The use of DryShield versus rubber dam isolation systems among pediatric patients with different airway patency: A randomized clinical trial.

Objectives: This randomized clinical trial aimed to evaluate the impact of DryShield isolation (DSI) and rubber dam isolation (RDI) system usage on vital signs, behavior, pain and discomfort, and chairside time required among children with different airway patencies based on the Modified Mallampati Classification (MMC). Material and methods: Healthy, cooperative children who required fissure sealant in at least two contralateral, fully erupted, permanent first molars were included. Airway patency was determined by two trained and calibrated dentists using the MMC. The participants were categorized based on their MMC scores into patent airways (classes I and II) and non-patent airways (classes III and IV). The dental procedure was videotaped during treatment, and vital signs, including arterial oxygen saturation, heart rate, and blood pressure, were recorded every 3 min. The participants' subjective pain and discomfort were evaluated using a previously validated Arabic interview questionnaire and a validated Arabic version of the Wong-Baker Faces Pain Rating Scale. The participants' behavior and behavioral pain were evaluated utilizing the Frankl Behavior Scale and the face, legs, activity, cry, and consolability scales, respectively. Results: There were no significant differences in any of the vital signs between DSI and RDI. DSI use yielded a significant reduction in chairside time (P < 0.001) and was more bothersome (P < 0.001) than RDI use among all participants, regardless of airway patency. DSI was associated with significantly better behavior during the dental procedure (P = 0.002) and less behavioral pain (P < 0.001) among all participants, regardless of airway patency. Conclusion: Irrespective of airway patency, DSI outperformed RDI in terms of behavior, pain, and procedure duration; however, DSI was characterized by noise, pressure on soft tissues, and an increased tendency to induce gag reflexes.

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.

Assessing Tele-Oral Medicine in Saudi Arabia: A Cross-Sectional Study on Specialists' Experiences and Effectiveness in Oral Healthcare.

INTRODUCTION: Teledentistry is an emerging tool to exchange medical information and clinical images to facilitate the diagnosis, prevention, and treatment of oral diseases and patient assurance and education. Considering the shortage of oral medicine specialists in Saudi Arabia, this study aims to assess the experiences of dental specialists with tele-oral medicine and its potential applicability in addressing this shortage. MATERIALS AND METHODS: This was a pilot, cross-sectional study conducted among specialists in the field of oral medicine from January 2020 to March 2020. A total of 16 preselected cases with oral lesions, including clinical history and images, were developed, validated, and shared via email with study participants. Each case included questions on differential diagnosis, provisional diagnosis, and management. The responses were recorded, analyzed, and presented as means and percentages. RESULTS: A total of 49 subjects participated in this study and more than half were under 40 years of age and two-thirds were women. A total of 23 participants had prior experience with tele-oral medicine, mainly via WhatsApp (95.7%), and these cases were received from patients, their families, friends, or other dentists. For all study cases, the correct diagnosis score ranged between 73.50 and 100%, and correct management ranged between 51 and 98%. CONCLUSIONS: Tele-oral medicine is an effective tool that may play an important role in patient management in rural regions with a shortage of oral medicine services. Further studies with larger sample sizes and in collaboration with international centers are warranted to confirm these findings.

Evaluation of the Erbium-doped Yttrium Aluminum Garnet Laser and the Conventional Method on Pain Perception and Anxiety Level in Children during Caries Removal: A Randomized Split-mouth Study.

Aim and objective: To assess and compare children's anxiety level and pain perception during cavity preparation using an erbium-doped yttrium aluminum garnet (Er:YAG) laser vs traditional rotational treatment. Materials and methods: A randomized, controlled, split-mouth clinical trial was carried out in 35 healthy children with 70 carious primary molars. Teeth were divided equally into two groups according to the method of treatment. A bur was used to prepare the cavity in one quadrant, while an Er:YAG laser was used to prepare the cavity in the other quadrant. Anxiety was assessed using Venham's dental anxiety scale and a fingertip pulse oximeter. The pain was assessed using the Wong-Baker Face Pain Rating Scale, and the number of local anesthesia (LA) needed during both procedures was also considered. Results: The mean age was 9.4 ± 1.29. Males accounted for 51.4% of the participants. There were no statistically significant variations in pulse rate at the baseline between Er:YAG laser and the conventional treatments. The mean pulse rate was higher during the conventional intervention than during the laser intervention; this difference was statistically significant vs the baseline pulse rate. The mean pulse rate with the conventional method was significantly higher during and after cavity formation than with the laser method. The Er:YAG laser and the conventional groups showed statistically significant differences in the Venham's and Wong-Baker scores. The scores of both scales were much higher in the conventional group. The number of participants who requested LA during the conventional technique was significantly higher than during the laser procedure. Conclusion: Using Er:YAG lasers to remove caries produces minimal pain and anxiety and reduces the requirement for LA. Clinical significance: During cavity preparation, the Er:YAG laser helps children stay calm. How to cite this article: Abdrabuh RE, El Meligy OAES, Felemban OM, et al. Evaluation of the Erbium-doped Yttrium Aluminum Garnet Laser and the Conventional Method on Pain Perception and Anxiety Level in Children during Caries Removal: A Randomized Split-mouth Study. Int J Clin Pediatr Dent 2023;16(S-1):S39-S44.

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.

Restoration Integrity in Primary Teeth Prepared Using Erbium/Yttrium-Aluminum-Garnet Laser: A Randomized Split-Mouth Clinical Study.

The most frequently used and universally accepted technique for removing caries is mechanical ablation of decayed tissues by rotating drills. New minimally invasive strategies, such as the use of lasers to perform highly controlled tissue ablation, have been introduced in dental practice. The aim of this study was to assess and compare treatment with a 2940 nm erbium/yttrium-aluminum-garnet (Er:YAG) laser versus a conventional rotary treatment during cavity preparation in children with regard to restoration integrity. In a randomized, controlled, blinded trial using a split-mouth design, 40 (9-12-year-old) children with 80 carious primary molars were included. The cavity in one quadrant was randomized to be treated conventionally using a bur, while the cavity in the other quadrant was prepared using an Er:YAG laser. At the one-year follow-up, clinical examinations were conducted to assess the integrity of the restorations according to the Ryge criteria. The data were analyzed using SPSS version 22 (IBM Inc., Chicago, IL, USA). The average age of the participants was 9.4 ± 1.29 years. Males accounted for 51.4% of the participants. The Ryge criteria showed clinical success of restorations, and there was no discernible difference between the conventional and laser intervention techniques. Over one year, no statistically significant differences in the clinical integrity based on the Ryge criteria were found following class I cavity preparation in primary teeth with either procedure.

The effect of virtual reality distraction on anxiety level during dental treatment among anxious pediatric patients: a randomized clinical trial.

This study evaluated the effect of Virtual Reality Distraction (VRD) on dental anxiety among anxious children undergoing prophylactic dental treatment by utilizing both subjective (Venham Anxiety and Behavioral Rating Scale (VABRS)) and objective (heart rate (HR) and salivary cortisol level (SCL)) measures. This randomized controlled study included 36 (6- to 14-year-old) healthy and anxious children who needed prophylactic dental treatment and had a history of previous dental treatment. The eligible children's anxiety level was evaluated using a modified version of the Abeer Dental Anxiety Scale-Arabic version (M-ACDAS) and those who scored at least 14 or more out of 21 were included. Participants were randomly distributed to either the VRD or control group. In the VRD group, participants wore the VRD eyeglasses during prophylactic dental treatment. In the control group, subjects received their treatment while watching a video cartoon on a regular screen. The participants were videotaped during the treatment, and their HR was recorded at four time points. Also, a sample from each participant's saliva was collected twice, at the baseline and after the procedure. The mean M-ACDAS score at baseline in the VRD and the control groups was not statistically significant (p = 0.424). At the end of the treatment, the SCL was significantly lower in the VRD group (p < 0.001). Neither the VABRS (p = 0.171) nor the HR significantly differed between the VRD and control groups. Virtual reality distraction is a non-invasive method that has the potential to significantly reduce anxiety during prophylactic dental treatment among anxious children.

The Effect of Using a Camouflaged Dental Syringe on Children's Anxiety and Behavioral Pain.

BACKGROUND: Seeing a dental syringe can be terrifying, especially for young children, and hiding it during local anesthesia (LA) administration can sometimes be challenging for the pediatric dentist. OBJECTIVE: To assess the effect of a camouflaged dental syringe on children's anxiety and behavioral pain in comparison to the traditional dental syringe during local anesthesia administration in pediatric patients. MATERIALS AND METHODS: This randomized clinical trial included cooperative and healthy 6- to 10-year-old children scheduled for non-urgent dental treatment that required buccal infiltration anesthesia (BIA) in the maxillary arch. The subjects were randomized into either the test or the control groups. In the test group, subjects received BIA using the camouflaged dental syringe. Subjects in the control group received the BIA using a traditional dental syringe. A single-trained dentist administered all the anesthesia. Heart rate (HR) was monitored at three different time points (before, during, and after) the BIA administration. Subjects' anxiety and behavioral pain were measured using Venham's Anxiety Rating Scale (VARS) and the Face, Leg, Activity, Cry, and Consolability (FLACC) scale, respectively, by two trained and calibrated investigators. RESULTS: A total of 60 subjects with a mean age of 8.3 ±1.3 years were included. The scores of the VARS in the subjects in the camouflaged group were somewhat lower than the subjects in the traditional group, but the observed difference did not reach statistical significance (P=0.113). However, subjects in the camouflaged group showed significantly lower FLACC scores compared to the traditional group (P=0.034). CONCLUSION: The utilization of a camouflaged dental syringe is effective in improving children's behavior during local anesthesia administration; therefore, it is recommended as an alternative to using the traditional syringe.

Oral health-related quality of life in children with celiac disease.

PURPOSE: There is limited knowledge about oral health-related quality of life (OHRQoL) in children with celiac disease (CD). This study aimed to assess OHRQoL in children with CD compared to healthy controls. METHODS: This case-control study included children with CD and healthy controls. Three scales were used to assess OHRQoL in different age groups: 6-7 years, 8-10 years, and 11-14 years. The OHRQoL scores were compared between cases and controls to examine the possible associations between OHRQoL and demographics, socioeconomic status, and oral health. RESULTS: Overall, 104 children with CD and 104 healthy children (controls) were included. The mean age was 10.67 ± 2.39 years in CD patients and 10.69 ± 2.36 in controls (P = 0.971). Male and female children constituted 50% of each group. Children with CD had significantly higher OHRQoL scores than controls (P = 0.003). Low education levels of parents of children with CD and a higher number of siblings in controls were associated with high OHRQoL scores (P = 0.002, P < 0.020, and P = 0.010, respectively). Recurrent aphthous stomatitis (RAS) increased the OHRQoL scores by 7.5 on average (P = 0.016). CONCLUSION: Children with CD had poor OHRQoL compared with healthy controls. Poor OHRQoL in children with CD was associated with RAS and with lower parental income and education. RAS was an independent predictor of poor OHRQoL in children with CD.

Factors influencing the desire for orthodontic treatment among patients and parents in Saudi Arabia: A cross-sectional study.

OBJECTIVES: The decision to pursue orthodontic treatment is influenced by a variety of cosmetic, functional, and social reasons. This study compared the factors that influence adults' decisions before orthodontic treatment versus parents' decisions prior to their children's orthodontic treatment in Jeddah city, Saudi Arabia. MATERIALS AND METHODS: A cross-sectional survey was distributed to the patients of orthodontic clinics of King Abdulaziz University in addition to a private orthodontic clinic in Jeddah city, Saudi Arabia. The survey consisted of two versions of a questionnaire: one for adults and one for children's parents. The survey inquired about the participants' demographics, factors that led to the necessity of treatment, and considerations before opting for orthodontic treatment. The factors influencing the decision-making process of adults were compared to that of parents using the Chi-square test. RESULTS: A total of 417 subjects participated, 331 adults and 86 parents. The majority of the respondents in both groups were females. When compared to children, adults were more aware of the necessity for orthodontic treatment (78.5% of adults vs. 41.9% of children). The primary motivation for adults and parents to begin orthodontic treatment was to improve their esthetic appearance (58.6% and 87.2%), whereas functional concerns were less frequently reported (12.1% and 15.1%). Adults relied on less trustworthy sources of information about orthodontic treatment options, whereas parents relied on more dependable sources. CONCLUSIONS: The main reason for opting for orthodontic treatment in Jeddah city, Saudi Arabia was esthetic for both adults and children.

Oral and dental manifestations of celiac disease in children: a case-control study.

BACKGROUND: Celiac disease (CD) is an immune-mediated enteropathy. CD may also involve complications with the oral cavity, which can result in various dental and oral pathologies. There are currently a limited number of studies on the oral manifestation of CD. This study aims to compare the oral manifestations of children with CD against healthy controls in Saudi Arabia. MATERIALS AND METHODS: This study includes 208 children aged 6-14 years, distributed equally into CD patients and healthy controls. A parent completed and validated the interview questionnaire, which included the child's personal information and medical history. A dental examination was undertaken to measure possible recurrent aphthous stomatitis (RAS), dental enamel defects (DEDs), dental caries experience, and dental malocclusion. Data were analyzed using descriptive statistics and bivariate and multivariate analysis. RESULTS: Two hundred and eight participants were included (104 CD patients and 104 controls). The mean age for CD patients was 10.67 ± 2.39 years and 10.69 ± 2.36 for the healthy controls. CD children had more RAS than controls (42.3% vs. 15.4%, P < 0.001) (OR = 4.03, 95% CI = 2.09-7.81) and more DEDs than healthy controls (70.2% vs. 34.6%, P < 0.001) (OR = 4.45, 95% CI = 2.48-7.97). No significant difference was found in the frequency of malocclusion between cases and controls. CONCLUSION: Saudi Arabian children with CD had a greater number of clinical findings of RAS and DEDs than healthy controls. Pediatric dentists should consider the possibility of CD in child patients presenting with RAS or DEDs.

Why do students skip classroom lectures: A single dental school report.

BACKGROUND: Conventional classroom lectures continue to represent a major component of the dental education system to ensure optimum delivery of knowledge. Certain number of students are less compliant and likely to skip classes which may impact the overall academic performance. The aim of this study was to investigate dental students' attitude towards classroom attendance and potential reasons for absenteeism at King Abdulaziz University-Faculty of Dentistry (KAU-FD). METHODS: This was a cross-sectional survey of all dental students actively enrolled at KAU-FD from January to June 2019. The survey included questions on demographics, average travel time to school, current dental year, most recent GPA, student's perspective toward classroom lectures. The survey was validated and distributed to all students at a pre-selected time frame. Data were analysed and presented as frequencies and percentages; chi-square test was used to explore parameters association. RESULTS: A total of 678 students consented and completed the survey. Overall, 44.3% of students were more likely to skip two classes or less per month. Second year dental students were more likely to be absent from classroom lectures (31.3%), while 3rd year dental students were less likely to do so (15.4%). Reported students' justifications for missing classes included early morning classes (47.9%), exams preparation (42%), and lecturer's weak presentation skills (41.9%). CONCLUSION: Compliance of dental students with classroom attendance has been an ongoing challenge for most programs. The current data suggests a multifactorial module for students' attitude toward classroom attendance. Future studies focusing on reasons behind classroom attendance behavior and addressing students' concerns are needed.

Effect of virtual reality distraction on pain and anxiety during infiltration anesthesia in pediatric patients: a randomized clinical trial.

BACKGROUND: Different distraction techniques have been used in dentistry and have shown great results in managing anxious pediatric patients specially during local anesthesia administration. One of the recently invented techniques is virtual reality. The purpose of the study was to evaluate the effect of virtual reality distraction on anxiety and pain during buccal infiltration anesthesia in pediatric patients. METHODS: Healthy, cooperative 6- to 12-year-old children requiring buccal infiltration anesthesia were randomly assigned to a test or control group. In the test group, local anesthesia was administered while the subjects were watching a cartoon video using virtual reality goggles. Subjects in the control group watched a cartoon video on a screen during the administration of local anesthesia. To assess anxiety in both groups, heart rate was recorded using a pulse oximeter at five time points: (1) once the subject sets on the dental chair as a baseline; (2) when video is on; (3) at topical anesthesia application; (4) during needle insertion; (5) after the administration of local anesthesia. The face, legs, activity, cry, consolability (FLACC) behavioral pain assessment scale and the Wong-Baker FACES pain rating scale were used to assess pain. RESULTS: A total of 50 subjects were included with a mean age of 8.4 ± 1.46 years. Twenty-nine (58.0%) of the subjects were females. The mean heart rate at all time points except baseline was significantly higher among the test group compared to the control group. Multiple regression analysis showed that younger subjects and females had higher mean FLACC behavioral pain assessment scale scores (P = 0.034 and P = 0.004, respectively) regardless of the distraction technique used. Younger subjects and subjects with higher baseline heart rate reported higher mean Wong-Baker FACES pain rating scale score (P = 0.031 and P = 0.010, respectively), controlling for all other variables. CONCLUSION: Female subjects and the younger age group were more likely to report higher pain scores during local anesthesia administration regardless of the type of distraction used. TRIAL REGISTRATION: The study was retrospectively registered in ClinicalTrials.gov with the identifier: NCT04483336 on 23/07/2020.

Nature and clinical significance of incidental findings in maxillofacial cone-beam computed tomography: a systematic review.

OBJECTIVE: This systematic review was conducted to assess the types, potential clinical significance, and treatment implications of incidental findings (IFs) in CBCT diagnostic imaging of the maxillofacial region. MATERIAL AND METHODS: The authors searched several electronic databases and grey literature without time restriction for studies on the IFs in maxillofacial CBCT. Studies that classified the IFs based on their potential clinical significance were included. The methodological quality of the included studies was evaluated by the STROBE criteria. RESULTS: The online searches of the electronic databases yielded 1323 records. Five articles were included in the final qualitative analysis. The methodological quality ranged from low to moderate risk of bias. Percentages of IFs with high (requiring intervention/referral), moderate (requiring monitoring), and low clinical significance ranged from 0.3 to 31.4%, 15.6 to 28.9%, and 43.46 to 71.1%, respectively. There was an inconsistency between the studies in the clinical significance of 58.8% of the IFs identified. CONCLUSION: Most IFs in maxillofacial CBCT are either normal variants or findings that do not require referral or treatment. There was no clear consensus on the recommended management of most common IFs. The lack of consensus on clinical significance emphasizes the importance of collaboration between medical and dental specialties to establish professional guidelines for the management of commonly encountered IFs in CBCT.

The application of teledentistry for Saudi patients' care: A national survey study.

BACKGROUND/PURPOSE: Teledentistry has emerged as a new communication tool in various dental disciplines around the world. The aim of this study was to investigate the applicability and reliability of teledentistry in the field of diagnostic dentistry and explore the perception of Saudi dentists of its benefits and concerns. MATERIALS AND METHODS: An electronic survey with 40 questions was developed, validated and distributed electronically by email and social media channels to dentists from different specialty in Saudi Arabia. Collected data were analyzed for statistical significance. RESULTS: A total of 148 dentists completed the survey. The current data demonstrated that 50% of study participants have had applied teledentistry in their clinical practice. Out of all, 90% have computers in their dental offices and 72% have been using electronic medical records in which radiographs and clinical images are uploaded. Most participants had smart phones (91%), in which they were used more commonly (74.3%) than conventional cameras (54.1%) to capture and share patients' clinical images over communication applications (74.3%) and less likely through emails (62.2%). Overall, 83% were confident that teledentistry can improve daily dental practice, specifically in the fields of oral radiology followed by endodontics and oral medicine. CONCLUSION: Teledentistry is an emerging tool with potential to improve the delivery of diagnostic dental care for communities with limited or no access to dental specialists. As of today, teledentistry has not been truly implemented by the Saudi dental community. Development of national programs to educate the public and promote teledentistry among dental practitioners are warranted.

Dental maturity in children with celiac disease: a case-control study.

BACKGROUND: Celiac disease (CD) is an immune-related enteropathy triggered by gluten ingestion in susceptible individuals. Oral manifestations of CD have been frequently described, although reports on dental maturity (DM) are scant. Thus, the aim of this study is to assess the prevalence of DM in CD patients and to test for possible predictors. METHODS: This is a case-control study of children with CD and healthy controls between 2017 and 2020. A panoramic radiograph and comprehensive oral examination were performed for each participant. Dental age (DA) was measured according to Demirjian's method and DM was calculated by subtracting the chronological age (CA) from the DA. Statistical analysis was performed to compare the DM between CD patients and controls, and a multivariate analysis was utilized to look for predictors of DM. RESULTS: Two-hundred and eight participants (104 children with CD, and 104 healthy controls) were incorporated. The mean age for CD patients was 10.67 ± 2.40 years, and 10.69 ± 2.37 years for healthy controls (P = 0.971). CD patients had a higher prevalence of delayed DM than controls (62.5% vs. 3%, respectively). They also had a greater delay in DM than controls (- 7.94 ± 10.94 vs. 6.99 ± 8.77, P < 0.001). A multivariate analysis identified age between 6 and 7 years (ß ± SE = 16.21 ± 2.58, P < 0.001), as the only predictor for DM. CONCLUSIONS: CD patients had a greater prevalence of delayed DM than controls. No predictors for DM could be found, except young age.

Accuracy of Cone-beam Computed Tomography and Extraoral Bitewings Compared to Intraoral Bitewings in Detection of Interproximal Caries.

AIM AND OBJECTIVE: The purpose of this study is to evaluate the diagnostic accuracy of cone-beam computed tomography (CBCT) and extraoral bitewings in the detection of interproximal caries compared to intraoral bitewings. MATERIALS AND METHODS: Seven preserved cadaver heads with 106 teeth (molars, premolars, and canines) including 183 proximal surfaces were used. Five r adiographic modalities were studied: intraoral bitewings, extraoral bitewings, iCAT 3D, ProMax 3D high r esolution, and ProMax 3D low r esolution. Seven pediatric dental r esidents were r ecruited and calibrated as observers and asked to evaluate each proximal surface. Teeth were extracted, mounted, drilled, caries detection dye was applied, and the surfaces were examined under the light microscope. Interexaminer r eliability, sensitivity, specificity, and area under the curve values were compared. RESULTS: No significant differences were found in sensitivity, specificity, and area under the curve values between the five r adiographic modalities. R estorations may influence the accuracy of caries diagnosis. CONCLUSION: Cone-beam computed tomography radiographs and extraoral bitewings showed similar accuracies in detecting interproximal caries compared to intraoral bitewings. This suggests that with proper training and experience, CBCT and extraoral bitewings could be comparable to intraoral bitewings in detecting interproximal caries. CLINICAL SIGNIFICANCE: Cone-beam computed tomography and extraoral bitewings could potentially serve as alternatives to intraoral bitewings to diagnose proximal caries, especially when the CBCT study is needed for a specific diagnostic purpose.

Effects of Familial Characteristics on Dental Fear: A Cross-sectional Study.

AIM: Dental fear (DF) in children is a multifactorial problem that may affect the child's dental treatment and behavior at the dental office. This study aimed to evaluate the familial characteristics affecting DF among Arabic-speaking 12- to 15-year-old children in Jeddah, Saudi Arabia. MATERIALS AND METHODS: A cross-sectional study assessing 16 middle schools in Jeddah, Saudi Arabia, was performed through multistage stratified random sampling. DF among children was measured using the children fear survey schedule-dental subscale (CFSS-DS) questionnaire. A parental questionnaire was used to collect information regarding familial socioeconomic status, parental DF, and DF among siblings and friends. The data were analyzed using the t test, one-way analysis of variance (ANOVA), and multiple linear regression analysis. RESULTS: A total of 1,522 children were included. Socioeconomic variables were not associated with DF among children. Parental DF, parental dental experiences, siblings' DF, and friends' DF were significantly associated with DF in children. In the regression analysis, mothers' anxiety at the last dental visit, siblings' DF, and friends' DF were significant predictors of DF among children. CONCLUSION: DF in children is associated with mothers' anxiety during their last dental visit and DF in siblings or friends. CLINICAL SIGNIFICANCE: Obtaining comprehensive dental, family, and social history from patients is as essential as asking about medical history for pediatric dentists to plan the most appropriate and effective behavioral management techniques for their pediatric patients. Understanding the etiology of DF assists clinicians to provide better oral health services for their fearful patients.