Prescription of panoramic radiographs in children using age-based prevalence of dental anomalies and pathologies.

BACKGROUND: Panoramic radiographs (PRs) are used in the detection and diagnosis of developmental dental anomalies and pathologies (DDAPs) in children. AIM: The primary objective of this observational cohort study was to evaluate the age-based prevalence of DDAP on PRs, whereas the secondary objective was to determine a threshold age for the detection of DDAP to provide supportive evidence for the prescription of PR in paediatric dental practice. DESIGN: The study examined diagnostic PRs from 581 subjects aged 6 to 19 years. All PRs were reviewed by experienced, calibrated, masked examiners for the identification or presence of anomalies in size, shape, position, structure, and other developmental anomalies and pathologies (ODAP) of the face-neck region in a standardized condition. The data were statistically analyzed for interpretation. RESULTS: Overall, 74% (n = 411) of the cohort had at least one anomaly (shape anomaly: 12%, number anomaly: 17%, positional anomaly: 28%, structural anomaly: 0%, and ODAP: 63%). The optimal Youden index cutoff for any anomaly was 9 years. Twelve and 15 years also showed predictive ability. CONCLUSION: The results suggest that PRs should be prescribed at ages 9, 12, and 15 years for the diagnosis of DDAP.

A comparative evaluation of video modeling and social stories for improving oral hygiene in children with autism spectrum disorder: A pilot study.

INTRODUCTION: The purpose of this pilot study was to compare video modeling (VM) to a toothbrushing social story (TSS) for improving oral hygiene in children with autism spectrum disorder (ASD). METHODS: Four to 17-year-old children and adolescents with ASD were evaluated at a pre-intervention visit for quality of oral hygiene using plaque and gingival indices. A pre-intervention survey assessed caregivers' perceptions of their children's daily oral hygiene practices. Participants were randomized into VM or TSS groups and caregivers received daily emails to access a VM or TSS presentation when completing toothbrushing for their child for 30 days. At the one-month visit, oral hygiene was re-evaluated, and post-intervention surveys were completed. RESULTS: There were significant improvements in plaque and gingival scores for VM (0.68 ± 0.20; 0.59 ± 0.15) and TSS (0.50 ± 0.11; 0.40 ± 0.10) groups at post-intervention compared to pre-intervention visits. No significant improvements in plaque or gingival scores were noted between the VM and TSS groups. Caregivers' perceptions regarding oral hygiene acceptance by their children was promising for the VM group. CONCLUSIONS: VM and TSS interventions improved oral hygiene in subjects with ASD. There was greater acceptance of daily oral hygiene in the VM compared to the TSS group.

Evaluation of problem-based learning in dental trauma education: An observational cohort study.

BACKGROUND/AIM: Problem-based learning (PBL) allows higher thinking among dental students and has improved first-time pass-rates in predoctoral pediatric dentistry education. The aim of this retrospective observational cohort study was to evaluate the impact of PBL-based, traumatic dental injuries case discussions on predoctoral dental trauma education. MATERIALS AND METHODS: Student performance and perceptions after receiving dental trauma curriculum with or without PBL-based dental trauma case discussions were evaluated. All the students challenged their simulated patient-based assessments. Three recall-based, objective structured clinical examinations, and critical thinking competencies assessed student knowledge about management of traumatic injuries affecting primary or permanent dentition including avulsion. The scores and number of attempts for each competency were compared between the study cohorts using t-tests. Student's self-perceived learning outcomes were measured through a voluntary, five-question survey. Mantel-Haenszel ordinal Chi-square tests were used to assess for differences in rates of agreement on survey responses from the students. Linear regression was used to assess effect of training on scores adjusting for student type (predoctoral or advanced standing). Pearson's correlations were used to assess association between scores. Significance was set at 0.05. RESULTS: For the PBL cohort, there was a significant (p > 0.05) improvement in the first-time pass-rates and scores in three out of four competencies. A higher proportion of students in the PBL cohort perceived that their dental trauma education improved their radiographic and diagnostic skills compared to the cohort that did not receive PBL (p > 0.05). There was no correlation between recall-memory versus critical thinking competencies (r < 0.5). CONCLUSION: The PBL-based dental trauma case discussion had a positive impact on predoctoral student learning and perceived benefits while managing simulated traumatic dental injuries. Due to a lack of correlation between recall-memory and critical thinking assessments, evaluation of predoctoral student's dental trauma competencies should involve multi-model assessment.

Bifid Mandibular Canals: A Pediatric Case Series with Clinical Implications.

Aim: The aim of this case series is to provide a detailed account of pediatric cases with bifid mandibular canal (BMC) along with clinical implications. Background: The prevalence of BMC on panoramic radiographs has been reported to be 0.03-1.90% in adults. Only one study reported prevalence of BMC in children based on cone-beam computed tomography (CBCT) images. As CBCT images are not routinely prescribed in children, it is important to understand if panoramic radiographs provide a valuable tool to diagnose BMC in children. Case description: This case series provides a review of three cases of nonsyndromic, bilateral BMC, and associated radiculomegaly affecting mandibular permanent first molars in children during the mixed dentition stage. An overview of clinical implications of BMC in children is also discussed to help clinicians provide appropriate dental care and anticipatory guidance. Conclusion: Bifid mandibular canal (BMC) has never been reported in children during mixed dentition stage based on panoramic radiographs. This is the first case series reporting BMC and associated dental anomalies in children. Clinical significance: This case series will help clinicians in diagnosing BMC during mixed dentition stage and understand its clinical implications. Additionally, this case series will help define future cross-sectional studies evaluating BMC and associated dental anomalies in children. How to cite this article: Puranik CP, Chandki R, Mladenovic R, et al. Bifid Mandibular Canals: A Pediatric Case Series with Clinical Implications. Int J Clin Pediatr Dent 2023;16(3):547-549.

Effect of association of temperature and pollutant levels on COVID-19 spread over Jaipur.

The association of temperature and air pollutants is a very prominent factor which significantly affects human health and may cause diseases such as respiratory illness, cardiovascular mortality in spreading of different pathogenic diseases. The pandemic due to covid-19 infection may be affected by temperature and concentration of pollutants. Jaipur is one of the most polluted cities in Rajasthan of India as per World Health Organization, 2016; also, Jaipur city has a hot semi-arid climate with extremely hot summers. This fact tempered us to examine the impact of the association of temperature and pollutants on corona-virus infection in humans over Jaipur. Analysis was conducted by correlating air pollutants (PM10, PM2.5, NO2, SO2, CO) on seasonal variations because the temperature is one of the major factors in changing seasons. Association between the number of Covid cases and temperature in Jaipur was observed during December 2019 to December 2020. Seasonal analysis indicated that the intensity of Covid-19 infection varied according to increase or decrease in temperature.

Perception and outcomes after implementation of problem-based learning in predoctoral pediatric dentistry clinical education.

PURPOSE: Problem-based learning (PBL) has been a useful addition to health-based curricula by supporting learning with contributory discussion, research, and critical analysis of evidence in a peer-supported learning format. The aim of this study was to determine the impact of PBL on pediatric dentistry clinical education. METHODS: First-time pass-rates in clinical and objective structured clinical examinations were measured in student cohorts receiving pediatric curricular formats with (PBL+) or without a PBL (PBL-) experience. Student perceived learning outcomes were measured through a voluntary survey. The numbers of each competency attempt were compared between the study groups (PBL+ or PBL-) using Wilcoxon Rank-Sum tests or Fisher's exact tests. Mantel-Hanzel ordinal chi-square tested for differences in rates of agreement on survey responses from students in the PBL+ or PBL- groups. Significance was set at 0.05. RESULTS: There was a significant improvement in the first-time pass-rates in five of seven competencies in the PBL+ group. A significantly higher proportion of students in the PBL+ group perceived that their predoctoral pediatric dentistry rotation improved their diagnostic skills compared to the students in the PBL- group (p < 0.001). However, there was no significant difference (p > 0.05) between the perceptions on satisfaction of clinical or non-clinical staff support, perceived self-improvement in radiographic or clinical skills or overall benefits of the predoctoral pediatric dentistry rotation. CONCLUSION: The addition of a PBL component to a traditional curricular format in a pediatric dentistry clinical rotation had a positive impact on learning in a predoctoral dental program.

Acrylated Hydroxyazobenzene Copolymers in Composite-Resin Matrix Inhibits Streptococcus mutans Biofilms In Vitro.

Purpose: The purpose of this study was to evaluate the effect of acrylated hydroxyazobenzene (AHA) copolymers in a composite-resin matrix on Streptococcus mutans (SM) biofilms. Methods: The AHA was synthesized and polymerized within a bisphenol A-glycidyl methacrylate and triethylene glycol dimethacrylate (bisGMA:TEGDMA) matrix while bisGMA:TEGDMA discs served as controls. The cytotoxicity of AHA was determined using a cell viability assay. Sucrose-dependent SM biofilms were grown on the AHA and control substrates. At 24 hours and after mechanical toothbrushing (equivalent to six months), the number of live SM was quantified on the substrates and in the surrounding media. Microscopic images of the substrates were captured after live-dead staining. Results: The AHA substrates were as biocompatible as bisGMA: TEGDMA substrates. The microscopic images and quantification demonstrated no live SM on the AHA substrates and in the surrounding media as compared to the controls. The inhibitory efficacy of AHA substrates on SM biofilm was intact even after mechanical toothbrushing. Conclusions: Acrylated hydroxyazobenzene in a composite-resin matrix completely inhibits SM proliferation growth and demonstrates a zone of SM inhibition. The antibacterial propertyof AHA could be harnessed for caries prevention in high caries-risk children by incorporating AHA into the restorative and sealant materials.

Association Between Autism Spectrum Disorder and Dental Anomalies of the Permanent Dentition.

Purpose: The purpose of this study was to evaluate the association between dental anomalies of the permanent dentition and autism spectrum disorder (ASD). Methods: The dental and medical records and panoramic radiographs of 200 six- to 17-year-old subjects with a diagnosis of ASD were assessed retrospectively. The controls were 200 age- and gender-matched healthy children. The individual counts of shape, number, and positional dental anomalies and the total counts of all anomalies were recorded. Medical comorbidities were defined and documented as two subgroups: ASD subjects with (ASD-C) or without (ASD-NC) comorbidities. Results: Seventy-seven percent of ASD subjects had at least one comorbidity. Sixty-five percent of ASD subjects demonstrated at least one dental anomaly in comparison to controls (53 percent). There were no significant differences for the prevalence of number, shape, positional, or total anomalies between control, ASD-C, or ASD-NC groups. The ASD-NC group had a significantly higher proportion of pyramidal molars (P=0.02) and ectopically erupting teeth (P=0.04) when compared to controls. Conclusions: There were no significant differences in prevalence for shape, number, or positional anomalies in the permanent dentition between autism spectrum disorder subjects and healthy controls. The prevalence of pyramidal teeth and ectopic eruption was significantly associated with ASD.

Oral and dental findings in emanuel syndrome.

Emanuel Syndrome (ES; OMIM# 609029) is a rare disorder caused by an unbalanced chromosomal translocation [supernumerary der(22)t(11,22)] and characterized by multiple congenital abnormalities. With limited published cases and low prevalence (1:110 000), detailed ES-associated oro-dental findings have not previously been reported. This is a case report of a 14-year-old boy with ES who presented with congenital cardiac, renal, auditory, musculoskeletal problems, and global developmental delay. The patient was managed with risperidone, melatonin, omeprazole, guanfacine, and oxcarbazepine. Anxiety-associated self-injurious behaviour was seen along with stereotypic hand movements. Consistent with previous reports, microcephaly and micrognathia were noted. Oro-facial cleft or gross asymmetry, however, was not observed. Significant oro-dental findings included delayed eruption of primary and permanent teeth, oligodontia (two erupted and five unerupted permanent teeth), and short-root anomaly of central incisors. The patient demonstrated anxiety-triggered bruxism with generalized attrition. This case report provides a comprehensive list of systemic ES findings along with oro-dental manifestations, which have previously not been reported in detail.

The use of nanoparticles as biomaterials in dentistry.

Maintenance of oral health is a major challenge in dentistry. Different materials have been used to treat various dental diseases, although treatment success is limited by features of the biomaterials used. To overcome these limitations, materials incorporated with nanoparticles (NPs) can be used in dental applications including endodontics, periodontics, tissue engineering, oral surgery, and imaging. The unique properties of NPs, including their surface:volume ratio, antibacterial action, physical, mechanical, and biological characteristics, and unique particle size have rendered them effective vehicles for dental applications. In this review, we provide insights into the various applications of NPs in dentistry, including their benefits, limitations, properties, actions and future potential.

Rethinking Lethality in Youth Suicide Attempts: First Suicide Attempt Outcomes in Youth Ages 10 to 24.

OBJECTIVE: Although suicide is the second most frequent cause of death in American youth, suicide research has heretofore been confined to convenience samples that represent neither psychiatric nor general populations and that fail to include individuals dying at their first attempts. These limitations were addressed by assembling a youth cohort followed from the first medically recorded attempt (index attempt [IA]). It was hypothesized this approach would more accurately represent the prevalence of completed suicide after an attempt and underscore lethality based on method. METHOD: This study draws from a previously reported retrospective-prospective all-age cohort identified through the Rochester Epidemiology Project. The original 1,490-subject sample included 813 Olmsted County youth 10 to 24 years old (n = 258 male, n = 555 female; 54.6% of total cohort) with IAs from January 1, 1986 through December 31, 2007 and followed until December 31, 2010. RESULTS: Twenty-nine of 813 subjects (3.6%) killed themselves during the study period, with 28 of 29 dying before their 25th birthday and 20 of 28 (71.4%) dying at their first attempt. Despite composing only 31.7% of the cohort (258 of 813), male subjects composed most suicides: 23 of 29 (79.3% of suicides; 8.9% of male subjects) versus 6 of 29 female subjects (20.7% of suicides; 1.1% of female subjects). Eighty-five percent of all IA deaths involved firearms. More than a third of youth-41.2%-lacked a psychiatric history prior to IA. CONCLUSION: These data show that more than half the IAs occurred in youth, with approximately three-fourths of completed youth suicides occurring at the IAs. In parsing cause of IA death in the all-age cohort, the contribution of firearms figured even more prominently in the subsample of youth (85.0%) than in those at least 25 years old (64.3%). The high IA lethality suggests that prevention efforts commencing after the IA are too late for most victims.

Slitted leading edge profiles for the reduction of turbulence-aerofoil interaction noise.

Aerofoils operating in a turbulent flow are an efficient source of noise radiation by scattering vorticity into sound at the leading edge (LE). Much work has now been undertaken demonstrating the effectiveness of serrations, or undulations, introduced onto the LE can substantially reduce broadband LE interaction noise. However, all of this work is focused on sinusoidal LE serration profiles. In this paper, an alternative profile is proposed that is capable of providing significantly greater noise reductions than the maximum noise reductions that can be achieved by single-wavelength serrations of the same peak-to-root amplitude. In its most general realization, the LE serration profiles simply comprise of a sawtooth or single wavelength serration for which every root has a single narrow slit. This simple geometry, upon interaction with a turbulent flow, produces compact source regions at either end of the slit, which then destructively interfere, leading to considerably less efficient noise radiation than conventional single-wavelength geometries. The paper will demonstrate experimentally that even slits by themselves can provide greater levels of noise reduction than conventional profiles of the same peak-to-root amplitude.

An overview of application of silver nanoparticles for biomaterials in dentistry.

Oral cavity is a gateway to the entire body and protection of this gateway is a major goal in dentistry. Plaque biofilm is a major cause of majority of dental diseases and although various biomaterials have been applied for their cure, limitations pertaining to the material properties prevent achievement of desired outcomes. Nanoparticle applications have become useful tools for various dental applications in endodontics, periodontics, restorative dentistry, orthodontics and oral cancers. Off these, silver nanoparticles (AgNPs) have been used in medicine and dentistry due to its antimicrobial properties. AgNPs have been incorporated into biomaterials in order to prevent or reduce biofilm formation. Due to greater surface to volume ratio and small particle size, they possess excellent antimicrobial action without affecting the mechanical properties of the material. This unique property of AgNPs makes these materials as fillers of choice in different biomaterials whereby they play a vital role in improving the properties. This review aims to discuss the influence of addition of AgNPs to various biomaterials used in different dental applications.

Mucocele on Lower Lip: A Case Series.

Mucocele is a common salivary gland disorder that can appear in the lacrimal sac, paranasal sinuses, oral cavity, appendix, or gall bladder. These lesions occur due to mucous accumulation resulting from the alteration of minor salivary glands. Lower lip is the most common site of occurrence of these lesions in the oral cavity and most probable cause is trauma or habit of lip biting. Diagnosis is mainly clinical due to its pathognomonic presentation. We report a case series of mucocele in children treated by conventional surgical excision of the lesion.

A Predictive Model for Root Caries Incidence.

This study aimed to find the set of risk indicators best able to predict root caries (RC) incidence in caries-active adults utilizing data from the Xylitol for Adult Caries Trial (X-ACT). Five logistic regression models were compared with respect to their predictive performance for incident RC using data from placebo-control participants with exposed root surfaces at baseline and from two study centers with ancillary data collection (n = 155). Prediction performance was assessed from baseline variables and after including ancillary variables [smoking, diet, use of removable partial dentures (RPD), toothbrush use, income, education, and dental insurance]. A sensitivity analysis added treatment to the models for both the control and treatment participants (n = 301) to predict RC for the control participants. Forty-nine percent of the control participants had incident RC. The model including the number of follow-up years at risk, the number of root surfaces at risk, RC index, gender, race, age, and smoking resulted in the best prediction performance, having the highest AUC and lowest Brier score. The sensitivity analysis supported the primary analysis and gave slightly better performance summary measures. The set of risk indicators best able to predict RC incidence included an increased number of root surfaces at risk and increased RC index at baseline, followed by white race and nonsmoking, which were strong nonsignificant predictors. Gender, age, and increased number of follow-up years at risk, while included in the model, were also not statistically significant. The inclusion of health, diet, RPD use, toothbrush use, income, education, and dental insurance variables did not improve the prediction performance.

Oral phenotype and variation in focal dermal hypoplasia.

Focal dermal hypoplasia (FDH) or Goltz Syndrome (OMIM# 305600) is an X-linked dominant ectodermal dysplasia caused by mutations in the PORCN gene. This gene encodes an endoplasmic reticulum transmembrane protein that is involved in processing the embryonically critical WNT signaling proteins. Individuals diagnosed with FDH were recruited to participate in the study through the National Foundation for Ectodermal Dysplasia. Individuals were evaluated to characterize the FDH phenotype. Each participant completed a brief dental survey and oral evaluation using artificial light. To identify the oral soft and hard tissue findings 19 individuals (16 female and 3 male) participated with a median age of 10 years (range 2-56 years). Soft and hard tissue defects were present in 68% (13) and 94% (18) of the patients, respectively. Dental anomalies were highly prevalent with 68% (13) demonstrating vertical enamel grooving, 52% (10) having peg shaped tooth deformities, and 78% (15) having enamel hypoplasia with or without discoloration. Cleft lip and cleft palate presented in 15% (3) of the participants. Other findings included 57% (11) having intra-oral lipoma or papilloma with no site predilection. Dental malocclusions were common with 63% (12) having some degree of malocclusion with 15% (3) of participants having class III malocclusion with an anterior dental cross bite. Participants frequently reported speech problems or difficulty with chewing (73%; N = 14). This study shows there is marked variation in the oral phenotype of individuals with FDH and underscores the important role of WNT signaling in oro-facial development.