Alternative Augmentative Communication in paediatric dentistry: a mighty tool to amplify mother tongue's power.

AIM: The role of a child's mother tongue in shaping his/her identity and emotional development is crucial. In the context of paediatric dentistry, this principle should always be reminded. The child's right to effective communication, even when a language barrier exists, is a fundamental principle, as recently stated in the 'Rights from the Start' rights fact sheet. Preserving a child's native language in the dental setting, especially in the context of an increasingly diverse society with a significant number of refugee children, is essential. Augmentative and Alternative Communication (AAC) strategies can assist in bridging language gaps and improving treatment outcomes, blending with the traditional approaches used in paediatric dentistry. The article promotes flexibility, innovation, and empathy in paediatric dentistry to provide optimal care and ensure that every child's rights are respected. CONCLUSION: • The relationship with one's mother language plays a central role in children's growth and in the relationship they can develop with the world, "motherised" by the words of the caregiver. • The interaction between immigrant children from different linguistic and cultural backgrounds and dentists providing their care requires the integration of traditional paediatric dental techniques with AAC strategies that can compensate for deficient oral communication. • Dentists treating immigrant children should follow the suggestions proposed in this article to establish the best and most tailored paediatric setting for the child's specific needs.

Assessing modalities used to alleviate postoperative pain in children receiving dental treatment under general anaesthesia: a systematic review.

Postoperative pain is generally a novel experience among paediatric patients. Topical anaesthetics, distraction procedures, and buffering of anaesthetic solutions have been used in reducing the postoperative pain. In this review, the authors assessed various modalities used to alleviate postoperative pain in children's dental treatment under general anaesthesia. Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocol were strictly adhered to in this systematic review. Specific keywords including postoperative pain, general anaesthesia, children, and dental extraction were used in the search for relevant randomized control trial studies in Web of Science, Scopus and PubMed, and included articles published until June 2021. From a total of 191 abstracts, 21 were reviewed. From the six studies with the usage of non-steroidal anti-inflammatory drugs (NSAIDs) alone or in combination with paracetamol, four observed that the preoperative use of NSAIDs alone or in combination was better than paracetamol alone, one discovered preoperative intravenous paracetamol was better than postoperative intravenous paracetamol, and the remaining study found no difference among various groups. Of two studies comparing the usage of non-steroidal anti-inflammatory drugs with opioid analgesics, one stated intravenous fentanyl in combination was better, while the other study found no difference among groups. The results obtained in this review can be utilized by physicians to control postoperative pain in children undergoing dental treatment under general anaesthesia.

Role of artificial intelligence in behavior management of pediatric dental patients-a mini review.

The influence of behavioral science on various organizations has been experiencing remarkable growth worldwide. With the integration of recent technological advancements, behavioral science's impact has expanded into diverse fields such as finance and policy. The term "artificial intelligence" (AI) has become increasingly prevalent, but it is essential to provide clarity before proceeding. AI pertains to the theory and creation of systems capable of executing tasks that typically necessitate human intelligence. Integrating artificial intelligence (AI) in pediatric dentistry has emerged as a promising avenue to enhance patient care, improve diagnostic accuracy, streamline treatment planning, and augment patient engagement. AI-driven tools such as image analysis, natural language processing, and machine learning algorithms assist in early caries detection, orthodontic treatment planning, behavior management, and personalized oral hygiene education for pediatric patients. This paper presents an overview of AI's applications in pediatric dentistry, particularly behavior management, highlighting its potential to revolutionize traditional pediatric dental practices.

Parental use and acceptance of an accessible, commercially available intraoral camera for teledentistry in their children.

PURPOSE: The potential of combining teledentistry and engaging parents as underutilised resources to monitor paediatric dental health was emphasised during the COVID-19 pandemic and remains underexplored. This study aims to assess parental acceptance and use of a commercially available intraoral camera (IOC) for effective remote monitoring. METHODS: 47 child-parent dyads, where the parent was the main caregiver and the child was treated under general anaesthesia for early childhood caries, were recruited. Caregivers were trained to image their child's teeth on a commercially available IOC. Subsequently, submitted images were reviewed asynchronously by dentists for image quality, presence of dislodged fillings, abscesses, cavitation, and oral hygiene. Post-surgery monitoring was performed using teledentistry at 1 and 2 months and in-person at 4 months. A modified Telehealth Usability Questionnaire (TUQ) was used to record caregiver acceptance for study procedures. RESULTS: A mean TUQ of 6.09 out of 7 was scored by caregivers. Caregiver-reported issues were limited to problems with technique and child uncooperativeness. The number of clear images during the second teledentistry review was improved compared to the first (p = 0.007). 68% of children liked having images of their teeth taken. CONCLUSION: This study supports the feasibility of using an IOC as a clinically appropriate avenue for teledentistry with a high level of caregiver-child acceptance.

The Effect of Temperament on Outcomes of Opioid and Non-Opioid Pediatric Dental Sedation.

Purpose: To assess oral sedation success using midazolam and hydroxyzine with and without meperidine, and to assess the relationship between child temperament and sedation outcomes. Methods: This study recruited children between the ages of 36 and 95 months who were randomly assigned to receive dental treatment with an oral sedation regimen of midazolam (0.5 mg/kg) and hydroxyzine (1.0 mg/kg) with or without meperidine (1.5 mg/kg). Data were collected from the treatment log and electronic health records. Parents completed the Child Behavior Questionnaire Short Form (CBQ-SF) to assess temperament. Results: The study included 37 participants. The overall treatment success rate was 54 percent. There were no significant differences in sedation outcome with age, sex, insurance status, sedation regimen, isolation method or duration of procedure. Children with high pre-operative Frankl behavioral ratings were more likely to have a successful sedation outcome (P <0.01). Children who displayed high soothability experienced higher rates of success (P =0.04), which was more pronounced in the non-opioid group (P <0.01). Conclusion: The study showed low rates of success for a relatively small sample size. There was no difference in sedation success between the opioid group and non-opioid group. However, pre-procedure behavior and temperament characteristic of sooth- ability may warrant more exploration as predictors of sedation success.

Dog-Assisted Therapy (DAT) for the management of anxiety during paediatric dental care. A scoping review.

AIM: Distraction techniques in paediatric dentistry can be effective in decreasing the child's attention span from an unpleasant or stressful procedure. Distraction is achieved through imagination, audio, and/or visual stimuli. It has been shown that the accompaniment and participation of animals or pets, specifically dogs (Dog-Assisted Therapy or DAT), during medical, oral, and therapeutic activities can improve the physical and mental health of patients, especially children. However, there is limited information available regarding the impact of incorporating a certified therapy dog into the paediatric dental environment as a distraction strategy to alleviate anxiety levels during dental procedures. METHODS: This scoping review aimed to identify and review published articles concerning the use of DAT in paediatric dentistry. The article discusses indications, benefits, and potential risks to human health and safety in clinical settings. Eligible sources encompass clinical trials, observational studies, and narrative reviews written in either English or Spanish and published over the last two decades, sourced from four electronic databases. Ultimately, seven pertinent studies were included in the review. CONCLUSION: DAT presents itself as a promising alternative in managing anxiety and stress among children during dental visits. The integration of a therapy dog and its handler into the paediatric oral care team should be thoughtfully considered by clinicians as a means to enhance the comfort and compliance of apprehensive patients.

Violencia contra niños, niñas y adolescentes: actuación del odontólogo y nivel de conocimiento para la detección y atención de casos / Violence against children and adolescents: dentist´s performance and knowledge levels for case detection and care

Objetivo: Analizar el nivel de conocimiento del pro-fesional odontólogo sobre la violencia ejercida en niños, niñas y adolescentes, poniendo énfasis en la importancia de su actuación para la detección, aten-ción y derivación de potenciales casos que posibi-liten, dentro de un contexto multidisciplinario, una intervención oportuna y efectiva. Materiales y méto-dos: Se realizó una encuesta a 132 odontólogos, 123 mujeres y 9 hombres, con experiencia profesional de 2 a 43 años, profesores universitarios especialistas en odontopediatría, cursantes de carreras de espe-cialización y posgrados afines o aquellos que desa-rrollan sus actividades laborales en 2 hospitales pú-blicos de la Ciudad Autónoma de Buenos Aires aten-diendo a menores de edad. La encuesta totalizó 15 preguntas distribuidas en 3 categorías cuyos ejes te-máticos ahondaron respecto al conocimiento sobre violencia ejercida contra menores (Categoría 1), sos-pecha de un presunto maltrato infantil en la consulta (Categoría 2) y factores que condicionan la eventual derivación del caso (Categoría 3). Cada pregunta in-cluida en las 3 categorías se direccionó conforme a si el ámbito profesional del sujeto encuestado era es-pecialista/cursante de posgrado (Grupo 1) u hospi-talario (Grupo 2). Resultados: En la primera categoría se observó una significativa carencia de formación específica en la etapa de grado con un 89% para el grupo 1 y 93,75% para el grupo 2, aunque éstos úl-timos han accedido a cursos de perfeccionamiento y actividades tendientes a incrementar destrezas y aptitudes en un 71,87%, contrastando con el 24% del otro grupo. Asimismo, el 29% del grupo 1 y un 50% del grupo 2 conocían los protocolos establecidos en sus entornos profesionales. Ambos consideraron que el odontólogo no está capacitado para detectar conductas orientativas hacia posibles casos (89%, grupo 1; 87,5%, grupo 2). Para la segunda categoría, el grupo 1 respondió positivamente en un 73%, en tanto que el grupo 2 lo hizo en un 84,38%. En la ter-cera categoría se destacó para el grupo 1 un elevado porcentaje en las preguntas relacionadas al temor por parte del odontólogo de agravar las acciones Objetivo: Analizar el nivel de conocimiento del pro-fesional odontólogo sobre la violencia ejercida en niños, niñas y adolescentes, poniendo énfasis en la importancia de su actuación para la detección, aten-ción y derivación de potenciales casos que posibi-liten, dentro de un contexto multidisciplinario, una intervención oportuna y efectiva. Materiales y méto-dos: Se realizó una encuesta a 132 odontólogos, 123 mujeres y 9 hombres, con experiencia profesional de 2 a 43 años, profesores universitarios especialistas en odontopediatría, cursantes de carreras de espe-cialización y posgrados afines o aquellos que desa-rrollan sus actividades laborales en 2 hospitales pú-blicos de la Ciudad Autónoma de Buenos Aires aten-diendo a menores de edad. La encuesta totalizó 15 preguntas distribuidas en 3 categorías cuyos ejes te-máticos ahondaron respecto al conocimiento sobre violencia ejercida contra menores (Categoría 1), sos-pecha de un presunto maltrato infantil en la consulta (Categoría 2) y factores que condicionan la eventual derivación del caso (Categoría 3). Cada pregunta in-cluida en las 3 categorías se direccionó conforme a si el ámbito profesional del sujeto encuestado era es-pecialista/cursante de posgrado (Grupo 1) u hospi-talario (Grupo 2). Resultados: En la primera categoría se observó una significativa carencia de formación específica en la etapa de grado con un 89% para el grupo 1 y 93,75% para el grupo 2, aunque éstos úl-timos han accedido a cursos de perfeccionamiento y actividades tendientes a incrementar destrezas y aptitudes en un 71,87%, contrastando con el 24% del otro grupo. Asimismo, el 29% del grupo 1 y un 50% del grupo 2 conocían los protocolos establecidos en sus entornos profesionales. Ambos consideraron que el odontólogo no está capacitado para detectar conductas orientativas hacia posibles casos (89%, grupo 1; 87,5%, grupo 2). Para la segunda categoría, el grupo 1 respondió positivamente en un 73%, en tanto que el grupo 2 lo hizo en un 84,38%. En la ter-cera categoría se destacó para el grupo 1 un elevado porcentaje en las preguntas relacionadas al temor por parte del odontólogo de agravar las acciones de violencia familiar (64%) o represalias (55%) contra el niño si efectuaran la derivación. En los mismos ítems, el grupo 2 respondió con porcentajes disímiles (28,13% y 31,25%, respectivamente). Finalmente, se diferenciaron claramente los resultados en cuanto al desconocimiento de los procedimientos a seguir si amerita derivar un caso, con un 71% para el grupo 1 y un 34,38% para el grupo 2. Conclusión: Se hace imperioso instruir y capacitar al profesional odontólogo, concientizándolo sobre la necesidad de conocer la legislación vigente y los mecanismos de detección y ulterior derivación. Si bien aquellos que desempeñan su labor a nivel hospitalario aparecen como mejor preparados para actuar, existe un evidente desconocimiento general que conlleva el riesgo de no advertir o proceder inadecuadamente en casos de violencia que atenta contra la seguridad de niños, niñas y adolescentes (AU)

Objective: To analyze the level of knowledge of the dental professional about violence committed in children and adolescents, emphasizing the importance of their actions for the detection, care and referral of potential cases that allow, within a multidisciplinary context, an intervention timely and effective. Materials and methods: A survey was carried out with 132 dentists, 123 women and 9 men, with professional experience of 2 to 43 years, university professors in the specialty of pediatric dentistry, students of specialization course and related postgraduate courses or those who carry out their work activities in 2 public hospitals in the Autonomous City of Buenos Aires that care for minors. The survey included 15 questions distributed in 3 categories whose thematic axes delved into knowledge about violence committed against minors (Category 1), suspicion of alleged child abuses in the consultation (Category 2) and factors that condition the eventual referral of the case (Category 3). Each question included in the 3 categories is addressed according to whether the professional field of the surveyed subject was a specialist/graduate student (Group 1) or a hospitalist (Group 2). Results: In the first category, a significant lack of specific training is observed in the undergraduate stage with 89% for group 1 and 93.75% for group 2, although the latter have accessed courses and improvement activities aimed at to increase skills and abilities by 71.87%, in contrast to 24% in the other group. Likewise, 29% of group 1 and 50% of group 2 knew the protocols established in their professional environments. Both considered that the dentist is not trained to detect guiding behaviors towards possible cases (89%, group 1; 87.5%, group 2). For the second category, group 1 responded positively by 73%, while group 2 did so by 84.38%. In the third category, a high percentage stood out for group 1 in the questions related to the dentist's fear of aggravating the actions of family violence (64%) or retaliation (55%) against the child if he made the referral. In the same items, group 2 responded with dissimilar percentages (28.13% and 31.25%, respectively). Finally, the results were clearly differentiated in terms of lack of knowledge of the procedures to follow if a case warrants referral, with 71% for group 1 and 34.38% for group 2. Conclusion: It is imperative to instruct and train the professional dentist, raising awareness about the need to know current legislation and the detection and subsequent referral mechanisms. Although those who carry out their work at the hospital level seem to be better prepared to act, there is an evident widespread lack of knowledge that entails the risk of not announcing or acting inappropriately in cases of violence that threaten the safety of children and adolescents (AU)

Intervención interdisciplinaria para la prevención primaria de la caries en lactantes de 0 a 18 meses / Interdisciplinary intervention for the primary prevention of dental caries in children under 18 months

Introducción: la caries es la enfermedad crónica más frecuente en la infancia. La presencia de caries en la dentición temporal es el principal factor de riesgo para desarrollar caries en la dentición definitiva. La mayoría de los factores de riesgo de la caries son modificables y pueden convertirse en elementos para la prevención y control de la enfermedad. Con el objetivo de reducir la incidencia de caries a la edad de 18 meses se diseña una intervención interdisciplinaria de prevención primaria dirigida a familias con niños que se visitan siguiendo el Protocol d’activitats preventives i de promoció de la salut a l’edat pediátrica (PAPPS). Material y métodos: ensayo clínico no aleatorizado, realizado en dos centros de asistencia primaria de Catalunya desde enero de 2019 hasta junio de 2022. En uno de los centros se diseñó e implementó una intervención educativa de prevención primaria de la caries con consejos y habilidades para las familias. En el otro centro se mantuvo el protocolo habitual de recomendaciones. Se evaluó y comparó la incidencia de caries en ambos grupos a la edad de 18 meses con un modelo de regresión logística estimado con el programa R. Resultados: la incidencia de caries a los 18 meses fue superior en los niños del grupo control (OR = 6,0; IC 95% 1,8-20,2), a pesar de que la valoración del riesgo de caries basada en el sistema llamado Caries Management by Risk Assessment (CAMBRA) indicó mayor riesgo de desarrollo de caries en los lactantes del grupo intervención. Conclusión: la intervención interdisciplinaria de prevención primaria de la caries incorporada en los programas de salud infantil reduce la incidencia de caries en los primeros años de vida. (AU)

Introduction: caries is the most common chronic disease in childhood. The presence of caries in the primary dentition is the main risk factor for developing caries in the permanent dentition. Most of the risk factors for caries are modifiable and can become elements for the prevention and control of the disease. With the goal of reducing the incidence of caries in children at age 18 months, we designed an interdisciplinary primary prevention intervention aimed at families with children who attended routine preventive visits within the PAPPS (“Protocol d’activitats preventives i de promoció de la salut a l’edat pediàtrica”) child health programme. Methodology: non-randomized clinical trial carried out in two primary care centres in Catalonia between January 2019 and June 2022. In one of the centres, an educational intervention for the primary prevention of caries was designed and implemented to provide families with guidance and skills. In the other centre, patients received standard care. The incidence of caries was assessed and compared in both groups at age 18 months by means of a logistic regression model fitted with the R software. Results: the incidence of caries at 18 months was higher in children in the control group (OR=6.0; 95% CI: 1.8-20.2), despite the fact that the caries risk assessment by means of the “Caries Management by Risk Assessment” (CAMBRA) protocol indicated a higher risk of caries in infants in the intervention group. Conclusion: the interdisciplinary primary caries prevention intervention integrated into the child health prevention and promotion programme achieved a reduction in the incidence of caries in early childhood. (AU)

Manejo odontológico en paciente con síndrome de Cornelia de Lange / Dental treatment of a patient with Cornelia de Lange syndrome

El síndrome de Cornelia de Lange (SCdL) es un trastorno genético poco frecuente y se atribuye principalmente a mutaciones en los genes NIPBL, SMC3 y SMC1A. Sus principales características clínicas son múltiples anomalías congénitas, dimorfismo facial, hirsutismo, hipertricosis, retraso psicomotor, discapacidad intelectual, restricción del crecimiento prenatal y postnatal, anomalías de manos y pies, así como malformaciones congénitas que afectan a distintos órganos. En pacientes con SCdL es necesario hacer hincapié en la higiene oral debido a la discapacidad intelectual que puede presentarse y asegurarse de que se realiza una adecuada valoración y saneamiento dental de forma periódica con el fin de prevenir enfermedades bucodentales. El objetivo de este reporte de caso es describir el manejo odontológico de un paciente de 10 años con SCdL y revisar las características clínicas y hallazgos radiológicos presentes en la cavidad oral (AU)

Cornelia de Lange syndrome (CdLS) is a rare genetic disorder and is principally attributed to mutations in the NIPBL, SMC3 and SMC1A genes. The main clinical characteristics are multiple congenital anomalies, facial dimorphism, hirsutism, hypertrichosis, psychomotor retardation, intellectual disability, prenatal and postnatal growth restriction, hand and foot anomalies, as well as congenital malformations affecting different organs. In patients with CDLS, it is necessary to focus on oral hygiene due to the intellectual disability that may be present and to ensure that adequate dental valuation and hygiene is routinely performed in order to prevent oral diseases. The aim of this case report is to describe the dental management of a 10-year-old patient with CDLS and review the clinical characteristics and radiological findings that are present in the oral cavity (AU)

Periodontitis en niños sanos de 3 años: dos casos con seguimiento a 5 años / Periodontitis in healthy 3-year-old children: two cases with 5-year follow-up

Objetivo: La periodontitis en dentición primaria es ex- cepcional en niños sin enfermedades sistémicas. El objetivo de este informe es describir las características clínicas y ra- diográficas de dos casos de niños de 3 años sistémicamente sanos con periodontitis, y su tratamiento con seguimiento a 5 años. Casos clínicos: En ambos casos, a los 3 años de edad los niños fueron derivados al especialista en periodoncia por su odontopediatra debido a la pérdida muy temprana de inci- sivos inferiores. El examen clínico y radiográfico mostró pér- dida de inserción clínica, pérdida ósea y movilidad dental en otros incisivos superiores e inferiores. Se realizó la intercon- sulta médica y se descartó que los niños padecieran enferme- dades relacionadas con el diagnóstico de periodontitis como manifestación de una enfermedad sistémica. El tratamiento consistió en la instrucción de medidas de higiene bucal que debían ser ejecutadas por los padres, ins- trumentación subgingival, antisépticos locales, medicación antibiótica sistémica y mantenimiento periodontal. No se rea- lizaron extracciones como parte del tratamiento. En ambos casos uno de los incisivos presentes al momento de la con- sulta se perdió prematuramente, antes de los 4 años. El resto de los incisivos primarios cumplieron su ciclo normal. Luego de 5 años de seguimiento, a la edad de 8 años, ambos niños presentaban los incisivos y los primeros molares permanentes periodontalmente sanos y el resto de los dientes primarios sin signos de periodontitis (AU)

Aim: Periodontitis in primary dentition is exceptional in children without systemic diseases. The objective of this article is to describe the clinical and radiographic charac- teristics of two cases of systemically healthy 3-year-old chil- dren with periodontitis, and their treatment, with a 5-year follow-up. Clinical cases: In both cases, at 3 years of age, the chil- dren were referred to a periodontic specialist by their pediat- ric dentist, due to the very early loss of lower incisors. Clin- ical and radiographic examination showed loss of clinical attachment, bone loss and dental mobility in other upper and lower incisors. A medical consultation was carried out and diseases related to the diagnosis of periodontitis as a mani- festation of a systemic disease were ruled out. The treatment consisted of instruction on oral hygiene measures that had to be carried out by the parents, subgingival instrumentation, local antiseptics, systemic antibiotic medication, and perio- dontal maintenance. No extractions were performed as part of the treatment. In both cases, one of the incisors present at the time of consultation was lost prematurely, before the age of 4 years. The rest of the primary incisors completed their normal cycle. After 5 years of follow-up, at the age of 8 years, both children showed periodontally healthy incisors and first permanent molars, and the rest of the primary teeth without signs of periodontitis (AU)

Time to complain about pain: Children's self-reported procedural pain in a randomised control trial of Hall and conventional stainless steel crown techniques.

BACKGROUND: Children's pain in dentistry has undesirable short- and long-term consequences; therefore, less invasive treatments merit consideration. AIM: To investigate procedural pain scores for two treatments for carious primary molars in New Zealand primary care. DESIGN: This study was a split-mouth randomised control trial, with secondary outcome analysis. Children (4-8 years) with proximal carious lesions on matched primary molars had one tooth treated with the Hall technique (HT) and one treated with a conventional stainless steel crown (CT); treatment type and order of treatment were randomly allocated (allocation concealment). The Wong-Baker self-report pain scale measured pretreatment dental pain, procedural pain at each treatment and post-operative pain. RESULTS: Data were analysed for 103 children: 49 children had the HT first and 54 children had the CT first. Procedural pain scores did not differ by treatment type, with 71.8% and 76.7% of children reporting low pain for the HT and the CT, respectively. Fewer children reported low procedural pain for the second treatment than the first (p = .047). Most children reported low procedural pain for both treatments (58.3%), although 41.7% experienced moderate-high procedural pain with at least one treatment. CONCLUSIONS: The HT caused pain for as many children as the CT. There is an opportunity for better dental pain management in this setting.

Relación entre el perfil epidemiológico y nivel socioeconómico de la población que demanda atención en la Cátedra de Odontología Integral Niños / Relationship between the epidemiological profile and socioeconomic level of the population requiring care at the Children´s Comprehensive Dentistry Chair

Se identificó el perfil epidemiológico y se caracterizó la situación de la población en base al Nivel Socio-Económico (NSE) asociado al estado dentario y se es-tablecieron las zonas geográficas de pacientes que asistieron a la Cátedra Odontología Integral Niños (COIN) de FOUBA durante el año 2019. La muestra total se conformó con 541 niños de 9,2±3,3 años; masculi-nos 51,0%. La segmentación de los estratos sociales dio como resultado que del total de pacientes, el 33,3% perteneció a Clase Baja D2/E, el 39,2% a Clase Baja Superior D1, el 22,4% a Clase Media Baja C3, el 4% a Clase Media Alta C2 y el 1,1% a Clase Alta ABC1. La mayor demanda de atención provino de las dos clases más bajas de la pirámide social, aunque se trata de un servicio arancelado. Los indicadores del estado den-tario ceod, ceos, CPOD y CPOS, indicaron que los niños de menor posición socioeconómica presentaron los índices más altos. La mayor concurrencia provino de la Ciudad Autónoma de Buenos Aires (52%), respecto a los pacientes concurrentes del Gran Buenos Aires (37%), el 80% provino de la zona Oeste y Sur (AU)

The epidemiological profile was identified, and the situation of the population was characterized based on Socio-Economic Status (SES) associated with their dental state. Geographical areas of patients who attended the FOUBA Children's Comprehensive Dentistry Chair during 2019 were established. The total sample consisted of 541 children aged 9.2±3.3 years; males 51.0%. The segmentation of the social strata resulted in 33.3% belonging to Low-Class D2/E, 39.2% to Upper Lower-Class D1, 22.4% to Lower Middle-Class C3, 4% to Upper Middle-Class C2, and 1.1% to Upper-Class ABC1. The largest demand for care came from the two lowest classes of the social pyramid, even though it is a fee-based service. The indicators of dental status dmft, dmfs, DMFT and DMFS, showed that children coming from the lowest socio-economic position presented the highest rate of occurrence. The highest attendance came from the City of Buenos Aires (52%), compared to patients from Buenos Aires suburbs (37%), of which 80% were from the Western and Southern suburbs (AU)

Tratamiento integral de una adolescente con dentinogénesis imperfecta tipo I / Comprehensive treatment of an adolescent with type I dentinogenesis imperfecta

La dentinogénesis imperfecta (DI) es un desorden hereditario de carácter autosómico dominante, que se origina durante la etapa de histodiferenciación en el desarrollo dental y altera la formación de la denti-na. Se considera una displasia dentinaria que puede afectar ambas denticiones con una incidencia de 1 en 6000 a 8000 nacimientos. El tratamiento del pa-ciente con DI es complejo y multidisciplinario, supone un desafío para el odontólogo, ya que por lo general están involucradas todas las piezas dentarias y afec-ta no solo la salud buco dental sino el aspecto emo-cional y psicológico de los pacientes. Objetivo: des-cribir el tratamiento integral y rehabilitador realiza-do en una paciente adolescente con diagnóstico de DI tipo I. Relato del caso: Paciente de sexo femenino de 14 años, que concurrió en demanda de atención a la Cátedra de Odontología Integral Niños de la FOU-BA derivada del Hospital "Prof. Dr. Juan P. Garrahan" con diagnóstico de osteogénesis imperfecta tipo III (OI). Nunca recibió atención odontológica y el motivo de consulta fue la apariencia estética de sus piezas dentarias. Se realizó el examen clínico y radiográfico arrojando el diagnóstico de DI tipo I asociada a OI. Conclusión: El tratamiento rehabilitador de la DI tipo I en los pacientes en crecimiento y desarrollo debe estar dirigido a intervenir de manera integral y tem-prana para resolver la apariencia estética y funcio-nal, evitar las repercusiones sociales y emocionales y acompañar a los pacientes y sus familias (AU)

Dentinogenesis imperfecta (DI) is an autosomal dominant inherited disorder that originates during the histodifferentiation stage of tooth development and alters dentin formation. It is considered a den-tin dysplasia that can affect both dentitions with an incidence of 1 in 6000 to 8000 births. The treatment of patients with DI is complex and multidisciplinary, it is a challenge for the dentist, since in general all the teeth are involved and it affects not only oral health but also the emotional and psychological aspect of the patients. Objective: To describe the comprehen-sive and rehabilitative treatment carried out in an adolescent patient with a diagnosis of DI type I. Case report: A 14-year-old female patient, who required dental attention at the Department of Pediatric Den-tistry of FOUBA and was referred from the Hospital "Prof. Dr. Juan P. Garrahan" with a diagnosis of os-teogenesis imperfecta type III (OI). The patient never received dental care and the reason for consultation was esthetic appearance of her teeth. A clinical and radiographic examination was performed, resulting in a diagnosis of DI type I associated with OI. Conclu-sion: Rehabilitative treatment of DI in growing and developing patients will be aimed at early and com-prehensive intervention to resolve esthetic and func-tional appearance, avoid social and emotional reper-cussions and accompany patients and their families (AU)

Pulpectomía mecanizada en molares primarios: caso clínico / Mechanized pulpectomy in primary molars: a clinical case

Las pulpectomías en molares primarios están indica-das en casos de diagnóstico de pulpitis irreversible o necrosis y reabsorción radicular mínima o nula. Son tratamientos laboriosos y extensos, que sólo pueden ser llevados a cabo en pacientes colaboradores. En búsqueda de simplificar esta terapéutica y mejorar su eficacia, se propone la mecanización de la pre-paración de los conductos de molares primarios. Diversos autores aseguran que esta técnica opti-miza el tiempo clínico y mejora la calidad del trata-miento, obteniendo gran aceptación en la literatura actual. Se presenta la secuencia de procedimientos, resolución y controles de dos tratamientos de pul-pectomía con instrumentación mecanizada en mola-res primarios (AU)

Pulpectomies in primary molars are indicated in cases of irreversible pulpitis or necrosis with mini-mal or no root resorption. They are laborious and ex-tensive treatments, which only can be carried out in cooperative patients. In order to simplify this therapy and improve its effectiveness, the mechanization of root canal preparation is proposed. Several authors assume that this technique optimizes preparation time and improves the quality of treatment, obtaining great acceptance in the current literature. We report the sequence of procedures, resolution, and controls of two pulpectomies with mechanized instrumenta-tion in primary molars (AU)

Factors Associated with Prolonged Exposure to General Anesthesia During Dental Rehabilitation Under General Anesthesia In Patients Under Age Three Years.

Purpose: The purpose of this study was to determine the risk of prolonged general anesthesia (GA) for pediatric dental patients and understand factors that contribute to prolonged GA in patients under age three years in an academic hospital. Methods: A retrospective chart review for pediatric dental patients treated using GA collected data for patient age, treatment provided, other services involved in patient management, and case GA length. Further chart analysis was completed by a multidisciplinary team for cases of prolonged general anesthesia. Results: A total of 114 cases were evaluated. The incidence of prolonged GA exposure was 21.9 percent (N equals 25). Cohort data of cases younger than three years show that cases of prolonged GA exposure were more likely to be closer to age three, require longer non-throat pack time, require more restorative procedures, require longer procedure times, and utilize additional surgical services more often (P<0.05). Four common themes for prolonged exposure were identified (significant restorative needs, provider-level training, anesthesia complications, and utilization of other services), with most cases (88 percent) experiencing multiple themes as contributing factors. Few adverse effects were noted, and none had long-lasting effects. Conclusions: Dental rehabilitation cases in very young patients are at risk for prolonged exposure to GA. Providers should be aware of total anesthesia time while completing dental rehabilitation using GA and proactively attempt to reduce the risk of prolonged exposure.

Nanopartículas de plata contra bacterias presentes en biofilm dental de pacientes pediátricos / Silver nanoparticles against bacteria present in dental biofilm of pediatric patients

Introducción: el biofilm dental microbiano es el precursor de diversas enfermedades orales, una de ellas la caries, ésta representa la enferme- dad oral más significativa a nivel mundial, con una incidencia de 1.76 billones de niños afectados. Las nanopartículas de plata (AgNPs) se están usando como alternativa para el control y prevención del biofilm dental, ya que poseen propiedades antimicrobianas contra bacterias relacionadas a estas enfermedades. Sin embargo, no hay estudios que evalúen este comportamiento en pacientes pediátricos. Objetivo: eva- luar la actividad antimicrobiana de las AgNPs en bacterias de aislados clínicos tomados de pacientes pediátricos. Material y métodos: se tomó muestra del biofilm dental de 22 pacientes pediátricos, el efecto micro- biológico se evaluó mediante ensayos microbiológicos estandarizados internacionalmente por triplicado, usando dos diferentes tamaños de AgNPs. Resultados: los dos tamaños de AgNPs mostraron inhibición bacteriana, sin embargo, sólo se vio una diferencia estadísticamente significativa entre el género (p < 0.05), además, en general, hubo una correlación positiva significativa en relación a la concentración de las AgNPs y la velocidad del crecimiento bacteriano (p < 0.05). Conclusión: las AgNPs se pueden considerar como una alternativa para la prevención del biofilm dental y de esta manera para el control de diferentes enfermedades orales (AU))

Introduction: dental biofilm is the precursor of oral diseases, one of them dental caries, this represents the most significant oral disease worldwide with an incidence of 1.76 billion affected children. Silver nanoparticles (AgNPs) are being used as an alternative for the control and prevention of dental biofilm since they have antimicrobial properties against bacteria related to these diseases. However, there are no studies evaluating this behavior in pediatric patients. Objective: to evaluate the antimicrobial activity of AgNPs in bacteria from clinical isolates taken from pediatric patients. Material and methods: a sample of dental biofilm was taken from 22 pediatric patients, the microbiological effect was evaluated by international standardized microbiological tests in triplicate, using two different sizes of AgNPs. Results: the two sizes of AgNPs showed bacterial inhibition, however, only a statistically significant difference was seen between gender (p < 0.05), in addition, in general, there was a significant positive correlation in relation to the concentration of AgNPs and the speed bacterial growth (p < 0.05). Conclusion: AgNPs can be considered as an alternative for the prevention of dental biofilm and thus for the control of different oral diseases (AU)

Aplicación de Biodentine en Endodoncia Regenerativa: Presentación de Tres Casos Clínicos / Application of Biodentine in Regenerative Endodontics: Presentation of Three Clinical Cases

El Biodentine es un material biocerámico y bioacti-vo que puede emplearse como sustituto activo de la dentina. Entre sus numerosos usos se incorpora su utilización como sellador del coágulo en los procedi-mientos endodónticos regenerativos, logrando me-jores propiedades con respecto al Gold standard. Se presenta la resolución clínica y radiográfica de tres situaciones clínicas, mediante la aplicación del proto-colo de los procedimientos endodónticos regenerati-vos, en los que se utilizó Biodentine como alternativa para el sellado del coágulo a nivel cérvico-radicular, en la obturación a nivel del límite amelocementario (AU)

Biodentine is a bio-ceramic and bioactive material that can be used as an active substitute for dentin. Its many uses include its use as a clot sealer in regenerative endodontic procedures, achieving better properties compared to the Gold standard. The clinical and radiographic resolution of three clinical situations is presented, by applying the protocol of regenerative endodontic procedures, where Biodentine was used as an alternative for sealing the clot at the cervical-radicular level in the obturation at the level of the cementoenamel limit (AU)

Perfil de caries de la infancia temprana / Profile of early childhood caries

La Caries de la Infancia Temprana (CIT) se ha descrito como una patología de origen multifactorial en niños hasta los 71 meses de edad. Se considera como Ca-ries de la Infancia Temprana Severa (CITS) cuando a los 3 años el índice ceod es ≥ 4; a los 4 años, ≥ 5, y a los 5 años ≥ 6. La rehabilitación de las lesiones provo-cadas por esta patología puede ser compleja debido a la calidad y cantidad de estructura remanente y a la edad de los pacientes afectados. Objetivos: Estimar la frecuencia de CIT y CITS en niños menores a 72 me-ses que concurrieron para su atención, e identificar el tipo de práctica realizada, y la adhesión al trata-miento. Métodos: Diseño retrospectivo observacional sobre las historias clínicas de pacientes menores a 72 meses asistidos por los cursantes de la Especiali-zación en Odontopediatría, entre febrero 2021 y julio 2022. Resultados: La muestra quedó constituida por 101 niños, de 46+13,5 meses. El 91% presentó CITS. La totalidad de los pacientes mantuvieron lactancia nocturna prolongada después del año, siendo en el 72,3% a libre demanda durante el sueño, en un perío-do de 23+6 meses. Se registró un total de 1010 lesio-nes de caries. El 29,3% de los pacientes abandonaron el tratamiento. Conclusiones: La mayor parte de los niños presentaron Caries de la Infancia Temprana Severa, con altos valores de patología y lactancia noc-turna prolongada a libre demanda después del año Los tratamientos recomendados en estos casos son muy prolongados y requieren de prácticas invasivas, complejas y de alto costo, lo que provoca el abandono del tratamiento (AU)

Early childhood caries (ECC) is defined as a multifactorial disease in children 71 months of age or younger. When the dmft index is ≥4 (age 3), ≥5 (age 4), or ≥6 (age 5) it is referred to as Severe early childhood caries (SECC). Management of ECC is complex due to the quality and quantity of remaining structure of teeth at an early age. Objectives: To estimate the frequency of ECC and SECC in children < 72 months of age undergoing comprehensive treatment, to identify the type of treatment provided and treatment compliance. Methods: Retrospective observational design on dental records of patients under 72 months of age treated by Pediatric Dentistry Specialty Program students between February 2021 and July 2022. Results: The sample included 101 children, mean age 46+13.5 months, 91% of patients with SECC. All patients were fed nightly for over 1 year, 72.3% of whom were fed nightly on demand over a period of 23±6 months. A total of 1010 caries lesions were detected. 29.3% of children discontinued treatment. Conclusions: Most of the children presented severe early childhood caries with high values of pathology and prolonged nocturnal breastfeeding on demand after one year. The recommended treatments in these cases are very long and require invasive, complex and expensive practices, which causes abandonment of the treatment (AU)

Dental Trauma in Children with Autistic Disorder: A Retrospective Study.

BACKGROUND: The oral health care of autistic children is elaborated; they often fail to define dental problems, and a family-centered approach can be useful to improve and intercept these disorders. AIM: To assess the oral status of autistic children, comparing it with no autistic patients. MATERIALS AND METHODS: A retrospective study analyzed the oral health status of 70 children, 35 with autism and 35 without the disorder. Conditions assessed were dental trauma type, periodontal tissue injuries, soft tissue lip injuries, different treatments carried out, associated soft tissue findings and disorders, and the long-term management. All patients (≤15 years of age) were chosen consecutively. RESULTS: Females (57%) suffered more traumatic injuries than males (43%) in the autistic group, whereas males affected by dental trauma (54%) are predominant in the control group. The enamel fracture was the main finding among the dental trauma types in both groups followed by enamel/dentin/pulp fracture (31%), root fracture (11%), and avulsions (3%) in the autistic group and by avulsions (20%), root fracture (11%), and enamel/dentin/pulp fracture (6%) in the control group. The comparison of all variables of the two groups showed a statistically significant difference (P < 0.012). The lower lip was statistically more injured than the upper lip (P < 0.005). CONCLUSIONS: The composite restorative technique was the most common approach carried out; the long-term evaluation, when possible, was predominantly managed through root canal therapy in the control group (81%), and root canal therapy (50%) and tooth extraction (50%) in the sample group.