Impact of the COVID-19 Pandemic on Paediatric Dental Treatment: A Retrospective Study in Banja Luka, Bosnia and Herzegovina.

Dentists are at significant risk of COVID-19 infection. It was difficult to find a balance between dental care, especially preventive and other non-urgent dental procedures, and prevention of potential exposure to SARS-CoV-2 infection. The aim of the present study was to assess the influence of the COVID-19 pandemic on dental treatment in children in the Dental Clinic of the University of Banja Luka, and to compare it before and during the first and second years of the pandemic. All dental records of paediatric patients who attended the Dental Clinic (for the period March 2019 to March 2022) were analysed. The data on selected dental treatment procedures were divided into three groups per year and compared. The results during the first year of the COVID-19 pandemic showed a reduction in single treatments compared to the year before, while in the second year there was an increase in some interventions such as oral hygiene training and patient motivation, deciduous tooth extraction, and glass ionomer filling. Although the number of dental treatments in the clinic in the second year nearly returned to pre-pandemic levels, preventive and restorative interventions are the most appropriate strategy to improve the oral health of children after the COVID-19 pandemic.

Clinical Testing of Walking Bleach, In-Office, and Combined Bleaching of Endodontically Treated Teeth.

Objective. The causes of internal posteruptive discoloration of teeth are bleeding, necroses, infections, and endodontic filling materials. The aim of this study was to establish the results of bleaching endodontically treated teeth using walking bleach, in-office, and combined techniques, using 30% carbamide peroxide and 35% hydrogen peroxide, as well as the effect of etiological factors, and the time elapsed after endodontic treatment on the success of bleaching. Materials and Methods. The research involved 30 endodontically treated teeth in healthy patients. Retroalveolar X-rays were taken to check the quality of root canal obturation. Endodontic treatment and obturation were carried out on the discolored non-vital teeth without any previous endodontic treatment. Before bleaching, two millimeters of the filling were removed from the root canal and the very entry into the canal was protected with glass ionomer cement. The teeth were divided into three groups, depending on the bleaching technique: walking bleach technique (10 patients), in-office technique (10 patients), and combined technique (10 patients). The teeth were bleached with 30% carbamide peroxide and 35% hydrogen peroxide. The bleaching procedure was repeated in all the patients three times. The color of all teeth was determined based on the Vita Classic guide before and after bleaching. The Χ2 square and Kruskal−Wallis tests were used to identify differences in teeth bleaching results. Results. A statistically significant difference (p < 0.05) was established between bleaching success and the time elapsed after endodontic treatment. There were no statistically significant differences observed between the bleaching success and etiological factors, bleaching techniques, or bleaching agents. Conclusions. The effectiveness of non-vital tooth bleaching is affected by the time elapsed after endodontic treatment.

Identifying risk factors of severe early childhood caries in infants from Bosnia and Herzegovina.

OBJECTIVE: The aim of the study was to investigate risk factors for S-ECC among infants under 24 months of age living in Banja Luka, Bosnia and Herzegovina. METHODS: A cross-sectional population-based study was carried out. Considering inclusion criteria, the total sample consisted of 192 examined infants under 24 months of age. Parents/caregivers were interviewed ahead of each dental examination of children. Following data collection, outcome measures were: the presence/absence of S-ECC (children with at least one active early carious lesion on the smooth surfaces of the maxillary anterior teeth/caries-free children) and the severity of dental caries (no caries, initial caries and cavitated caries lesion). RESULTS: Overall results of the study indicated that 22.9% of infants had initial caries, while 12.0% (95% CI: 8.1-17.3) of infants had at least one cavitated carious lesion. Multivariate logistic regression analysis showed that the age of infants (p < 0.001) and family monthly income (p = 0.003) variables were statistically significant predictors for the development of caries. CONCLUSIONS: This research found that the most important risk predictors for the development and severity (intensity) of S-ECC in infants under 24 months of age were low monthly income of parents and the infant's age.

Validation of Cariogram in Caries Prediction in Women and Their Children 4 Years After Pregnancy - Longitudinal Study.

BACKGROUND: Cariogram®, an algorithm-based software model, for predicting caries risk has been used to assess the caries risk profile of many different groups. The aims of the study were to evaluate Cariogram caries risk assessment during pregnancy with DMFT/dmft incidence in mothers and their children 4 years after pregnancy and to check if there is an association between children's caries risk profiles using Cariogram and caries risk profiles (by Cariogram) of their mothers during pregnancy. METHODS: The study population consisted of 96 pregnant women (average age 27.4±7.2 years at baseline) who completed clinical baseline examination and salivary tests. The follow-up study was initiated 4 years later and the 80 pairs of mother and children (from that pregnancy) were re-examined using the same procedure at baseline. An individual caries risk profile and DMFT/dmft incidence were made for each woman and child. The prediction of the Cariogram was compared to the actual dental experience in 4 years. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for two cut-offs were calculated to express the outcome. RESULTS: The results showed a strong association between the risk categories of pregnant women and their offspring as well as between caries development in offspring and the Cariogram risk categories of pregnant women. Sensitivity and PPV for new DMFT (ΔDMFT>0) 4 years after for women were  high (>80%) for those participants assessed with 0-60% "chance to avoid caries", as well as diagnostic accuracy (74.00%). High specificity (91.00%), very high PPV (95.00%) and clinically useful values according to Youden's index (0.53) were obtained for moderate-risk and two lowest-risk groups for dmft in children. CONCLUSION: Cariogram was valid in the authors' sample only and highly predictive in caries risk assessment in investigated children based on caries risk assessment of their mothers in pregnancy.