Pediatric dentistry最新文献

{"title":"Triazolam for Pediatric Dental Sedation: A Retrospective Evaluation of Safety and Changes in Visit Behavior.","authors":"Sheaffer Yinger, Daniel Claman, Jennifer Luca, Kim Hammersmith, Erin Gross, Beau Meyer","doi":"","DOIUrl":"","url":null,"abstract":"<p><p><b>Purpose:</b> To describe triazolam in pediatric dental mild to moderate sedation and report changes to overall visit behavior for permanent first molar extraction. <b>Methods:</b> This retrospective chart review from 2018 to 2022 analyzed demographic, procedural, and behavioral data for children eight years and older receiving triazolam for a permanent first molar extraction. The outcomes included adverse events measured by deviations in heart rate and oxygen saturation and changes to overall visit-level Frankl scores from the referral to sedation visit. Descriptive statistics and non-parametric statistical analyses were conducted. <b>Results:</b> The study population (n equals 82) was predominantly female (61 percent), English-speaking (85 percent), and White (41 percent) or Black (39 percent). The most common indication for mild to moderate sedation was dental anxiety (28 percent). There were zero instances of adverse events requiring emergency intervention or the use of reversal medication. The change in visit-level Frankl scores was significantly positive (P<0.001). <b>Conclusion:</b> Triazolam is likely a safe choice for mild to moderate sedation, leading to improved overall visit behavior in children undergoing a permanent first molar extraction.</p>","PeriodicalId":101357,"journal":{"name":"Pediatric dentistry","volume":"46 1","pages":"63-67"},"PeriodicalIF":0.0,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140051459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing the environmental impact of nitrous oxide use.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":101357,"journal":{"name":"Pediatric dentistry","volume":"46 1","pages":"57"},"PeriodicalIF":0.0,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140051457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Applications of Artificial Intelligence for Pediatric Dentistry: A Systematic Review and Meta-Analysis.","authors":"Rata Rokhshad, Ping Zhang, Hossein Mohammad-Rahimi, Parnian Shobeiri, Falk Schwendicke","doi":"","DOIUrl":"","url":null,"abstract":"<p><p><b>Purpose:</b> To systematically evaluate artificial intelligence applications for diagnostic and treatment planning possibilities in pediatric dentistry. <b>Methods:</b> PubMed^®, EMBASE^®, Scopus, Web of Science^™, IEEE, medRxiv, arXiv, and Google Scholar were searched using specific search queries. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) checklist was used to assess the risk of bias assessment of the included studies. <b>Results:</b> Based on the initial screening, 33 eligible studies were included (among 3,542). Eleven studies appeared to have low bias risk across all QUADAS-2 domains. Most applications focused on early childhood caries diagnosis and prediction, tooth identification, oral health evaluation, and supernumerary tooth identification. Six studies evaluated AI tools for mesiodens or supernumerary tooth identification on radigraphs, four for primary tooth identification and/or numbering, seven studies to detect caries on radiographs, and 12 to predict early childhood caries. For these four tasks, the reported accuracy of AI varied from 60 percent to 99 percent, sensitivity was from 20 percent to 100 percent, specificity was from 49 percent to 100 percent, F1-score was from 60 percent to 97 percent, and the area-under-the-curve varied from 87 percent to 100 percent. <b>Conclusions:</b> The overall body of evidence regarding artificial intelligence applications in pediatric dentistry does not allow for firm conclusions. For a wide range of applications, AI shows promising accuracy. Future studies should focus on a comparison of AI against the standard of care and employ a set of standardized outcomes and metrics to allow comparison across studies.</p>","PeriodicalId":101357,"journal":{"name":"Pediatric dentistry","volume":"46 1","pages":"27-35"},"PeriodicalIF":0.0,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140051453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Vital Pulp Therapies in Primary Teeth 2024.","authors":"James A Coll, Vineet Dhar, Chia-Yu Chen, Yasmi O Crystal, Marcio Guelmann, Abdullah A Marghalani, Shahad AlShamali, Zheng Xu, Gerald N Glickman, Rachel Wedeward","doi":"","DOIUrl":"","url":null,"abstract":"<p><p><b>Purpose:</b> The purpose of this study was to present an evidence-based guideline for primary teeth with deep caries or trauma requiring vital pulp therapies (VPT). <b>Methods:</b> A systematic review/meta-analysis on vital primary teeth resulting from trauma or caries was conducted using GRADE to assess the certainty of evidence for clinical recommendations. A decision tree was provided for choosing VPTs. <b>Results:</b> No articles on trauma VPT were found. For VPT in primary teeth with deep caries, indirect pulp treatment (IPT) or pulpotomy using the calcium silicate cement (mineral trioxide aggregate [MTA] or Biodentine^®) show increased success over using direct pulp capping (DPC) and other pulpotomies. Different liners do not affect IPT success (high certainty) or DPC capping agents' success (very low certainty) after 24 months. It is strongly recommended, with high certainty from 24-month data, that calcium silicate cement pulpotomy is preferred over formocresol, ferric sulfate, zinc oxide eugenol pulpotomy, and other pulpotomies. Using selective caries removal and IPT for deep caries is strongly recommended with moderate certainty over complete and stepwise removal. Statistically, this results in significantly fewer pulp exposures. No caries removal and Hall technique crown may be used when indicated (moderate certainty at 24 months). For vital primary incisors with deep caries, pulpotomy was significantly better statistically than pulpectomy. Teeth diagnosed with/without reversible pulpitis pain showed comparable success after 12 months of treatment by IPT or calcium silicate cement pulpotomy. The following had little or no significant effect on MTA pulpotomy success: coronal pulp removal methods; irrigation solution; method to control hemorrhage; base over MTA; treatment in one or two visits; anterior or posterior teeth. <b>Conclusions:</b> Indirect pulp treatment or calcium silicate cement pulpotomy is likely to increase vital pulp therapy success over other VPTs such as direct pulp capping and other pulpotomies after 24 months (moderate certainty).</p>","PeriodicalId":101357,"journal":{"name":"Pediatric dentistry","volume":"46 1","pages":"13-26"},"PeriodicalIF":0.0,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140051460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supplemental Oxygen Concentrations and the Use of Suction to Mitigate Risk of Oral Surgical Fires Using a Laboratory Model.","authors":"Alexandra R Kolar, Mark A Saxen, James E Jones, Juan F Yepes, George Eckert","doi":"","DOIUrl":"","url":null,"abstract":"<p><p><b>Purpose:</b> Intraoral oxygen pooling during dental sedation, especially using supplemental oxygen, is associated with an increased risk of spontaneous perioperative fire. The purpose of this in vitro study was to examine the effectiveness of intraoral suctioning for reducing oxygen pooling to safe levels during a simulated dental procedure. <b>Methods:</b> Phase one: Twenty trials were completed for each of the three suctioning devices: high-volume evacuation (HVE), fixed tip saliva ejector (SE), and Yankauer suction (YS). Phase two: Twenty trials were completed for each of three suctioning scenarios: no suctioning and continuous suctioning for the HVE and SE. <b>Results:</b> In phase one, the slope for change (decrease) in oxygen during suction was significantly larger for SE than HVE (P<0.001) and YS (P<0.001), but for HVE and YS were not significantly different. Mean oxygen levels during suction were significantly higher for SE than HVE (P<0.001) and YS (P<0.001). In phase two, oxygen increased faster for no suction than for SE and HVE (P<0.001) and increased faster for SE than HVE (P<0.001). Mean oxygen levels were significantly lower for HVE than for SE (P<0.001) and no suction (P<0.001), and significantly lower for SE than no suction (P<0.001). <b>Conclusion:</b> All three devices were effective for reducing intraoral oxygen concentration to acceptable levels during the procedure. The HVE was the most effective suction device for rapidly evacuating pooled intraoral oxygen.</p>","PeriodicalId":101357,"journal":{"name":"Pediatric dentistry","volume":"46 1","pages":"58-62"},"PeriodicalIF":0.0,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140051458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adopting Dental Caries Preventive Procedures.","authors":"Norman Tinanof, Vineet Dhar","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":101357,"journal":{"name":"Pediatric dentistry","volume":"46 1","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140051451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Randomized Clinical Trial to Assess Caries Arrest by Using Silver Diamine Fluoride in U.S. Children: Interim Findings.","authors":"Margherita Fontana, Divya Khera, Steven Levy, George Eckert, Barry Katz, Emily Yanca, Carlos González-Cabezas, Amr Moursi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p><b>Purpose:</b> To assess the effectiveness of 38 percent silver diamine fluoride (SDF) in arresting cavitated caries lesions in young U.S. children. <b>Methods:</b> Children 12 to 71 months of age with severe early childhood caries participated in this phase three, multicenter, randomized, placebocontrolled trial. SDF was applied twice (at baseline and six months), and children were followed for eight months. A planned interim analysis of only the six-month primary outcome caries arrest data, for approximately half of the cohort (680 of 1,144 children), was conducted using a generalized estimating equation model, accounting for non-independence among carious lesions within a patient. Results: Five hundred ninety-nine of the 680 participants, with 1,413 lesions, completed the six-month exam. Lesions in the SDF group demonstrated 54 percent arrest versus 21 percent in the placebo (P<0.001). <b>Conclusions:</b> Silver diamine fluoride was effective at arresting active cavitated lesions in this population, leading to the early stop of the trial. Final analyses of all data and other outcomes are currently underway.</p>","PeriodicalId":101357,"journal":{"name":"Pediatric dentistry","volume":"46 1","pages":"8-12"},"PeriodicalIF":0.0,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10921985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140051450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dental Desensitization to Increase Comfort with Preventive Dental Visits for Children with Autism Spectrum Disorder.","authors":"Jean Star, Helen Mo, Tara Glavin, Whitney Ence","doi":"","DOIUrl":"","url":null,"abstract":"<p><p><b>Purpose:</b> To evaluate the impact of a dental desensitization clinical program on the ability of children with autism spectrum disorder (ASD) to complete a routine preventive dental visit. <b>Methods:</b> English-speaking children with a diagnosis of ASD were enrolled in a prospective cohort study as part of a dental desensitization program. A task analysis (TA) and desensitization plan breaking down a routine dental visit into seven steps was designed and implemented. At each dental visit over a two-year period, the child's comfort level with each step of the TA was collected. <b>Results:</b> Fifty-two patients participated in this program (average age equals 7.9±3.6 years, 80 percent male). Each participant completed, on average, 6.7 desensitization visits. Approximately half of the study participants were able to complete all steps of the TA during the study period. There was a statistically significant positive relationship between the number of desensitization visits and the number of steps of the dental visit the child could complete comfortably. Children with expressive and receptive language skills were more likely to complete all steps of the TA. <b>Conclusion:</b> Dental desensitization is a behavior guidance intervention that can support children with autism spectrum disorder to complete routine preventive dental visits.</p>","PeriodicalId":101357,"journal":{"name":"Pediatric dentistry","volume":"45 6","pages":"518-523"},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138833915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Reduced Operating Room Access on Dental Departments in Children's Hospitals.","authors":"Homa Amini, Paul S Casamassimo, C Scott Litch, Chelsea Fosse, James R Boynton","doi":"","DOIUrl":"","url":null,"abstract":"<p><p><b>Purpose:</b> Access to hospital operating rooms (HORs) for pediatric dental patients worsened with the COVID-19 pandemic. The purpose of this study was to assess the impact of hospital operating room denials for dental patients on service and teaching missions in selected US children's hospitals (CHs). <b>Methods:</b> A 12-question online survey was sent to administrative heads of 34 CH dental departments. <b>Results:</b> Twenty-two surveys were completed. All respondent CHs were engaged in pediatric dentistry training. The majority (68 percent) reported that access to HORs worsened since 2017, resulting in longer wait times for hospital dental service cases (82 percent), decreased ability to achieve and maintain oral health for special needs patients (64 percent), more caries-related emergency department visits (50 percent), and delays in medical surgery for children needing dental clearance (45 percent). A quarter (27 percent) reported HOR availability somewhat affected resident training. <b>Conclusion:</b> Lack of access to hospital operating rooms in training hospitals had a negative impact on the quality and timeliness of care and the quality of training.</p>","PeriodicalId":101357,"journal":{"name":"Pediatric dentistry","volume":"45 6","pages":"504-509"},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138833917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Tooth Vital Pulp Treatment Interventions: Systematic Review and Meta-Analyses.","authors":"James A Coll, Vineet Dhar, Chia-Yu Chen, Yasmi O Crystal, Marcio Guelmann, Abdullah A Marghalani, Shahad AlShamali, Zheng Xu, Gerald Glickman, Rachel Wedeward","doi":"","DOIUrl":"","url":null,"abstract":"<p><p><b>Purpose:</b> to update the 2016 systematic review evidence for vital pulp therapy (VPT) for primary teeth affected by caries or trauma. <b>Methods:</b> The population, intervention, comparison, outcomes, and study (PICOS) design inclusion/exclusion was used for multiple databases. Risk of bias, meta-analyses using RevMan, and certainty of evidence was created. <b>Results:</b> A total of 299 studies were included; no trauma was found. Indirect pulp treatment (IPT) resulted in 97 percent success. Two calcium silicate cement (CSC) pulpotomies' success using mineral trioxide aggregate (MTA) and Biodentine^® were 94 percent and 90 percent, respectively, greater than for direct pulp capping (DPC; 86 percent) and other pulpotomies (moderate certainty). The success of IPT versus pulpotomy at 24 months showed no significant difference (P=0.31). Different liners or capping agents did not affect the success of IPT (P=0.79) or DPC at 24 months (P=0.24). The two CSC pulpotomies were not significantly different based on 24-month success (P=0.34). The formocresol pulpotomy success at 24 months was significantly lower than for MTA (P=0.02). Ferric sulfate had a significant lower success at 24 months than MTA pulpotomy (69 percent versus 92 percent; P=0.03). Zinc oxide eugenol, as a singular pulpotomy, had low success (65 percent). Selective/stepwise caries removal did significantly better at avoiding pulp exposures than complete excavation (P<0.001). Complete, selective, and no caries removal (Hall technique [HT], steel crown placement with no caries removal) had no significant difference in pulp vitality success for deep caries at 24 months (P=0.29). For deep caries affecting vital incisors, pulpotomy had significantly greater success than pulpectomy (P=0.002). The following had no significant effect on MTA pulpotomy success: coronal pulp removal methods; irrigation solution; method to control hemorrhage; base over MTA; treatment in one or two visits; and anterior or posterior teeth. <b>Conclusions:</b> Vital pulp therapy success of indirect pulp treatment or two calcium silicate cement pulpotomies demonstrated improved success over direct pulp capping and other pulpotomies based on 24-month evidence with moderate certainty. The Hall technique did not significantly reduce pulp vitality success versus caries removal.</p>","PeriodicalId":101357,"journal":{"name":"Pediatric dentistry","volume":"45 6","pages":"474-546"},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138833921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}