Perception of Pain With Bitewing, DIAGNOcam, and Teeth Separation Amongst Children.

BACKGROUND: This study evaluated the pain and discomfort associated with 3 diagnostic techniques for proximal carious lesions in children aged 5 to 8 years: bitewing (BW) radiographs, DIAGNOcam, and temporary teeth separation. METHODS: The study included 60 healthy children between the ages of 5 and 8 years who had no prior history of dry mouth or mouth breathing, were definitely positive or positive based on Frankl Behavioral Rating Scale, had at least one pair of matched bilateral primary molars and/or permanent first molars in close contact with the adjacent tooth, and were free of restorations and frank cavitation. Each patient evaluated all 3 techniques. The pain and discomfort ratings were obtained by the Wong-Baker FACES Pain Rating Scale immediately after taking 2 standardised BW radiographs or undergoing use of DIAGNOcam and 2 days after temporary teeth separation with elastic separators by a single trained and experienced paediatric dentist. RESULTS: The DIAGNOcam procedure resulted in much higher pain and discomfort (3.69 ± 3.10) than the other 2 diagnostic techniques. Within-participant pain and discomfort scored significantly higher with DIAGNOcam compared to BW radiographs (P < .001) and temporary teeth separation (P = .002). CONCLUSIONS: The DIAGNOcam diagnostic technique caused much more pain and discomfort than BW radiographs and temporary teeth separation using orthodontic elastic separators. The report is part of a randomised clinical trial that was registered at www. CLINICALTRIALS: gov under the identifier NCT03685058.

Oral health related knowledge, attitude and behavior among group of mothers in relation to their primary school children's oral health: a cross-sectional study.

The etiology of oral diseases in children is complex and multifactorial. The oral health of children can be influenced by various factors, including parental knowledge, attitudes and behaviors, as well as socioeconomic status. The objective of this study was to assess, among mothers of children aged 6-12 years, (1) mothers' knowledge about their children's oral health, (2) mothers' attitude toward their children's oral health, and (3) mothers' dental behavior concerning their oral health and to evaluate their influence on their children's dental caries. This cross-sectional study involved three questionnaires to be filled in by mothers of primary school children in addition to an oral examination of their children to measure decayed, missing, filled teeth for primary (dmft) and permanenet (DMFT) dentitions. The mother-child pairs were recruited through multistage stratified random sampling of primary schools in Jeddah, Saudi Arabia. The questionnaire was comprised of four sections: 1-demographic characteristics and socioeconomic status 2-Hiroshima University Dental Behavioral Inventory (mothers' attitudes and behavior pertaining to their oral health) 3-mothers' knowledge regarding the oral health of their children 4-mothers' attitude toward their children oral health. A total of 1496 mother-child pairs completed the study. The mean values of dmft were 4.08 ± 3.47; DMFT was 1.82 ± 2.07; total dmft and DMFT were 5.65 ± 4.05. According to the questionnaire results, mothers in private schools had a more favorable attitude and behavior toward their oral health, as well as a more favorable knowledge and attitude toward their children's oral health. The multiple linear regression model revealed that children's dmft/DMFT scores were significantly related to mother education, mother questionnaire scores, and the Simplified Oral Hygiene Index. Children's oral health is significantly impacted by oral health-related knowledge, attitude and behaviors of their mothers in addition to income status and education level.

Non-Destructive In Vitro Evaluation of an Internal Adaptation of Recent Pulp-Capping Materials in Permanent Teeth Using OCT and Micro-CT.

The objective of this study was to assess and compare the internal adaptation of various pulp-capping materials, namely TheraCal, Biodentine, and mineral trioxide aggregate (MTA), on the dentin of permanent teeth through the utilization of micro-computed tomography (MCT) and optical coherence tomography (OCT). Thirty permanent molars were divided into three groups using a random process: group A (TheraCal), group B (Biodentine), and group C (MTA, which served as the control group). On the buccal surface of each tooth, a class V cavity of a standardized cylindrical shape was prepared. Subsequently, the respective pulp-capping material was applied to the cavity based on the assigned group, followed by restoration with composite resin. Based on the MCT results, it was observed that group A had a considerably larger gap volume in comparison to groups B and C (p < 0.001). There was no significant difference in gap volume between groups B and C. Regarding the OCT findings, group A displayed a substantially higher level of light reflection than groups B and C (p < 0.001). Group C exhibited a significantly lower level of light reflection in comparison to group B (p < 0.001). Biodentine and MTA revealed similar outcomes in terms of how well they adhered to the dentinal surface in permanent teeth. Both materials exhibited superior performance in comparison to TheraCal. The utilization of OCT in clinical practice could be advantageous as it enables dentists to monitor and evaluate restorations during post-treatment follow-up. It is imperative to intensify efforts aimed at making OCT equipment more accessible and applicable, overcoming its current limitations, and allowing for its widespread utilization in clinical practice.

Effect of Light-Curable Resin-Modified Glass Ionomer Varnish on Non-Cavitated Proximal Caries Lesions in Primary Molars: A Randomized Controlled Trial.

The purpose of this study was to radiographically and clinically assess, after six and twelve months, the additive effect of light-curable resin-modified glass ionomer (LCRMGI) varnish on preventive standard-of-care measures (sodium fluoride varnish, oral hygiene instructions, and dietary counseling) for the treatment of non-cavitated proximal carious lesions in primary molars. This prospective, split-mouth, randomized clinical trial recruited 5-8-year-old children with at least one pair of bilateral non-cavitated proximal carious lesions in the enamel or outer third of the dentin. The lesions were randomized into one of two groups: experimental (which received LCRMGI varnish with the preventive standard-of-care measures) or control (which received the preventive standard-of-care measure). A total of 47 out of 53 participants, with 70 out of 80 pairs, completed the study. Radiographically, lesions in the experimental groups were more likely to regress after six (OR = 3.25) and twelve months (OR = 2.67), but it was not statistically significant (p = 0.052 and p = 0.055, respectively). Clinically, the experimental group showed significantly higher regression rates than the control group after six and twelve months (p = 0.041 and p = 0.003, respectively). The LCRMGI varnish demonstrated promising potential as an adjuvant to preventive standard-of-care measures in promoting regression and inhibiting the progression of non-cavitated proximal carious lesions.

Genotoxicity and cytotoxicity of cone beam computed tomography in children.

BACKGROUND: Dental radiographs are essential tools for diagnosis. However, there are significant concerns about the dangerous effect of radiation especially on children. The aim of this study was to evaluate genotoxicity and cytotoxicity in the exfoliated cells of buccal mucosa of children subjected to Cone Beam Computed Tomography (CBCT). METHODS: The study included 18 healthy children aged (9-12 years) who were exposed to CBCT. All CBCT scans were performed with the i-CAT CBCT. Exfoliated buccal cells were scraped from the left and right cheek immediately before the exposure, after 10 ± 2 days, and after 1 month. Cells were stained using Feulgen/fast green stain and examined under light microscopy. Genotoxicity (Micronuclei) and cytotoxicity (condensed chromatin, karyorrhexis, pyknosis, and karyolysis) were scored. Statistical analysis was performed using the McNemar test, Wilcoxon Signed-Rank test, and Mann-Whitney U test at a significance level of p < 0.05. RESULTS: There were statistically significant differences in the mean percentages of micronuclei, condensed chromatin, karyorrhexis, pyknosis, and karyolysis before and 10 ± 2 days after the CBCT scan (p < 0.05). There were no statistically significant differences in the frequency of micronuclei, condensed chromatin, karyorrhexis, or pyknosis before and 1 month after the exposure (p > 0.05) except for karyolysis (p < 0.05). CONCLUSIONS: CBCT may induce genotoxicity and cytotoxicity in buccal mucosa cells of children. Therefore, CBCT should not be prescribed unless necessary as it cannot be considered a risk-free procedure.

Tissue Engineering of Necrotic Dental Pulp of Immature Teeth with Apical Periodontitis in Dogs: Radiographic and Histological Evaluation.

AIM: To evaluate tissue engineering technology to regenerate pulp-dentin like tissues in pulp canals of immature necrotic permanent teeth with apical periodontitis in dogs. STUDY DESIGN: The study was performed on 36 teeth in 12 dogs. The experiment was carried out using split mouth design. In each dog 3 teeth were selected for implementing the study procedure. Apical periodontitis was induced in Group A and B teeth. Group (A): immature upper left 2nd permanent incisors that were transplanted with a construct of autologous dental pulp stem cells with growth factors seeded in a chitosn hydrogel scaffold. Group (B): immature upper right 2nd permanent incisor that received only growth factors with scaffold. A third tooth in each dog was selected randomly for isolation of dental pulp stem cells (DPSCs). Both groups were closed with a double coronal seal of white MTA (Mineral trioxide aggregate) and glass ionomer cement. Both groups were monitored radiographically for 4 months and histologically after sacrificing the animals. RESULTS: There was no statistically significant difference in radiographic findings between group (A) and group (B) for healing of radiolucencies, while there was statistically significant difference between group (A) and group (B) regarding radicular thickening, root lengthening and apical closure. Histologically, group (A) teeth showed regeneration of pulp- dentin like tissue while group (B) teeth did not show any tissue regeneration. CONCLUSION: Dental pulp stem cells and growth factors incorporated in chitosan hydrogel are able to regenerate pulp- dentine like tissue and help in complete root maturation of non-vital immature permanent teeth with apical periodontitis in dogs.

Effect of Probiotic Lactobacillus reuteri on Salivary Cariogenic Bacterial Counts among Groups of Preschool Children in Jeddah, Saudi Arabia: A Randomized Clinical Trial.

OBJECTIVES: To evaluate the effect of probiotic Lactobacilli reuteri lozenges on caries-associated salivary bacterial counts (Mutans streptococci and Lactobacillus), dental plaque accumulation, and salivary buffer capacity in a group of preschool children. STUDY DESIGN: The study group consisted of 178 healthy children (aged 3-6 years). Children were randomly grouped: the experimental group (n = 90) received L. reuteri probiotic lozenges and the control group (n = 88) received placebo lozenges, twice daily, for 28 days. Salivary Mutans streptococci and Lactobacillus counts, and buffer capacity were assessed using chair-side caries-risk test (CRT®) kits. The Simplified Oral Hygiene index (OHI-S) was used to assess dental plaque accumulation at baseline and after 28 days. RESULTS: After 28 days, the experimental group had a statistically significant reduction in Mutans streptococci and lactobacilli (p = 0.000 and p = 0.020, respectively) and both groups had less plaque accumulation than at baseline. While the buffer capacity in the experimental group increased more than in the control group, it was not statistically significant (p = 0.577). Compliance was 90%, with no adverse events. CONCLUSIONS: Consumption of probiotic lozenges containing L. reuteri reduces caries-associated bacterial counts significantly. Probiotics consumption may have a beneficial caries-preventive effect.

Oral Health Quality of Life in Children with Cerebral Palsy: Parental Perceptions.

OBJECTIVE: To assess the parents' perception of the oral health-related quality of life (OHRQOL) in children with Cerebral Palsy (CP) and compare it with normally developing children. STUDY DESIGN: 63 children with CP were recruited from 8 disability centers, and 99 healthy controls were recruited from 5 elementary schools. The ages of the children in both groups were from 6-12 years. The Franciscan Hospital for Children Oral Health-Related Quality of Life (FHC-OHRQOL) was used to measure the OHRQOL and an oral examination was conducted in the schools/centers of the children to assess the teeth, gingival health, and oral hygiene. RESULTS: The FHC-OHRQOL showed a significant difference in 3 out of 4 sections indicating lower OHRQOL in the CP group. The examination showed no significant difference in the dental and gingival health and in the level of oral hygiene. CONCLUSION: The OHRQOL of children with CP is significantly lower than that of normally developing children although the oral health status of children with CP is not significantly different from that of normally developing children.

Dental Pulp Revascularization of Necrotic Permanent Teeth with Immature Apices.

OBJECTIVES: The treatment of immature necrotic teeth with apical periodontitis presents challenges in endodontic and pediatric dentistry. Revascularization is a recent treatment for such cases as an alternative to conventional apexification. The purpose is to examine the effect of a pulpal revascularization procedure on immature necrotic teeth with apical periodontitis. STUDY DESIGN: Twenty patients were enrolled for pulp revascularization procedure by root canal disinfection using a triple antibiotic mixture for 1-2 weeks, followed by creating a blood clot, sealing the root canal orifice using white mineral trioxide aggregate and a coronal seal of composite resin. Patients were recalled periodically for up to 24 months. RESULTS: During follow-up, all patients were asymptomatic. Three cases of chronic apical periodontitis showed clinical disappearance of the sinus tract 2 weeks after treatment. Radiography revealed progressive periapical radiolucency resolution within the first 12 months. Within 12-24 months, the treated teeth showed progressive increases in dentinal wall thickness, root length and continued root development. CONCLUSIONS: Clinical and radiographic evidence showed successful revascularization treatments of immature necrotic permanent teeth with apical periodontitis. More studies are necessary to understand the underlying mechanisms and to perform histopathology of the pulp space contents after revascularization procedures.

Sodium Hypochlorite Versus Formocresol and Ferric Sulfate Pulpotomies in Primary Molars: 18-month Follow-up.

PURPOSE: This study's purpose was to compare the clinical and radiographic success rates of 5.25 percent Sodium Hypochlorite (NaOCl) pulpotomies to Formocresol (FC) and Ferric Sulfate (FS) in decayed primary molars. METHODS: Eighty-one primary molars, randomly divided into three groups, were treated with one of three different pulpotomy materials; NaOCl, FC and FS. The outcomes of the different groups were assessed clinically and radiographically every six months over 18 months. Chi-square test was used to detect differences in outcome measures in all groups. RESULTS: At six months, clinical and radiographic success rates were 100 percent for each group (27/27). At 12 months, clinical success was 100 percent (24/24), 96 percent (24/25), and 95.7 percent (22/23) for NaOCl, FC, and FS respectively. The radiographic success was 95.8 percent (23/24) for NaOCl group, and 100 percent for FC (25/25), and FS (23/23). At 18 months, the clinical success was 83.3 percent (20/24), 96 percent (24/25), and 87 percent (20/23) for NaOCL, FC, and FS respectively. The 18 month radiographic success was 91.7 percent (22/24), 100 percent (25/25), and 95.7 percent (22/23) for NaOCl, FC, and FS respectively. No significant differences were found in clinical or radiographic outcomes between the three groups at six, 12 and 18 months. CONCLUSION: The three pulpotomy medicaments yielded similar outcomes.

Early prevention of childhood caries with maternal xylitol consumption.

OBJECTIVE: To evaluate the effect of maternal xylitol consumption on children's salivary mutans streptococci (MS) level, caries activity, and plaque accumulation in contrast with maternal fluoride varnish in a group of mother-child pairs. METHODS: In this randomized controlled trial, the study subjects were 60 mother-child pairs recruited from the pediatric dentistry clinic and the hospital well baby clinic at King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia. The sample was recruited on the basis of maternal high salivary MS levels, and a child aged 10-36 months. The subjects were randomly assigned to experimental and control groups. Mothers in the experimental group chewed xylitol gum, 1.8 gram (66% xylitol by weight), 3 times/day for 3 months. Mothers in the control group received fluoride varnish. Both groups received oral hygiene instructions, dietary counseling, and restorative treatment. Children were examined after 6, 12, and 24 months from the initiation of the study to evaluate salivary MS levels, caries, and plaque accumulation. RESULTS: There was an increase in MS levels in the experimental and control children at 24 months, which was non-significant in the experimental group, and significantly higher in the control group when compared with the baseline (p=0.008). The decayed, missing, filled scores of the children in the experimental group showed no change after 24 months, contrary to the controls that showed a significant increase (p=0.001). Plaque scores revealed no differences over time or between the 2 groups. CONCLUSION: Compared with fluoride varnish, maternal xylitol consumption provided preventive outcomes on salivary MS and caries levels in children.

Genotoxic effects of dental panoramic radiograph in children.

UNLABELLED: This study was completed to evaluate chromosomal damage (micronucleus) and cellular death in exfoliated buccal mucosa cells taken from healthy children following exposure to panoramic radiation during dental radiography. METHOD: Twenty children who underwent panoramic dental radiography for diagnostic purposes were included. Cytological preparations were stained with Feulgen stain, identified under light microscopy. Micronuclei, apoptotic nuclear alterations (condensed chromatin, karyorrhexis, pyknosis) and necrosis (karyolysis) were scored. RESULTS: showed no statistically significant differences in children's micronucleated oral mucosa cells before and after panoramic dental X-Ray exposure. On the other hand, there was a statistically significant increase in nuclear alterations closely related to genotoxicity such as condensed chromatin, karyorrhexis and pyknosis, while karyolysis of oral mucosal cells did not show significant increase after panoramic X-Ray exposure. CONCLUSION: Dental panoramic radiography may not be a factor that induces chromosomal damage, but is able to promote genotoxicity in children.