Treatment Outcomes of Pulpotomy in Primary Teeth with Irreversible Pulpitis: A Systematic Review and Meta-Analysis.

AIM: This systematic review and meta-analysis aimed to evaluate the success rates of pulpotomy treatment for irreversible pulpitis in primary teeth. METHODS: This study was registered and conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. Relevant studies published between January 1980 and April 2023 were identified across eight online databases and two paediatric dentistry textbooks. Study selection, data extraction, and quality assessment were conducted by multiple investigators independently. Data analysis involved single-arm and two-arm meta-analyses, leave-one-out sensitivity analysis, meta-regression, and assessment of publication bias. The risks of bias were evaluated using the Cochrane Collaboration's assessment tools. The levels of evidence were determined using the Oxford Centre for Evidence-Based Medicine (OCEBM) tool. RESULTS: Five primary studies were included. The weighted mean overall success rates at 6-month and 12-month follow-ups were 97.2% and 94.4%, respectively. Two-arm meta-analysis revealed no significant difference (p > 0.05) between the use of mineral trioxide aggregate (MTA) and non-MTA bioceramic-based materials as pulpotomy medicaments. The sample size of each study did not affect the degree of data heterogeneity. Egger's test revealed no significant publication bias. CONCLUSIONS: Pulpotomy may be regarded as an alternative modality for treating primary teeth with irreversible pulpitis. Nevertheless, future well-designed trials and extended follow-up periods are warranted.

Association between passive smoking and dental caries status in children: A cross-sectional analytical study.

BACKGROUND: Several risk factors contribute to the development of dental caries in children, including sociodemographic, dietary, oral hygiene-related and other miscellaneous factors. Maternal smoking was highly associated with dental caries when compared to smoking by fathers or other household members. OBJECTIVES: The aim of the study was to determine the prevalence of dental caries and their association with exposure to environmental tobacco smoke (ETS) among 5- to 10-year-old students attending private and government schools. MATERIAL AND METHODS: A cross-sectional analytical study was conducted among schoolchildren. Data was collected from the primary caregivers using a pre-tested form to assess the ETS exposure under 5 domains based on history: antenatal exposure; exposure during the index period; exposure in the school neighborhood; exposure in restaurants/roadside stalls; and exposure in bus stops/railway stations. Dental caries was assessed based on the World Health Organization (WHO) guidelines from 1997. The association was reported using prevalence ratios (PRs) (95% confidence interval (CI)). RESULTS: Data was obtained from 211 schoolchildren attending government (39.8%) and private schools (60.2%). The overall prevalence (95% CI) of dental caries was 49.3% (42.5-56.1%). Among all the risk factors evaluated in the study, exposure to ETS was associated with a significantly increased risk of dental caries. The adjusted prevalence ratio (APR) of ETS exposure varied with the mother's educational status and high sugar exposure, although this was statistically insignificant. CONCLUSIONS: The prevalence of dental caries among schoolchildren aged 5 to 10 years in the city was moderate and similar to the national average. Among the risk factors assessed in the study, antenatal exposure to ETS was found to significantly increase the prevalence of dental caries by 41% after adjusting for other factors. Therefore, it is important to educate parents on the causal role of ETS exposure in dental caries.

Accuracy of different dental age assessment methods to determine chronological age among children with special needs.

AIM: This study aimed to validate the accuracy of dental age (DA) based on the dental development of permanent teeth in children with special needs using Demirjian, Willems, and London Atlas methods and to correlate the dental and chronological age (CA) of children with special needs in Malaysia. MATERIALS AND METHODS: The panoramic radiographic images belonging to children with special needs from the two teaching dental hospitals in Malaysia aged between 5 and 16 years were included in the study. The evaluation was performed by two observers using three methods (London Atlas, Demirjian, and Willems methods) to estimate the accurate DA. The outcome was determined by comparing the mean of the DA and CA. RESULTS: A total of 52 panoramic radiographs were available for the analysis. The London Atlas and Demirjian methods overestimated the DA with a mean of 0.05 and 0.20 years, respectively, while the Willems method underestimated by 0.19 years. The London Atlas method was highly precise and accurate, while Demirjian and Willems methods were the least precise and accurate. CONCLUSION: The London Atlas method of DA estimation is highly accurate and valid for children with special needs in the Malaysian population, followed by the Willems and Demirjian methods.

Risk Prediction of Maxillary Canine Impaction among 9-10-Year-Old Malaysian Children: A Radiographic Study.

Background: Early diagnosis and interceptive treatment of the maxillary canine impaction is crucial as it reduces treatment complexity and decreases complications and adverse outcomes. Aim and Objectives. To determine the mean maxillary canine position among 9-10-year-old children and predict the risk of impaction of the maxillary canines. Methodology. Panoramic radiographs (PANs) of 289 healthy children aged between 9 and 10 years were observed where the average position of maxillary canines was related to the lateral incisor, sector locations, and angulations to the bicondylar line were traced. The average position was obtained by using descriptive statistics. One sample Wilcoxon signed-rank test is done to predict the risk of canine impaction by comparing the data obtained to the average position from prior studies. Results: A total of 289 PANs (126 males and 163 females) were utilized for the analysis. The findings showed that the average position of the maxillary canines in our population was statistically different from the average position of nonimpacted canines in previous studies. However, on average, more than 85% of canines in our population were still located within the safe range of satisfactory position, with females showing slight predominance outside of the acceptable range. The mean scores of the angles between the right canine and lateral incisor were significantly higher among females than males (p = 0.001). Similarly, females had a significantly higher mean angle of the left canine than males (p < 0.001). In regard to the angles between the bicondylar line and permanent maxillary canine, the mean scores were not significantly different (p > 0.05) on both the left and right side. Conclusion: There is a low risk of impaction of maxillary canines in the Malaysian population. However, more retrospective studies using more radiographic and clinical indicators need to be done to confirm the risk of impaction further.

Synbiotic Musa acuminata skin extract and Streptococcus salivarius K12 inhibit candida species biofilm formation.

This study aimed to determine the effect of synbiotic Musa acuminata skin extract (MASE) and Streptococcus salivarius K12 (K12) on Candida species biofilm formation. Liquid chromatography quadrupole time-of-flight (LC-Q-TOF-MS) was conducted to characterize MASE. To determine the effect of synbiotic on Candida biofilm, 200 µL of RPMI-1640 containing Candida, K12, and MASE were pipetted into the same well and incubated at 37 °C for 72 h. A similar protocol was repeated with K12 or MASE to determine the probiotic and prebiotic effects, respectively. Dimorphism, biofilm biomass, and Candida total cell count (TCC) were determined. A total of 60 compounds were detected in MASE. C. albicans (ALT5) and Candida lusitaniae exhibited the highest reduction in biofilm biomass when co-cultured with prebiotic (77.70 ± 7.67%) and synbiotic (97.73 ± 0.28%), respectively. All Candida spp. had decreased TCC and hyphae when co-cultured with synbiotic. In conclusion, MASE and K12 inhibit Candida biofilm formation.

Knowledge, Perceived Risk, and Preventive Behaviors amidst Covid-19 Pandemic among Dental Students in Malaysia.

PURPOSE: Coronavirus disease 19 (COVID-19) has affected dental education in Malaysia. However, studies on dental students' knowledge, perception, and behaviors with regards to COVID-19 are very limited. Thus, this study aims to determine the knowledge status, perceived risk, and preventive behaviors of dental students in Malaysia regarding COVID-19. METHODS: A cross-sectional study was conducted among students from 13 dental schools across Malaysia using online questionnaires. RESULTS: From 355 respondents, 93.5% obtained a high score of knowledge of COVID-19. Female respondents scored higher than males in perceived risks and preventive behaviors. Chinese respondents scored highest in knowledge, while Malay respondents had the highest perceived risk score. The mean preventive behavior score did not vary across ethnicity. On-campus students scored higher in knowledge and perceived risk whereas off-campus students practiced more preventive behaviors. Clinical students' knowledge score was higher than preclinical students. Final year students scored higher in knowledge and perceived risk compared to their juniors. CONCLUSION: The majority of dental students have good knowledge and a high perceived risk of COVID-19, and they practiced most of the preventive behaviors. However, the latest information on this disease should be incorporated into dental schools' curriculums and updated periodically.

The effect of multisensory-adapted dental environment on children's behavior toward dental treatment: A systematic review.

OBJECTIVE: The objective was to assess the effectiveness of multisensory-adapted environment on children's behavior toward dental treatment, specifically in special need children. MATERIALS AND METHODS: The main health databases were selected such as SCOPUS, Medline, CINAHL, and Dentistry and Oral Sciences. A set of keywords was defined to identify the relevant article were (i.e., Snoezelen OR Multisensory OR sensory-adapted and Dentistry OR Oral). The articles were selected and extracted by two reviewers based on the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines and some predetermined exclusion criteria. Furthermore, the risk of bias assessment was done. RESULTS: A total of 317 papers were selected at the first phase from SCOPUS (97 papers), Medline (108 papers), CINAHL (110 papers), and Dentistry and Oral Sciences (2 papers). After applying the inclusion and exclusion criteria and duplicated papers were removed, only four eligible papers were selected for final synthesis. CONCLUSIONS: Multisensory-adapted dental environment effectively improves oral health behavior among special needs children in terms of physiological changes, behaviors, pain, and sensory discomfort. Thus, the clinician may introduce this approach in their clinical settings.

Knowledge and Perceptions Regarding Coronavirus (COVID-19) among Pediatric Dentists during Lockdown Period.

AIM: To assess the knowledge and perceptions of COVID-19 among pediatric dentists based on their dependent source of information. METHODS: A descriptive-analytical cross-sectional survey using a self-administered questionnaire with 23 questions was sent via Google forms to pediatric dentists. All participants were divided into three groups [postgraduate residents (PGs), private practitioners (PP), and faculty (F)]. The comparison of knowledge and perception scores was made based on occupation, source of information, and descriptive statistics used for the analysis using SPSS 21.0 (IBM, Armonk, NY, USA). RESULTS: A total of 291 pediatric dentists completed the survey, and the majority of them were females (65%). Overall, good mean scores were obtained for knowledge (9.2 ± 1.07) and perceptions (5.6 ± 1.5). The majority of the participants used health authorities (45%) to obtain updates on COVID-19, while social media (35.1%) and both (19.6%) accounted for the next two. A statistically significant difference (p < 0.05) was found among different pediatric dentists groups for relying on the source of information. CONCLUSION: Overall good pediatric dentists showed sufficient knowledge regarding COVID-19. The pediatric dentists' age, occupation, and source of information influenced knowledge regarding COVID-19, whereas perceptions were influenced by age and gender of the participants. Health authorities successfully educated pediatric dentists than the social media.

Probiotic inhibits oral carcinogenesis: A systematic review and meta-analysis.

OBJECTIVES: This systematic review aimed to investigate the effects if probiotics can inhibit oral carcinogenesis. DESIGN: PubMed, Web of Science, Scopus, and PLOS databases were searched up to February 2020 to identify randomised controlled trials that fulfilled the eligibility criteria. Joanna Briggs Institute (JBI) Critical Appraisal Tool was used for quality assessment of articles. This review was performed according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA-P) 2015 protocol guidelines. RESULT: The initial search retrieved 774 articles. Of these, only five articles were included in the qualitative synthesis. Two out of the five papers were further analysed for quantitative synthesis in meta-analysis. The majority of the included studies were found to be of "moderate quality". The qualitative synthesis found four probiotics that exhibited potential therapeutic effects in oral carcinogenesis, includingAcetobacter syzygii, AJ2, Lactobacillus plantarum, and Lactobacillus salivarius REN. Among them, the application of L. salivarius REN resulted in a 95 % lower risk for developing oral cancer (p < 0.05). CONCLUSION: It is known that probiotics have the potential to inhibit oral carcinogenesis, thus supporting the hypothesis of the study. The ability of L. salivarius REN to inhibit the development of oral cancer suggested that this bacterium can be a potential inhibitory agent against oral carcinogenesis.

Oral health status of children with type 1 diabetes: a comparative study.

BACKGROUND: The aim of this study was to compare the oral health status of children with type 1 diabetes and healthy controls. METHODS: This comparative study involved 64 children, 32 children with type 1 diabetes and 32 age- and gender-matched controls. Oral health examination was conducted using WHO criteria. Dental caries experience was recorded using DMFT/dmft index and periodontal parameters were assessed using plaque, gingivitis, gingival bleeding and calculus indexes. Dental caries and periodontal parameters between the two groups were compared using the Mann-Whitney U-test. RESULTS: Children with diabetes exhibited significantly greater plaque deposits (p=0.01) and a higher mean plaque index (p<0.01), when compared to healthy subjects. No significant difference in DMFT and dmft scores, mean bleeding index, calculus index and gingival index was found between the two groups. CONCLUSIONS: Children with type 1 diabetes had a poor oral health status with greater plaque accumulation than children without diabetes.

Oral health of children with type 1 diabetes mellitus: A systematic review.

AIM: This systematic review investigated the oral health status of children with type 1 diabetes. METHODS: A systematic search was conducted using PubMed/Medline, Web of Knowledge, SCOPUS and EMBASE. The search included all studies published from inception of database to January 2014. A total of 1179 abstracts were analyzed for selection in 2 phases. The first phase selection was based on the title and abstracts alone. The selected abstracts were then included for second phase, where full articles were obtained. The selection was carried out by 2 independent reviewers (Kappa value=0.809). Only 37 articles were included for final analysis in this review. RESULTS: There is conflicting evidence in the caries experience between children with type 1 diabetes and healthy children. For periodontal health, most studies reported significantly greater plaque accumulation and higher gingival index in children with type 1 diabetes. Cohort studies reported no significant differences in perioodontal parameters over time. CONCLUSIONS: There is conflicting evidence regarding the caries experience of children with type 1 diabetes, but they exhibit poorer periodontal health status with greater plaque accumulation compared to healthy children. Further studies are warranted to assess the oral health status of children with type 1 diabetes.