Factors Affecting the Duration of Fixed Orthodontic Treatment in Patients Treated in a University Department between 2016 and 2020.

Objective:The aim of this study was to assess the effect of possible influential factors on duration of fixed orthodontic treatment. Methods:This cross-sectional retrospective study included 505 female and 183 male orthodontic patients (a total of 688 persons) referring to a university department of orthodontics during 2016-2020. The study population included only those who had undergone fixed orthodontic treatment of both maxillary and mandibular arches. Information including age, gender, total treatment duration, number of missed treatment sessions, incidences of bracket debonding, and type of treatment plan were collected from patient records. Data were analyzed using SPSS software version 21 at 0.05 significance level. Results:The mean duration of orthodontic treatment was significantly longer in men than women (19.09±5.6 versus 18.22±4.56 months, respectively; P=0.040). The treatment duration was also longer in patients with a treatment plan including teeth extraction compared to non-extraction treatment plans (19.85±4.30 versus 17.56±5.02 months, respectively; P<0.001). Duration of treatment in patients with more than one missed treatment appointment was significantly longer than those who had . one missed session (P<0.001). Duration of treatment in patients with bracket debonding was significantly longer (P=0.030). Also, the duration of treatment had a significant correlation with the frequency of both missed sessions (r=0.365, P<0.001) and bracket debonding (r=0.098, P=0.01). Conclusion:Based on the results of the present study, missed sessions, treatment plan, and bracket debonding have the greatest effect on the duration of fixed orthodontic treatment.

Survival of Composite Resin Restorations of severely Decayed Primary Anterior Teeth retained by Glass Fiber Posts or Reversed-orientated Metal Posts.

AIM: The aim of this study was to compare the survival of composite resin restorations retained by glass fiber posts or reversed-orientated (upside-down) metal posts in severely decayed primary anterior teeth after 6, 12, and 18 months. MATERIALS AND METHODS: A total of forty-four 3- to 5-year-old children with bilateral severely decayed primary maxillary canines were included. Patients were treated under general anesthesia. After pulpectomy, an intracanal post was seated in the primary maxillary canine on each side: either a glass fiber post or a metallic post in reversed orientation and teeth restored with light-cured composite. Survival rate of each technique was evaluated at predetermined follow-ups and data were analyzed with McNemar's test (α = 0.05). RESULTS: The difference in survival of restorations retained by two types of posts was not statistically significant in clinical and radiographical evaluations after 6, 12, and 18 months. The survival rate of reversed-orientated metal and glass fiber posts after 18 months was 81.1 and 67.6% respectively (p = 0.14). CONCLUSION: Reversed-orientated metal post did not show lower clinical survival compared with glass fiber posts in 18-month follow-up. Hence, reversed-orientated metal post can be considered as a potential method to obtain retention for composite restorations in severely decayed primary anterior teeth. How to cite this article: Vafaei A, Ranjkesh B, L0vschall H, Erfanparast L, Jafarabadi MA, Oskouei SG, Isidor F. Survival of Composite Resin Restorations of severely Decayed Primary Anterior Teeth retained by Glass Fiber Posts or Reversed-orientated Metal Posts. Int J Clin Pediatr Dent 2016;9(2):109-113.

The Influence of Parenting Style and Child Temperament on Child-Parent-Dentist Interactions.

PURPOSE: This study aimed to investigate the interaction between parenting style and child's temperament as modulators of anxiety and behavior in children during the dental procedure. METHODS: Healthy four- to six-year-olds (n equals 288), with carious primary molars scheduled to receive amalgam fillings were selected. The Primary Caregivers Practices Report was used to assess the parenting style, and the Children's Behavior Questionnaire-Very Short Form was used to evaluate child temperament. Children were managed using common behavior management strategies. Child behavior and anxiety during the procedure were assessed using the Frankl behavior rating scale and the verbal skill scale, respectively. Spearman's correlation coefficient was used to examine the correlation among variables. RESULTS: Authoritative parenting style was positively related to positive child's behavior (P<.05) and negatively related to child's anxiety (P<.05). A positive relationship existed between permissive subscale and negative behaviors (P<.05) and child's anxiety (P<.05). There was a significant direct effect of authoritative parenting style on the effortful control trait (P<.05) and permissive parent style on the child negative affectivity (P<.05). CONCLUSIONS: Parenting style appeared to mediate child temperament and anxiety, and was related to the child's behavior. Parenting style should be considered in the selection of behavior guidance techniques.

Design and preliminary validation of the verbal skill scale in the dental setting: an anxiety scale for children.

PURPOSE: The purpose of this study was to design and examine the validity of a scale that uses the verbal performance of children as an indicator of dental anxiety. METHODS: A total of 128 healthy 4- to 6-year-olds were included. The first sessions consisted of a dental examination; in the second session, identical dental treatment was provided to all subjects. In each session, a short communication was done for verbal assessment. During treatment, Frankl and clinical anxiety rating scales were utilized to assess the child's anxiety. Construct validity was assessed using Spearman's correlation coefficient; a factor analysis, concurrent validity, and inter-rater reliability were determined by kappa agreement statistics. Chi-square and Fisher's exact tests were used to assess the difference between sexes. RESULTS: The agreement between the raters was high and significant (k=0.71, P<.001). Intraclass correlation coefficient of 50 same children (28 boys and 22 girls) across a 2-week period showed a strong correlation (correlation=0.8, P<.001). Spearman's correlation coefficient revealed a high and significant correlation between the measures (P<.001). The kappa values ranged from 0.58 to 0.67, suggesting moderate to good agreement between measures. CONCLUSIONS: The verbal skill scale is a reliable and valid measure of assessing child dental anxiety in a clinical context.

Emotional intelligence subscales: are they correlated with child anxiety and behavior in the dental setting?

OBJECTIVES: The present study aimed at evaluating the correlation between emotional intelligence subscales and childs anxiety and behavior in the dental setting. STUDY DESIGN: The study included 123 children aged 7-12 years, who were scheduled to attend two consecutive sessions. In the first session, the Bar-On Emotional Quotient Inventory: Youth Version (Bar-on EQ-I: YV) was administered to participants. The anxiety and behavior in children was evaluated during similar dental procedures in the second session using the Clinical Anxiety Rating Scale and the Frankl scale, respectively. RESULTS: 23 children were eliminated from the study, leaving 100 participants (47 boys and 53 girls) with a mean age of 9.32 +/- 1.59 years for study. There were statistically significant positive correlations between Frankl score and EQ total score (p < 0.001), interpersonal scale (p < 0.001), intrapersonal scale (p < 0.001), stress management (p = 0.03) and adaptability scale (p < 0.001). Significant negative correlations were found between anxiety score and, EQ total score (p < 0.001), interpersonal scale (p < 0.001), intrapersonal scale (p < 0.001), and adaptability scale (p < 0.001). Anxiety and stress management were not correlated (p = 0.16). Total EQ and EQ subscales can predict significance variance of Frankl score (p < 0.05) and anxiety score (p < 0.05) without confounding effect of age and sex (p > 0.05). CONCLUSIONS: The results provide evidence that children with higher total EQ as well as higher scores of intrapersonal, interpersonal, adaptability and stress management scales can generally be flexible and effective in coping in the dental setting. Higher score in stress management subscale seems to be related to better control over affective information including anxiety compared with other subscales in stressful situations. Overall, they behave and cooperate better than children with lower scores.

The impact of maternal emotional intelligence and parenting style on child anxiety and behavior in the dental setting

Objective. The present study investigated the correlations between maternal emotional intelligence (EQ), parenting style, child trait anxiety and child behavior in the dental setting. Study design. One-hundred seventeen children, aged 4-6 years old (mean 5.24 years), and their mothers participated in the study. The BarOn Emotional Quotient Inventory and Bumrind’s parenting style questionnaire were used to quantify maternal emotional intelligence and parenting style. Children’s anxiety and behavior was evaluated using the Spence Children’s Anxiety Scale (SCAS) and Frankl behavior scale. Results. Significant correlation was found between maternal EQ and child behavior (r=0.330; p<0.01); but not between parenting style and child behavior. There was no significant correlation between mother’s total EQ and child’s total anxiety; however, some subscales of EQ and anxiety showed significant correlations. There were significant correlations between authoritarian parenting style and separation anxiety (r=0.186; p<0.05) as well as authoritative parenting style and mother’s EQ (r=0.286; p<0.01). There was no significant correlation between child anxiety and behavior (r = -0.81). Regression analysis revealed maternal EQ is effective in predicting child behavior (β=0.340; p<0.01). Conclusion. This study provides preliminary evidence that the child’s behavior in the dental setting is correlated to mother’s emotional intelligence. Emotionally intelligent mothers were found to have predominantly authoritative parenting style (AU)

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The impact of maternal emotional intelligence and parenting style on child anxiety and behavior in the dental setting.

OBJECTIVE: The present study investigated the correlations between maternal emotional intelligence (EQ), parenting style, child trait anxiety and child behavior in the dental setting. STUDY DESIGN: One-hundred seventeen children, aged 4-6 years old (mean 5.24 years), and their mothers participated in the study. The BarOn Emotional Quotient Inventory and Bumrind's parenting style questionnaire were used to quantify maternal emotional intelligence and parenting style. Children's anxiety and behavior was evaluated using the Spence Children's Anxiety Scale (SCAS) and Frankl behavior scale. RESULTS: Significant correlation was found between maternal EQ and child behavior (r=0.330; p<0.01); but not between parenting style and child behavior. There was no significant correlation between mother's total EQ and child's total anxiety; however, some subscales of EQ and anxiety showed significant correlations. There were significant correlations between authoritarian parenting style and separation anxiety (r=0.186; p<0.05) as well as authoritative parenting style and mother's EQ (r=0.286; p<0.01). There was no significant correlation between child anxiety and behavior (r = -0.81). Regression analysis revealed maternal EQ is effective in predicting child behavior (ß=0.340; p<0.01). CONCLUSION: This study provides preliminary evidence that the child's behavior in the dental setting is correlated to mother's emotional intelligence. Emotionally intelligent mothers were found to have predominantly authoritative parenting style.

Can birth order affect temperament, anxiety and behavior in 5 to 7-year-old children in the dental setting?

AIM: The aim of this study was to evaluate the relationships between birth order and child's temperament, anxiety and behavior in the dental setting. MATERIALS AND METHODS: A total of 200 healthy children aged 5 to 7 years, were included in this double-blind randomized controlled trial. The study consisted of two sessions. In the initial appointment, parents were provided with instructions and asked to complete children's behavior questionnaire (CBQ). In the second appointment, identical dental treatments were rendered to all subjects. During treatment, Frankl scale for child's behavior, facial Image scale (FIS) for situational anxiety, and clinical anxiety rating scale for clinical anxiety were utilized. Analysis of data was done using U Mann-Whitney and Kruskal-Wallis tests. RESULTS: Only children had higher clinical (p = 0.041) and situational (p < 0.001) anxiety, and more negative behavior (p = 0.013) compared to children with siblings. In children with siblings, first-born child was in increased risk of developing negative behavior (p = 0.008), clinical anxiety (p < 0.001) and situational anxiety (p = 0.006). With an exception (sadness, p < 0.001), no significant differences in temperament scale were observed among children with different birth orders. CONCLUSION: According to the results, only children and laterborns are at higher risk of developing worse outcomes in the dental setting. CLINICAL SIGNIFICANCE: The role of birth order has been ignored as a possible factor of behavior during routine dental treatment and these findings may shed light on our understanding of behavior management strategies in the dental setting. Considering the increasing pattern of family with an only child both in modern and developing countries, this is more likely that the dental team will face children with negative outcome during dental treatment.

Can drawing be considered a projective measure for children's distress in paediatric dentistry?

BACKGROUND: Several tools have been developed for the measurement of emotional status of the child in paediatric dental clinics including nonverbal self-report techniques. Subjective methods like drawing and Child Drawing: Hospital (CD:H) score have recently been applied in hospitalized children. Studies, however, have not attempted to analyse children's drawings as an aid to investigate the subjective feelings of children in paediatric dental settings. AIM: To assess drawing as a measure for child's distress in paediatric dental settings. DESIGN: Fifty-four children, aged 4-11 years, participated in this study. After finishing the first therapeutic session, the child was instructed to draw a picture of a person in a dental clinic. The pictures were scored using CD:H score sheet and the findings were compared with SEM and Frankl scores. RESULTS: CD:H was correlated with both Frankl (correlation coefficient = -0.550) and SEM (correlation coefficient = +0.483) scales (P < 0.001). CONCLUSION: Drawing is a useful measure of children's emotional status in dental settings in a way that is easier, familiar and more enjoyable for the child patient.

Formocresol versus calcium hydroxide direct pulp capping of human primary molars: two year follow-up.

OBJECTIVES: Clinical and radiographic evaluation of the premedicated direct pulp capping using formocresol (PDC) versus conventional direct pulp capping using calcium hydroxide (CDC) in human carious primary molars. STUDY DESIGN: A total of 120 vital primary molars with pinpoint exposure during caries removal in 84 patients aged 4-5 years were selected. In the PDC group (n = 60), 20% Buckley's formocresol solution, and in the CDC group (n = 60), calcium hydroxide powder were applied to the exposure sites followed by placement of zinc oxide-eugenol base. Teeth were restored with preformed stainless steel crowns. Clinical and radiographic evaluations of the treatment outcomes were performed at regular intervals of 6 and 12 months, respectively, for two years post-operatively. RESULTS: The prevalence of spontaneous pain, sensitivity on percussion, and fistula were significantly higher in the CDC group compared to the PDC group (P < 0.05). The number of teeth exhibiting periapical/furcal radiolucency or external/internal root resorption was also higher in the CDC group (P < 0.05). The clinical success rate of the PDC was 90% compared to the 61.7% of the CDC (P < 0.05). The radiographic success rates of the PDC and CDC groups were 85% and 53.3%, respectively (P < 0.05). CONCLUSION: It seems formocresol premedicated direct pulp capping could safely be used as a substitute for conventional direct pulp capping.

Dental treatment duration as an indicator of the behavior of 3-to 9-year-old pediatric patients in clinical dental settings.

AIM: The aim of this study was to evaluate the age-specific effect of treatment duration on pediatric patient behavior. METHODS AND MATERIALS: A total of 450 children 3 to 9 years of age were allocated into six consecutive age groups (n=75 for each group). All children received dental treatment procedures which included the fabrication of a Type 1 composite resin restoration, then a dental prophylaxis followed by fluoride therapy with each procedure requiring an average of 20 minutes. The children's behavior was evaluated at the end of each treatment period using the sound, eye, and motor (SEM) scale. RESULTS: The results of a mixed analysis of variance (ANOVA) indicated a significant main effect of treatment duration, F (1.69, 255.01) = 188.29, P < 0.001, and of chronological age, F (1, 144) = 115.82, P < 0.001. Moreover, the main effects of time and chronological age was qualified by a significant interaction between time and chronological age, F (8.86, 255.01) = 115.82, P < 0.001. The beta weights (0.64 for age versus 0.44 for time) suggest chronological age contributes the most to predicting the behavior of children during dental treatment followed by the duration of treatment. CONCLUSION: Treatment duration may affect the behavior of pediatric patients parallel with chronological age and, thus, should be considered in the arrangement of the treatment plan. CLINICAL SIGNIFICANCE: The findings of this study suggest appropriate pediatric behavior management should include thoughtful scheduling of appointments according to a treatment plan formulated with consideration of the effects of age and appointment length.

Oculodentodigital dysplasia: disease spectrum in an eight-year-old boy, his parents and a sibling.

Oculodentodigital dysplasia is an extremely rare autosomal dominant pleiotropic disorder caused by mutations in the Connexin 43 gene (GJA1). Described here is a previously undiagnosed case of an 8-year-old boy with enamel and dentin hypoplasia and typical faces. In this presentation, many typical clinical and radiographical features of this condition are present. The characteristic features include a typical face, premature loss of primary teeth and odontodysplasia of permanent teeth, clinodactyly, ocular signs, and CNS involvement. To our knowledge, the case that we report here is the first case with mamelon-shaped tip of the tongue and enlarged midpalatal raphe.