORY TRACT

The prevalence of pathologies related to the soft palate and its surrounding structures is a serious challenge for medicine. Sleep apnea and other diseases directly related to this anatomical region pose a threat not only due to the actual cause of deaths, but also complications of concomitant diseases. In this regard, the definition of normative indicators of the upper respiratory tract, in particular the soft palate and its surrounding structures, is a relevant topic for study. The purpose of the work is to build and analyze the regression models of the area of the soft palate and tongue in young men and young women with an orthognathic bite without and taking into account the type of face, depending on the features of teleroentgenometric indicators of the upper respiratory tract. With the help of the licensed medical software OnyxCeph³™, version 3DPro and the diagnostic program “UniqCeph”, a cephalometric analysis of lateral teleroentgenograms of 49 young men and 76 young women with an orthognathic bite and the absence of upper respiratory tract pathology was performed (primary teleroentgenograms were obtained from the database of the Research Center and Department of Pediatric Dentistry, National Pirogov Memorial Medical University, Vinnytsia). Face types in young men and young women were determined using the Garson index. Regression models of the area of the soft palate and tongue depending on teleroentgenometric indicators of the upper respiratory tract were built using the license package “Statistica 6.0”. In Ukrainian young women with an orthognathic bite, regardless of face type, with very wide and wide face types, all possible models of the area of the soft palate and tongue were built depending on teleroentgenometric indicators of the upper respiratory tract with a coefficient of determination (R2) greater than 0.5 (R2= from 0.682 to 0.937, p&lt;0.001), which most often include the thickness of the soft palate and the length of the soft palate (42.9 % each), tongue height and tongue length (30.0% each), the value of the position of the hyoid bone relative to the vertical mandibular plane and the angle of inclination of the soft palate (20.0 % each). In Ukrainian young men with an orthognathic bite without taking into account the type of face and with a wide face type, all possible models of the area of the soft palate and tongue were also built depending on teleroentgenometric indicators of the upper respiratory tract with a coefficient of determination greater than 0.5 (R2= from 0.562 to 0.925, p&lt;0.001), which most often include the thickness of the soft palate and the length of the soft palate (33.3 % each).

The capability of regenerative endodontics to promote the complete root formation in immature permanent teeth with different initial pre-operative conditions.

To describe the potential possibility of complete root formation after regenerative endodontic procedures (REPs) in immature permanent teeth with different initial pre-operative conditions. Children who underwent REPs in the Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, China, from January 2013 to December 2022 were enrolled. Whether the tooth achieved complete root formation was determined using post-operative periapical radiography. The potential possibility of complete root formation after REPs in immature permanent teeth with different initial conditions is discussed. A total of 428 teeth from 401 patients were included, of which 258 (60.2%) achieved complete root formation. In cases that achieved complete root formation, the most serious type of trauma was avulsion, the teeth with the worst initial root development were less than one-third of the development (stages 6-7), and the longest duration of the presence of apical lesions in the tooth before the first visit was more than 180days. There is a significant difference in the root formation of teeth with different initial developmental stages and diagnoses. The active period of continued root formation was 5-21months post-operatively. The higher the initial stage of root development and the shorter the duration of the presence of apical lesions in the tooth before the first visit, the greater the possibility of root formation. However, complete root formation may still be expected after REPs in severely injured immature permanent teeth and teeth with poor initial pre-operative root development conditions (less than stage 7) at the first visit. This is also true for teeth with long-term and large-scale apical lesions.