Children

Background/Objectives: School violence represents a significant concern for educational communities worldwide, affecting student well-being and academic development. While prior research has documented prevalence rates and risk factors, limited studies have examined social–cognitive factors associated with antisocial behavior specifically within vocational education contexts using integrated analytical approaches. This exploratory cross-sectional study examined social–cognitive factors—specifically self-reported attitudes about aggression norms, prosocial attitudes, and school climate perceptions—associated with violence-supportive attitudes among Greek vocational students. Methods: A cross-sectional design employed validated self-report instruments and traditional statistical methods. The sample comprised 76 vocational high school students (38.2% male; ages 14–18; response rate 75.2%) from one school in Patras, Greece. Validated instruments assessed attitudes toward interpersonal peer violence (α = 0.87), peer aggression norms across four subscales (α = 0.83–0.90), and school climate dimensions (α = 0.70–0.75). Analyses included descriptive statistics, Pearson correlations with bootstrapped confidence intervals, MANOVA for multivariate group comparisons, independent samples t-tests, propensity score matching for urban–rural comparisons, polynomial regression for developmental patterns, and path analysis for theoretical model testing. Results: Strong associations emerged between perceived school-level and individual-level aggression norms (r = 0.80, p < 0.001, 95% CI [0.71, 0.87]), representing one of the strongest relationships documented in school violence research. Violence-supportive attitudes demonstrated inverse associations with prosocial alternative norms (r = −0.37, p < 0.001, 95% CI [−0.55, −0.16]). Significant gender differences emerged for teacher–student relationships (d = −0.78, p = 0.002), with females reporting substantially more positive perceptions. Propensity-matched urban students demonstrated higher aggression norm endorsement compared to rural students across multiple indicators (d = 0.61–0.78, all p < 0.020). Polynomial regression revealed curvilinear developmental patterns with optimal teacher relationship quality during mid-adolescence (ages 15–16). Path analysis supported a sequential association model wherein school-level norms related to individual attitudes through prosocial alternative beliefs (indirect effect β = −0.22, p = 0.002, 95% CI [−0.34, −0.11]). Conclusions: This preliminary investigation identified social–cognitive factors—particularly normative beliefs about aggression at both individual and environmental levels—as strongly associated with violence-supportive attitudes in Greek vocational education. The exceptionally strong alignment between school-level and individual-level aggression norms (r = 0.80) suggests that environmental normative contexts may play a more substantial role in attitude formation than previously recognized in this educational setting. Gender and urban–rural differences indicate meaningful heterogeneity requiring differentiated approaches. Future research should employ longitudinal designs with multi-informant assessment and larger multi-site samples to establish temporal precedence, reduce method variance, and test causal hypotheses regarding relationships between normative beliefs and behavioral outcomes. Full article

Background/Objectives: In Romania, therapeutic program programs for children with autism spectrum disorder (ASD) focus mainly on behavioral and educational approaches, with limited integration of adapted physical activity (APA). Therapeutic swimming may provide complementary benefits, addressing both physical and psychosocial challenges. This study explored parent-perceived changes across an adapted therapeutic swimming program, following ABA therapy, on the well-being, learning, attention, physical activity, and social functioning of children with ASD. A custom-developed parent-report tool (PPQ-Autism-Swim) was used to measure perceived changes across key developmental domains. Methods: Thirty-nine children with ASD were recruited, of whom 36 completed the full 8-week swimming intervention. Parent-report questionnaires, developed by behavioral therapists under the supervision of a clinical psychologist, were administered at three time points: 8 weeks before swimming (T − 8), immediately before swimming after Applied Behaviour Analysis (ABA) therapy (T0), and 8 weeks after swimming (T + 8). The questionnaire assessed five subscales: general well-being, physical activity and energy, attention and focus, learning and cognitive progress, and self-confidence and social behaviors. Data were analyzed using descriptive statistics, repeated-measures ANOVA, and thematic analysis of qualitative parental feedback. ABA therapy served as a behavioral baseline, allowing comparison with subsequent gains from swimming. Results: Parents reported higher scores across time points, suggesting perceived changes in several domains. From T − 8 to T0, moderate gains followed ABA therapy, while from T0 to T + 8, therapeutic swimming was associated with improvements. At T + 8, 35 of 36 children showed measurable progress, particularly in physical activity regulation and self-confidence. Parental feedback emphasized calmer behavior, improved sleep, increased social interaction, and greater pride in new skills. Reliability testing indicated good to excellent internal consistency (Cronbach’s α = 0.78–0.91). Conclusions: Therapeutic swimming appears to be an effective and motivating form of adapted physical education, complementing behavioral therapies and addressing multiple developmental challenges in children with ASD. Full article

Background: Cow’s milk protein allergy (CMPA) is among the most common pediatric food allergies. Understanding tolerance acquisition and diagnostic approaches is critical for optimizing care, particularly in Spain, where regional differences may impact management. This study analyzed real-world practices for determining CMPA oral tolerance acquisition by Spanish pediatricians. Methods: A questionnaire was distributed to healthcare providers in primary and hospital pediatric settings across various Spanish provinces. The survey addressed demographic profiles, diagnostic approaches, tolerance acquisition, and dietary modifications. Results: Among the 269 health professionals included (mean age 48.3 ± 11.0 years, 62.3% women), most worked in primary care (55.4%), 20.4% in public hospitals, and 17.8% in private practice. Overall, 35.5% routinely referred CMPA cases to specialists. Specific IgE testing (27.9%) and elimination diets (41.3%) were the main diagnostic tools. Diagnostic dairy-exclusion duration varied, mainly in non-IgE cases. Hospital-based diagnostic oral food challenges (OFC) were preferred for suspected IgE-mediated cases (95.7%), while home-based protocols were used for non-IgE suspected cases (80.7%). Guideline adherence for home-based OFC varied by specialty. Tolerance acquisition was evaluated annually by 67.7% of participants, with a mean success rate of 80%. Therapeutic dairy-exclusion duration varied, with 64.7% excluding CMP for 6–12 months. Minimum age for CMP reintroduction was considered dependent on phenotype and severity, with 12 months of age mentioned most frequently (17.1%). Conclusions: Despite general alignment with international guidelines, relevant variability exists in CMPA management in Spain. Harmonizing diagnostic and therapeutic practices across specialties and care levels may help standardize care and improve patient outcomes. Full article

Background: Early-life gut microbiota colonization plays a significant role in the neurodevelopment of infants and young children. However, the causal relationship between early-life gut microbiota colonization and neurodevelopment in preterm infants has not yet been conclusively established. Our research will initiate the PIGMAN (Premature Infants Gut Microbiota Assembly and Neurodevelopment) cohort study to systematically examine the dynamic interplay between gut microbiota developmental trajectories and neurodevelopmental processes in preterm infants. Methods: This study will employ a longitudinal cohort design and utilize data from the PIGMAN cohort, examining the interplay between gut microbiota metabolism and neurodevelopmental outcomes. The study design incorporates longitudinal stool sample collection, which will be analyzed through 16S rRNA gene sequencing and metagenomic shotgun sequencing, enabling comprehensive characterization of microbial community dynamics and functional metabolic pathways. Anticipated Results: Advanced analytical approaches incorporating causal inference methodologies will be implemented to identify significant microbial and metabolic biomarkers associated with neurodevelopmental outcomes in preterm neonates, and to establish causal pathways between these biomarkers and neurodevelopment. These analytical advancements will facilitate the construction of predictive models that utilize temporal microbial signatures and metabolite trajectories as prognostic indicators for neurodevelopmental outcomes. Causal inference method evaluations will further reveal that specific gut-derived metabolites, particularly those involved in cholesterol metabolism and neural signaling pathways—such as bile acids and GABA (gamma-aminobutyric acid)—exhibit superior predictive capacity for cognitive development trajectories. Anticipated Conclusions: The findings will collectively suggest that longitudinal metabolic profiling of the gut ecosystem, when combined with causal network analysis, provides a novel paradigm for developing clinically actionable predictive models of neurodevelopment in vulnerable preterm populations. Full article

Childhood emotional neglect and parental overprotection are two subtle yet influential caregiving patterns that shape emotional, relational, and self-regulatory development. Though they are often examined separately, emerging research suggests that they may act independently and together to increase vulnerability to disordered eating. This narrative review synthesizes contemporary theoretical and empirical contributions to clarify how emotional neglect and overprotection affect pathways related to emotion regulation, attachment processes, and self-concept development. The review introduces the concept of complementarity, explaining how these patterns may co-occur within the same family system or fluctuate among individual caregivers. This creates developmental contexts marked by emotional deprivation and restricted autonomy. Based on this synthesis, the manuscript presents an integrative framework that considers distinct and shared mechanisms connecting caregiving experiences to maladaptive eating patterns. Developmental and clinical implications are discussed, emphasizing the importance of assessing relational histories, supporting emotional clarity, and promoting autonomy in intervention planning. The limitations of the narrative approach and directions for future research are outlined, including the need for longitudinal designs, more precise measurement of caregiving dimensions, and a more systematic investigation of the interactive effects of emotional neglect and overprotection. Full article

Background: Premature loss of the second primary molars can result in arch space loss and later malocclusion. Distal shoe space maintainers (SMs) are used to guide the eruption of the permanent first molars, although their clinical effectiveness remains under-evaluated. Objective: We aimed to assess the clinical effectiveness and complication profile of distal shoe SMs in paediatric patients following premature loss of second primary molars. Methods: A PRISMA-compliant systematic review was conducted, with protocol registered in PROSPERO (CRD420251101518). Searches in PubMed, Scopus, Web of Science, Embase, and Cochrane Library identified clinical studies evaluating distal shoe appliances in children aged ≤6 years. Risk of bias was assessed using ROBINS-I and JBI tools. Results: Six clinical studies comprising 67 patients were included. Overall eruption success was 95.5% (64/67), with minor complications occurring in 25.4% of cases. Modified designs demonstrated fewer complications, although sample size was limited. Due to heterogeneity of methods and outcomes across studies, results are reported as descriptive metrics rather than inferential estimates. Conclusions: Distal shoe space maintainers are effective in promoting eruption of the first permanent molar with an acceptable complication profile. Their success depends heavily on technical execution and case selection. Further prospective studies with larger cohorts are required to validate optimal procedural parameters. Full article

Background: Refractive errors (REs) and amblyopia are the leading causes of visual impairment (VI) in children worldwide; however, national data for Mexico are scarce. Objective: We aim to estimate the clinical prevalence of RE, refractive amblyopia, and associated visual impairment (VI) in Mexican children aged 6–12 years. Methods: We analyzed 784,372 non-cycloplegic eye examinations from Salud Digna outpatient clinics across all 32 Mexican states (2021–2025). REs were classified as myopia (≤−0.50 D), hyperopia (≥+2.00 D), or astigmatism (≤ −1.00 D cylinder). Refractive amblyopia was defined as best-corrected visual acuity ≤ 20/30 in the most affected eye. The VI categories followed the WHO criteria. Results: Myopia was the most frequent (43.86%), followed by astigmatism (38.41%) and hyperopia (1.29%). Refractive amblyopia affected 4.94% of the children, predominantly due to astigmatic isoametropia (72.19%). VI related to refractive amblyopia occurred in 1.20% (mild), 0.37% (moderate), 0.01% (severe), and 0.01% (blindness) of children. Men showed a higher prevalence of RE and refractive amblyopia (p < 0.01). Geographic disparities were evident, with the central and southern states reporting the highest RA rates. Conclusions: Our outpatient-based study underscores REs, refractive amblyopia, and astigmatic ametropia as significant public health concerns in Mexican school-aged children. The high prevalence of uncorrected REs and refractive amblyopia highlights the need for nationwide school-based screening programs and early intervention strategies to mitigate long-term visual and developmental consequences. Full article

Background/Objectives: Hemolytic uremic syndrome is a thrombotic microangiopathy characterized by hemolytic anemia, thrombocytopenia, and acute kidney injury. Liver involvement in pediatric hemolytic uremic syndrome is increasingly recognized, but its clinical significance remains unclear. This study aimed to evaluate the relationship between liver involvement and clinical outcomes in children with hemolytic uremic syndrome. Methods: We retrospectively analyzed 25 pediatric patients diagnosed with hemolytic uremic syndrome. Patients were grouped based on liver involvement, defined by elevated transaminase levels. Demographic, clinical, laboratory, and treatment data were collected. Associations between liver involvement, intensive care unit admission, dialysis, plasma exchange, and length of intensive care unit stay were assessed using statistical analyses. Results: Liver involvement was observed in 68% of patients. Although liver involvement was not associated with the need for dialysis, affected patients required plasma exchange and intensive care unit admission significantly more often. An AST cutoff of ≥42 U/L moderately predicted adverse outcomes (AUC: 0.619), while ALT had limited prognostic value (AUC: 0.658). Transaminase levels normalized within a mean of 3.76 ± 1.92 days. No mortality was observed in our cohort, in contrast to previously reported rates of 2–5%. Conclusions: Liver involvement in pediatric hemolytic uremic syndrome is common but generally follows a reversible and benign course. While it is associated with increased intensive care unit admission and plasma exchange, it does not independently predict disease severity. These findings emphasize the importance of supportive management and suggest that liver involvement should be interpreted in the context of the overall clinical picture. Full article

Background: Atopic dermatitis (AD) is a common pediatric skin disease that is associated with other atopic comorbidities, all of which correlate with higher rates of neurocognitive alterations such as developmental delays and ADHD. Methods: We conducted a retrospective chart review from January 2022 through January 2024 and identified 79 children aged 0–5 years who were prescribed dupilumab in the Massachusetts General Brigham healthcare system. We defined the patient population (including demographics, atopic comorbidities, and neurocognitive burden), and assessed whether time to treatment access varied by patient or prescriber characteristics. Results: The mean age at dupilumab initiation was 3.4 years, and 62.0% of patients were male. The cohort was diverse (48.1% White, 25.3% Black, 16.5% Hispanic/Latino, 10.1% Asian/other), with 48.1% publicly insured. Atopic comorbidities were common: 64.6% had food allergies, 34.2% had asthma, and 10.1% had eosinophilic esophagitis (EOE); 73.4% had two or more atopic diagnoses. Neurodevelopmental disorders affected 43.0% of patients, with speech and language delay most frequent (25.3%) and higher rates among those with EOE (87.5% vs. 38.0%, p < 0.01). The mean time to dupilumab approval was 20.9 days, with dermatologists achieving faster approvals than other specialists (10.6 vs. 51.9 days, p < 0.001). Conclusions: Our findings reveal infrequently reported high rates of atopic and neurologic comorbidities in young children with AD and underscore the importance of coordinated inter-specialty collaboration to ensure timely access to dupilumab for these patients. Full article

Background/Objectives: Patient and public involvement (PPI) in the design, conduct, and dissemination of pragmatic trials may make trial results more relevant and meaningful. The nature of PPI in paediatric pragmatic trials has been poorly characterized in the literature. This study examined the prevalence and nature of PPI in paediatric pragmatic trials and lessons learned from researchers’ experiences. Methods: For this mixed methods study, we conducted an online survey and semi-structured interviews with corresponding authors of published paediatric pragmatic trials, identified using an online search filter in MEDLINE. Descriptive statistics and qualitative thematic analysis were used to analyse the data. Results: PPI was reported by 71/127 (56%) survey respondents. Reported impacts of PPI in the survey included the following: more feasible interventions (71%), higher-quality research (57%), improved recruitment and retention (57%), and increased applicability of research findings (57%). Both survey and interview participants identified that insufficient resources, time, and training for relationship development were challenges to PPI in paediatric trials. Three themes were identified from the semi-structured interview data (recruitment and engagement, sustaining PPI relationships, and PPI value added). Conclusions: PPI aligns with the purpose and intended impact of pragmatic trials, and paediatric researchers perceive that PPI leads to increased research relevance, quality, and dissemination. There is, however, a need for institutional and funding bodies to invest in PPI partnership, including offering support for researchers and providing opportunities for children, youth, and parents as PPI partners. Full article

Background/Objectives: The COVID-19 pandemic substantially altered children’s daily experiences, limiting social interactions, which are critical for language development. This study aims to explore how the pandemic influenced receptive and expressive language abilities in children under six years, focusing on the impact of exposure duration and differences with the pandemic period. Methods: This retrospective cross-sectional study reviewed 189 children assessed for language delay at our outpatient clinic between 2018 and 2021. Only children evaluated using the Sequenced Language Scale for Infants or the Preschool Receptive-Expressive Language Scale were included. Participants were categorized by assessment period: pre-COVID (2018–2019), acute-COVID (2020), and chronic-COVID (2021), and by age (toddlers vs. preschoolers). Linear regression assessed the relationship between pandemic exposure duration and language scores; non-parametric tests compared groups. Results: During the acute-COVID period, longer exposure was associated with lower receptive and expressive percentile scores. In preschoolers, receptive scores were significantly lower in the chronic-COVID group than in the pre-COVID group, while expressive scores were lower in the chronic-COVID group than in the acute-COVID group. Conclusions: Prolonged exposure to the pandemic environment was associated with measurable delays in both receptive and expressive language development, especially in preschoolers. The results suggest that pandemic restrictions can hinder children’s language acquisition, indicating the need to strengthen early screening and provide timely interventions to support their developmental recovery. Full article

Introduction: Preterm birth and neonatal intensive care unit (NICU) admission may elevate parental stress and impair early parent–infant interaction. In low-resource settings, where staff and resources are limited, parental education programmes are often also limited, further complicating care engagement. This study piloted the NeuroSense PremmieEd parenting educational programme to assess its preliminary impact on maternal stress and knowledge in a South African public-sector NICU. Objectives: This study aimed to pilot a contextually relevant parenting education intervention to enhance parental understanding of preterm infant behaviour, strengthen parents’ capacity to interpret and respond sensitively to infant cues, and reduce parental stress during NICU admission. Methodology: This sequential cohort pilot study involved 60 mothers of preterm infants (gestational age, 24–36 weeks) admitted to two comparable NICUs. Mothers (aged 18–45 years) were allocated to three groups. Arm 1 received standard care (n = 20), Arm 2 received a printed educational booklet (n = 20), and Arm 3 received the booklet plus a facilitated education session (n = 20). Pre- and post-intervention data were collected using the Knowledge of Preterm Infant Behaviour (KPIB) questionnaire and the Parental Stressor Scale: NICU (PSS:NICU). Descriptive statistics were used to explore differences between arms. Results: Knowledge scores measured with the KPIB tool showed a positive trend in all groups, with the greatest improvement observed in Arm 3; however, these changes were not statistically significant (p = 0.176). Maternal stress measured using the PSS:NICU increased significantly over time across all groups (F(1, 57) = 8.40, p = 0.005), with Arm 3 consistently reporting the lowest stress at both timepoints. Discussion: The facilitated intervention was associated with a trend towards improved maternal knowledge of preterm infant behaviour. This pilot study highlighted the potential of structured and culturally relevant education to support early parenting in a public-sector NICU in South Africa. Maternal stress levels remained high across all groups. While this finding may be due to parents’ experience of changes in infant medical condition, fatigue, and other factors, these were not investigated in this study and therefore warrant further exploration in future work. Conclusions: The NeuroSense PremmieEd programme shows promise in improving maternal understanding of preterm infant behaviour. The results highlight the need for further adaptation of content delivery, inclusion of diverse populations (e.g., by preterm category) and scalable, low-resource approaches to improve engagement and long-term outcomes. Full article

Introduction: Infrared thermography (IRT) is a non-invasive, non-ionizing imaging modality capable of rapidly capturing surface temperature variation. In dentistry, particularly orthodontics and TMD evaluation, IRT may serve as a valuable complementary tool to be added in conventional diagnostic protocols. Objective: Correlate possible relationships between thermographic findings of orofacial structures and cephalometric landmarks. Methods: An infrared imaging camera, FLIR^® i7, was used to record the regions of interest, correspondent to the temporal, masseter and orbicular oris muscles, in adolescents (n = 22). Bilateral temperature differences were considered as thermal asymmetries with a conventional threshold of 0.3 °C to distinguish an eventual hyperactivity or hyperfunctions of detrimental structures. The Trevisi cephalometric parameters that were taken into consideration for the study were SNA, SNB, ANB, OccltoSn, Wits relation to base and Molar/canine classes. Results: Most of the participants showed a normal temperature difference ΔΤ for the upper and lower orbicular oris muscle, right vs. left, 96% and 92%, respectively. The other ROIs presented a mixed pattern of thermal asymmetries; however, no statistically significant differences were found when crossed with the cephalometric landmarks. Conclusions: Asymmetrical patterns of infrared thermography can aid on the diagnosis and treatment plan of an orthodontic appointment, since the actual stability of pos-orthodontic treatment is highly dependent on the muscular activity of the tongue and lips, in particular when the patient has atypical swallowing. Our findings suggest that this technique can be used to quantify anatomical landmarks relevant to craniofacial morphology in specific populations, particularly at ages where muscular functional activity is strongly correlated with dentoskeletal development. Full article

Background: Given the rapid global increase in asthma cases, understanding the impact of climate change on respiratory health is necessary for evidence-based policymaking, particularly in low- and middle-income countries (LMICs). Objectives: To estimate the short-term associations between temperature (mean and diurnal range), particulate matter (PM_2.5 and PM₁₀), nitrogen dioxide (NO₂), ozone (O₃), and childhood asthma exacerbations in Cape Town, South Africa. Methods: We analysed daily hospital records (n = 7753; 2009, 2014, 2019) alongside citywide air quality and meteorological data using negative binomial mixed-effects models and distributed lag non-linear models to capture delayed effects. Results: NO₂ and PM₁₀ were consistently associated with a higher exacerbation risk, with additional delayed effects observed for PM_2.5, PM₁₀, and NO₂. Mean temperature and diurnal temperature range were also linked to an increased risk at short (lag 0–1) and medium (lag 4–5) delays. Conclusions: Temperature variability and traffic-related air pollution contribute to childhood asthma exacerbations in urban LMIC settings. The findings support child-centred early warning systems and stricter air quality controls aligned with WHO guidance. Full article

Background: Accurate assessment of pediatric foot biomechanics is challenging due to growth-related variability and limited quantitative tools. The supination and pronation angles of the ankle are critical for understanding lower limb alignment and pathological gait patterns. Objectives: This study introduces a novel digital pedoscopic system designed to enhance the quantitative evaluation of foot alignment and to demonstrate its clinical utility through clustering analysis of pediatric ankle angles. Methods: Thirty-five pediatric patients (mean age = 6.17 ± 4.54 years) with neurological or developmental disorders were evaluated using a semi-automated digital pedoscopic system to obtain quantitative measurements of ankle alignment. Key anatomical landmarks, including the heel, calf, and knee centers, were manually identified from posterior images, and the system automatically calculated ankle pronation and supination angles. K-means clustering analysis was applied to classify participants based on their biomechanical profiles. Results: A total of thirty-five pediatric patients were assessed, and the revised abstract now explicitly reports this sample size to improve clarity. Data-driven k-means clustering of bilateral rearfoot angles identified three clearly defined alignment subgroups—neutral, pronated, and supinated—each exhibiting characteristic distribution patterns and degrees of inter-individual variability. These findings highlight the system’s ability to quantitatively distinguish biomechanical phenotypes within a heterogeneous pediatric population. Visualization through scatter, box, and violin plots demonstrated distinct cluster-specific distributions and inter-individual variability in rearfoot alignment, demonstrating the feasibility of objective biomechanical stratification in pediatric populations. Conclusions: The digital pedoscopic imaging system provides a reliable and reproducible approach for quantitative assessment of foot alignment in children. Clustering analysis enables stratification of biomechanical subtypes, supporting individualized rehabilitation strategies and longitudinal monitoring in pediatric clinical practice. Full article

Background/Objectives: Patau syndrome (trisomy 13) is a rare genetic disorder with high mortality, and poor prognosis. Patients surviving beyond infancy usually present with severe psychomotor delays, failure to thrive, intellectual disabilities and seizures. Female sex and mosaic trisomy 13 are considered positive prognostic factors. Methods: Here we report an 8-year-old female patient with Patau syndrome, diagnosed prenatally, born prematurely at 35 + 4 weeks of gestation via vaginal delivery as a third child of 33 years old healthy and unrelated parents. The birth weight was 2087 g, Apgar scored 9 at 1 min and 10 at 5 min, also self-ventilating in room air since birth. The patient has several associated congenital abnormalities; however, medical adjustments such as multiple surgeries, PEG, hearing aids, glasses, anti-epileptic medications, and suction support the girl’s daily life. The patient attends a primary school with specialist support that fosters her physical and sensory development and promotes progress in communication. Despite the numerous obstacles she faces, the girl’s journey demonstrates remarkable growth and development with the support of an interdisciplinary care team. It highlights the critical role of personalized care and early intervention. Conclusions: Due to the increasing survival rates of patients with Patau syndrome, complex and multidisciplinary care is required for both the patients and their families to achieve the best possible outcomes and ensure proper care, growth, and development of the child. All medical procedures must be thoroughly assessed for potential complications and viable improvement in quality of life. Full article

Background: Dental caries is currently the most common chronic disease affecting the Spanish pediatric population. Therefore, the main objective of this study was to assess Caries Management by Risk Assessment (CAMBRA) in children attending a university dental clinic between the ages of 6 and 12 and establish the DMFT (decayed, missing, and filled teeth index for permanent teeth) of the sample. In addition, the study calculated the plaque index, salivary pH level, buffering capacity, and the quantity and quality of saliva in the sample and determined if there were statistical differences between sexes and between subgroups with DMFT = 0 (control) and DMFT > 0 (cases). Methods: A case–control study was conducted with 89 patients aged 6 to 12 years. Clinical and salivary indicators were measured. Caries risk was also assessed using the CAMBRA protocol, and the sample was also divided into control and case groups for further analysis. Results: The CAMBRA questionnaire showed that 65.2% of participants presented a high risk of caries. The sample showed an average DMFT of 0.65 with a plaque index of 57.2%. The mean salivary pH was 7.35 (±0.30). The average volume of stimulated saliva was 6.83 mL (±3.68), and the buffering capacity was classified as normal in 57% of cases. No statistically significant differences were found between sexes or in the evaluated risk factors. In the control group, the mean salivary pH value was 7.35, and the amount of stimulated saliva was 6.5 mL. The buffering capacity was classified as normal in 67% of cases. In contrast, the case group presented a mean pH value of 7.15 and a salivary volume of 5 mL, with a normal buffer capacity in 50% of cases. Conclusions: The CAMBRA protocol indicated that more than half of the participants presented a high risk of caries, indicating the need to customize treatment plans for each patient. The salivary pH showed statistic differences between the control and case groups, indicating the importance of incorporating salivary biomarkers into routine clinical practice. Full article