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9 pages, 461 KiB

Open AccessArticle

by Hollis Haotian Chai, Ivy Guofang Sun, Duangporn Duangthip, Sherry Shiqian Gao, Edward Chin Man Lo and Chun Hung Chu

Dent. J. 2024, 12(8), 248; https://doi.org/10.3390/dj12080248 - 5 Aug 2024

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Abstract

The objective of this prospective 12-month observational study is to examine the oral health-related quality of life (OHRQoL) among Hong Kong young children aged 3–4 years old receiving silver diamine fluoride (SDF) therapy for carious upper anterior primary teeth. A parental questionnaire was [...] Read more.

The objective of this prospective 12-month observational study is to examine the oral health-related quality of life (OHRQoL) among Hong Kong young children aged 3–4 years old receiving silver diamine fluoride (SDF) therapy for carious upper anterior primary teeth. A parental questionnaire was used to collect each child’s sociodemographic background and oral health habits at baseline. Data on parents’ satisfaction with their child’s dental aesthetics were collected at baseline and during a 12-month visit. The Chinese Early Childhood Oral Health Impact Scale (C-ECOHIS) was used to measure OHRQoL. A trained dentist performed examinations and recorded caries experience (dmft) and oral hygiene (visible plaque index) at baseline and 12 months. SDF was applied to the carious lesions. Out of 286 invited children, 248 (87%, 248/286) participated, and 211 (85%, 211/248) attended the 12-month examination. All SDF-treated carious lesions were discoloured at the 12-month examination. Regression analysis showed that the baseline C-ECOHIS score was associated with dmft (p < 0.001). The baseline and 12-month C-ECOHIS scores were 4.6 ± 5.5 and 5.0 ± 5.6, respectively (p = 0.42). The scores for parental satisfaction with dental aesthetics at baseline and 12 months were 59% to 46% (p < 0.001). Satisfaction was negatively associated with the number of discoloured upper anterior teeth (p < 0.001). In conclusion, SDF discoloured the carious upper anterior teeth of the Hong Kong kindergarten children. However, the discoloured lesions had no significant effects on the OHRQoL of these children. However, more parents became dissatisfied with their child’s dental aesthetics after SDF therapy. Hence, clinicians should inform parents well before they perform SDF therapy on children. Full article

(This article belongs to the Special Issue Oral Health Care in Paediatric Dentistry Volume 2)

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14 pages, 1676 KiB

Open AccessArticle

Molar Incisor Hypomineralization: Optimizing Treatment Protocols for Hypersensitivity: A Randomized Clinical Trial

by Elena Bardellini, Francesca Amadori, Laura Rosselli, Maria Luisa Garo, Alessandra Majorana and Giulio Conti

Dent. J. 2024, 12(6), 186; https://doi.org/10.3390/dj12060186 - 19 Jun 2024

Cited by 2 | Viewed by 1586

Abstract

Dentin hypersensitivity (DH) is a common challenge in pediatric patients with molar incisor hypomineralization (MIH), stemming from enamel porosity or exposed dentin after enamel breakdown. This three-arm randomized controlled clinical trial aims to evaluate the effectiveness of three different desensitizing treatment protocols. The [...] Read more.

Dentin hypersensitivity (DH) is a common challenge in pediatric patients with molar incisor hypomineralization (MIH), stemming from enamel porosity or exposed dentin after enamel breakdown. This three-arm randomized controlled clinical trial aims to evaluate the effectiveness of three different desensitizing treatment protocols. The study was conducted on 39 children, aged 6–14 years old, with MIH and DH. Group A received casein phosphopeptide plus amorphous calcium phosphate fluoride (CPP-ACPF) mousse and sham light therapy, Group B received placebo mousse and photo-bio-modulation therapy (PMBT), and Group C received both CPP-ACPF mousse and PMBT. DH evaluation using a visual analogue scale was performed at multiple time points. Both CPP-ACPF mousse and PMBT individually demonstrated desensitizing effects on dental elements affected by MIH. While PMBT had a greater immediate effect, the combination of the two therapies proved most effective in reducing DH. The VAS scores were statistically lower in group C compared to groups A and B, both after the first session (p = 0.0001) and after 28 days (p = 0.0005). This study suggests promising avenues for managing DH in MIH patients, highlighting the potential of combined therapies, specifically CPP-ACPF mousse and PMBT, for enhanced clinical outcomes. Full article

(This article belongs to the Special Issue Oral Health Care in Paediatric Dentistry Volume 2)

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11 pages, 913 KiB

Open AccessArticle

Retrospective Study Regarding the Correlation between Dental Anxiety and Color Preferences in Children with Severe Early Childhood Caries

by Daniela Esian, Cristina Bica, Alexandru Vlasa, Eugen Bud, Elena Stepco, Anamaria Bud and Liana Beresescu

Dent. J. 2024, 12(6), 155; https://doi.org/10.3390/dj12060155 - 22 May 2024

Viewed by 1026

Abstract

Background: Severe early childhood caries (S-ECC) is recognized as a significant chronic disease which affects the quality of life starting at very young ages and has a very rapid evolution towards pulp complication and loss of dental tissue. Children with a high caries [...] Read more.

Background: Severe early childhood caries (S-ECC) is recognized as a significant chronic disease which affects the quality of life starting at very young ages and has a very rapid evolution towards pulp complication and loss of dental tissue. Children with a high caries index DMFT are more likely to develop high levels of dental anxiety, which will influence the degree of cooperation during dental procedures. Emotions play an important role in the psychosomatic development of children, and all the factors that contribute to the modeling of these emotional states must be known and taken into consideration. Aim: The aim of this study was to assess the association between dental anxiety in children with S-ECC and the color preferences for the components of the dental environment to reduce the levels of dental anxiety during medical visits. Material and Method: For this study, 91 children between 3 and 6 years of age diagnosed with S-ECC were selected from the Pediatric Dentistry Department of UMFST from Targu Mures and from a private dental office. The level of dental anxiety was determined by measuring the pulse rate, and a questionnaire was completed to establish the color preferences for the dental office environment and the dentist’s attire. For this purpose, six different colors and their variants with three shades less intensity were chosen by using RGB (Red, Green, and Blue) identification codes for each color. Result: The results showed that there was a statistically significant difference between the age of the subjects and dental anxiety levels, but there was no significant correlation between the DMFT score and dental anxiety. Also, the results showed that there was no significant difference between girls and boys when choosing the colors preferred by them for the dental office, but when comparing the colors that represented happiness, significant statistical difference was found between the girls’ and boys’ groups (p = 0.0039). For all the subjects, the colors associated with happiness were light yellow and pink, while the colors associated with anxiety were red and dark blue. Conclusion: The data obtained showed that dental anxiety is strongly influenced by age, and an important role in inducing positive emotions is played by the dental environment if dressed in specific colors in order to reduce dental anxiety and create familiar conditions, especially for young children with S-ECC. Full article

(This article belongs to the Special Issue Oral Health Care in Paediatric Dentistry Volume 2)

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15 pages, 1777 KiB

Open AccessArticle

Dental Developmental Defects: A Pilot Study to Examine the Prevalence and Etiology in a Population of Children between 2 and 15 Years of Age

by Jorge Alvarado-Gaytán, Gloria Saavedra-Marbán, Laura Velayos-Galán, Nuria E. Gallardo-López, Manuel J. de Nova-García and Antonia M. Caleya

Dent. J. 2024, 12(4), 84; https://doi.org/10.3390/dj12040084 - 25 Mar 2024

Viewed by 1935

Abstract

Dental development defects (DDDs) are quantitative and/or qualitative alterations produced during odontogenesis that affect both primary and permanent dentition. The etiology remains unknown, being associated with prenatal, perinatal, and postnatal factors. The aims were to identify the possible etiological factors, as well as [...] Read more.

Dental development defects (DDDs) are quantitative and/or qualitative alterations produced during odontogenesis that affect both primary and permanent dentition. The etiology remains unknown, being associated with prenatal, perinatal, and postnatal factors. The aims were to identify the possible etiological factors, as well as the prevalence of DDDs in the primary and permanent dentition in a pediatric population. Two hundred twenty-one children between 2 and 15 years of age, patients of the master’s degree in Pediatric Dentistry of the Complutense University of Madrid, were reviewed. DDDs were observed in 60 children. Next, a cross-sectional, case-control study was carried out (60 children in the control group and 60 children in the case group). The parents or guardians completed a questionnaire aimed at identifying associated etiological factors. The prevalence of DDDs in patients attending our master’s program in both dentitions was 27.15%. Otitis, tonsillitis, high fevers, and medication intake stood out as the most relevant postnatal factors among cases and controls. The permanent maxillary right permanent central incisor and the primary mandibular right second molar were the most affected; there were no differences in relation to gender. One out of three children who presented DDDs in the primary dentition also presented DDDs in the permanent dentition. Prenatal and postnatal etiological factors showed a significant relationship with DDD alterations, considered risk factors for DDDs in both dentitions. Full article

(This article belongs to the Special Issue Oral Health Care in Paediatric Dentistry Volume 2)

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20 pages, 2755 KiB

Open AccessArticle

Effect of Commercial Children’s Mouthrinses and Toothpastes on the Viability of Neonatal Human Melanocytes: An In Vitro Study

by Shilpi Goenka and Hsi-Ming Lee

Dent. J. 2023, 11(12), 287; https://doi.org/10.3390/dj11120287 - 12 Dec 2023

Cited by 3 | Viewed by 2166

Abstract

In this study, we examined the cytotoxic effects of six commercial children’s mouthrinses (designated as #1, #2, #3, #4, #5, and #6) and four commercial children’s toothpastes (designated as #1, #2, #3, and #4) on primary human neonatal melanocytes that were used as [...] Read more.

In this study, we examined the cytotoxic effects of six commercial children’s mouthrinses (designated as #1, #2, #3, #4, #5, and #6) and four commercial children’s toothpastes (designated as #1, #2, #3, and #4) on primary human neonatal melanocytes that were used as a representative model for oral melanocytes. Mouthrinses diluted directly with culture medium (1:2, 1:5, 1:10, 1:100, and 1:1000) were added to monolayers of melanocytes for 2 min, followed by 24 h recovery, after which MTS cytotoxicity assay was conducted. The extracts of each toothpaste were prepared (50% w/v), diluted in culture medium (1:2, 1:5, 1:10, 1:50, 1:100, and 1:1000), and added to cell monolayers for 2 min (standard brushing time), followed by an analysis of cell viability after 24 h. Results showed that all mouthrinses except mouthrinse #4 showed significantly greater loss of cell viability, ascribed to cetylpyridinium chloride (CPC) that induced significant cytotoxicity to melanocytes (IC₅₀ = 54.33 µM). In the case of toothpastes, the examination of cellular morphology showed that a 2 min exposure to all toothpaste extracts induced a concentration-dependent decline in cell viability, pronounced in toothpaste containing sodium lauryl sulfate (SLS) detergent. Further results suggested SLS to be the critical driver of cytotoxicity (IC₅₀ = 317.73 µM). It is noteworthy that toothpaste #1 exhibited much lower levels of cytotoxicity compared to the other three toothpastes containing SLS. Taken together, these findings suggest that the melanocytotoxicity of children’s mouthrinse (#4) and toothpaste (#1) is comparatively low. To the best of our knowledge, this is the first study to examine the impact of children’s toothpastes and mouthrinses on neonatal primary human melanocytes. Future studies to investigate these findings in a realistic scenario replicating oral cavity conditions of the presence of microbiota, pellicle layer and saliva, and other cell types are warranted. Full article

(This article belongs to the Special Issue Oral Health Care in Paediatric Dentistry Volume 2)

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15 pages, 308 KiB

Open AccessFeature PaperArticle

Assessment of Pediatricians’ and General Practitioners’ Knowledge and Practice Regarding Oral Health, Dental Caries and Its Prevention in Children: A Cross-Sectional Study

by Antonija Tadin and Karmela Dzaja

Dent. J. 2023, 11(11), 259; https://doi.org/10.3390/dj11110259 - 6 Nov 2023

Cited by 1 | Viewed by 2480

Abstract

Objectives: This study aimed to evaluate and compare the knowledge and practices of family physicians (general practitioners) and pediatricians concerning children’s oral health. Materials and Methods: This research involved a cross-sectional survey with 446 respondents, consisting of 77.8% women and 22.1% men, with [...] Read more.

Objectives: This study aimed to evaluate and compare the knowledge and practices of family physicians (general practitioners) and pediatricians concerning children’s oral health. Materials and Methods: This research involved a cross-sectional survey with 446 respondents, consisting of 77.8% women and 22.1% men, with 81.6% being general (family) practitioners and 18.4% pediatricians. The survey comprised five sections, gathering information on participants’ sociodemographic characteristics, routine oral cavity examination in clinical practice, knowledge about dental caries and its prevention, teething symptoms, and alternatives to fluorides for preventing dental caries. Results: The findings revealed an overall poor understanding of dental caries and its prevention, with an average score of 5.1 ± 1.6 out of a possible 10 points. Notably, practitioners with fewer pediatric patients during the workday, no training on oral health, and uncertainty about physicians’ active role in oral health prevention exhibited lower knowledge levels (p ˂ 0.05). Over 90% of participants conducted dental and oral mucosal examinations on their patients. About 25% had received continuing education on children’s oral health, and 70.6% expressed interest in further education on the subject. Conclusions: This study highlights insufficient knowledge among physicians regarding dental caries and its prevention. With most participants eager to learn and actively promote children’s oral health, providing training is essential to boost their knowledge and support children’s oral health. Full article

(This article belongs to the Special Issue Oral Health Care in Paediatric Dentistry Volume 2)

14 pages, 900 KiB

Open AccessArticle

The Impact of the COVID-19 Pandemic on Pediatric Dentistry: Insights from an Italian Cross-Sectional Survey

by Giulio Conti, Francesca Amadori, Alessandra Bordanzi, Alessandra Majorana and Elena Bardellini

Dent. J. 2023, 11(6), 154; https://doi.org/10.3390/dj11060154 - 19 Jun 2023

Cited by 1 | Viewed by 1657

Abstract

Background. The COVID-19 pandemic has had a significant impact on pediatric dentistry and also dental education. This study aimed to assess the observed changes in children’s oral health by pediatric dentists and also served as an educational tool for dentistry students during the [...] Read more.

Background. The COVID-19 pandemic has had a significant impact on pediatric dentistry and also dental education. This study aimed to assess the observed changes in children’s oral health by pediatric dentists and also served as an educational tool for dentistry students during the pandemic. Methods. Postgraduate students in pediatric dentistry prepared a survey addressed to Italian pediatric dentists. Over 5476 dentists were invited to participate, and collaboration among the students took place through virtual meetings and electronic platforms. The online questionnaire was composed of 29 questions focusing on the management of pediatric patients during and after the lockdown period. A descriptive statistic was used for data analysis, and chi-square tests were performed (p < 0.05). Results. A total of 1752 pediatric dentists participated in the survey. During the lockdown, 68.3% of dentists exclusively handled dental emergencies. In the subsequent semester, a significant decrease in the number of pediatric treatments was reported. Pediatric dentists also noted a decline in children’s oral hygiene practices, a deterioration in dietary habits, and an increase in anxiety during dental procedures. Conclusions. This survey shed light on the diverse effects of the pandemic on children’s oral health and also provided valuable educational insights. Full article

(This article belongs to the Special Issue Oral Health Care in Paediatric Dentistry Volume 2)

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11 pages, 1513 KiB

Open AccessArticle

Association of Masticatory Efficiency and Reduced Number of Antagonistic Contacts Due to Extraction, Changing Dentition or Malocclusion in Children

by Odri Cicvaric, Renata Grzic, Marija Simunovic Erpusina, Suncana Simonic-Kocijan, Danko Bakarcic and Natasa Ivancic Jokic

Dent. J. 2023, 11(3), 64; https://doi.org/10.3390/dj11030064 - 28 Feb 2023

Cited by 3 | Viewed by 2330

Abstract

Background: Tooth extraction, changing dentition and malocclusion can decrease area of occlusal contact and negatively affect masticatory efficiency. Aim of this study was to evaluate difference in masticatory efficiency in association with previously named factors. Materials and methods: In this cross-sectional study masticatory [...] Read more.

Background: Tooth extraction, changing dentition and malocclusion can decrease area of occlusal contact and negatively affect masticatory efficiency. Aim of this study was to evaluate difference in masticatory efficiency in association with previously named factors. Materials and methods: In this cross-sectional study masticatory efficiency parameters (number of particles, mean diameter and mean surface of particles) determined with optical scanning method were compared between children with healthy dentition (12 girls, 12 boys, age 3 to 14) and children with lost antagonistic contacts due to tooth extraction, changing dentition and malocclusions (12 girls, 12 boys, age 3 to 14). Results: Number of chewed particles is significantly higher in a group of children with healthy dentition (p < 0.001), and chewed particles’ mean diameter and surface are significantly higher in the Group 2 (p < 0.001; p < 0.001). Number of lost occlusal contacts is not in correlation with masticatory efficiency parameters (p= 0.464; p= 0.483; p= 0.489). Conclusions: Children with lost antagonistic contacts have an impaired masticatory efficiency in comparison to children with complete dentition, but there is no difference regarding the aetiology of contact loss. Full article

(This article belongs to the Special Issue Oral Health Care in Paediatric Dentistry Volume 2)

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9 pages, 274 KiB

Open AccessArticle

The Oral Health Status and Treatment Needs of Pediatric Patients Living with Autism Spectrum Disorder: A Retrospective Study

by Sara Hasell, Ahmed Hussain and Keith Da Silva

Dent. J. 2022, 10(12), 224; https://doi.org/10.3390/dj10120224 - 28 Nov 2022

Cited by 9 | Viewed by 3219

Abstract

Background: The objective of this retrospective study was to assess the oral health status and treatment needs of children with ASD and to explore the differences in risk factors and oral health care status and the risk factors for treatment under GA. Methods: [...] Read more.

Background: The objective of this retrospective study was to assess the oral health status and treatment needs of children with ASD and to explore the differences in risk factors and oral health care status and the risk factors for treatment under GA. Methods: Dental charts of children between 6 and 14 years of age who were examined at a dental facility associated with the College of Dentistry, University of Saskatchewan between 2016 to 2019 were assessed. Children who were identified as having ASD, as well as an age- and gender-matched control group consisting of otherwise healthy children were included in the study. Results: The sample included 346 dental records, with 173 children having a diagnosis of ASD. Children diagnosed with ASD had significantly higher experience with caries (91.3% vs. 65.9%, p = 0.003) and severity (mean DMFT/dmft = 8.18 ± 1.62 vs. 4.93 ± 0.58 p = 0.007). Children with ASD were also older when visiting the dentist for the first time (age of 5.97 ± 1.18 vs. 2.79 ± 1.09, p = 0.02)). Children with ASD were less likely to brush once a day (66.5% vs. 88.4%, p = 0.02), were more likely to have bruxism (35.8% vs. 10.4%, p = 0.003) and were less likely to have class I occlusion (64.7% vs. 80.9%, p = 0.03). Findings from the logistic regression analysis revealed that children with ASD were also 2.13 times more likely to receive a referral for general anesthesia when all other variables were held constant (p = 0.03). Conclusions: This research demonstrates that children diagnosed with ASD may face more barriers with access to oral health care, leading to poorer outcomes and greater treatment dental needs. Full article

(This article belongs to the Special Issue Oral Health Care in Paediatric Dentistry Volume 2)

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17 pages, 2375 KiB

Open AccessSystematic Review

Ozone Treatment for the Management of Caries in Primary Dentition: A Systematic Review of Clinical Studies

by Federica Veneri, Tommaso Filippini, Ugo Consolo, Marco Vinceti and Luigi Generali

Dent. J. 2024, 12(3), 69; https://doi.org/10.3390/dj12030069 - 6 Mar 2024

Cited by 4 | Viewed by 2877

Abstract

Dental caries in children is a frequent and debilitating condition, whose management is often challenging. The aim of this systematic review was to investigate the effectiveness of ozone applications for the treatment of caries in primary dentition. According to PRISMA guidelines, a systematic [...] Read more.

Dental caries in children is a frequent and debilitating condition, whose management is often challenging. The aim of this systematic review was to investigate the effectiveness of ozone applications for the treatment of caries in primary dentition. According to PRISMA guidelines, a systematic literature search was performed up to 6 January 2024. Clinical studies using ozone to treat caries of deciduous teeth were considered for inclusion. Out of the 215 records retrieved, seven studies were eventually included in the review, all of which used gaseous ozone. Four studies were judged at high risk of bias, two at low risk, and one of some concerns. The great heterogeneity of designs, outcomes, and protocols made it impossible to conduct a meta-analysis. Despite some limitations, the evidence yielded by the included studies suggests that ozone application, regardless of the protocol applied, is comparable to other interventions in terms of clinical outcomes and anti-bacterial activity, with no reported adverse effects and good patient acceptance. Therefore, ozone application may be a non-invasive approach to treat caries in primary dentition, especially in very young and poorly cooperative patients. Further standardized and rigorous studies are, however, needed to identify the best clinical protocols for this specific field. Full article

(This article belongs to the Special Issue Oral Health Care in Paediatric Dentistry Volume 2)

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11 pages, 927 KiB

Open AccessProtocol

The Caries-Arrest Effectiveness of Silver Diamine Fluoride Treatment with Different Post-Treatment Instructions in Preschool Children: A Study Protocol for a Randomized Controlled Trial

by Ivy Guofang Sun, Duangporn Duangthip, Edward Chin Man Lo and Chun Hung Chu

Dent. J. 2023, 11(6), 145; https://doi.org/10.3390/dj11060145 - 5 Jun 2023

Cited by 4 | Viewed by 2693

Abstract

In this 12-month randomized active-controlled clinical trial, we compare two post-treatment instructions for silver diamine fluoride (SDF) therapy in arresting dentine caries. The trial will include at least 254 kindergarten children with active dentine caries. The children will be randomized into two groups [...] Read more.

In this 12-month randomized active-controlled clinical trial, we compare two post-treatment instructions for silver diamine fluoride (SDF) therapy in arresting dentine caries. The trial will include at least 254 kindergarten children with active dentine caries. The children will be randomized into two groups and receive a 38% SDF solution applied topically to their carious lesions. Children in Group A will rinse immediately, whereas those in Group B will refrain from rinsing, eating, and drinking for 30 min. One trained examiner will perform the dental examination at baseline and every six months. The primary outcome measurement will be the proportion of caries lesions that become arrested at the 12-month examination. Potential confounding factors and parents’ satisfaction with SDF therapy at baseline and after 12 months will be collected using parental questionnaires. This trial will provide evidence-based information for clinical practitioners to give post-treatment instructions for SDF therapy. This study is registered at ClinicalTrial.gov (USA) (registration number: NCT05655286). Full article

(This article belongs to the Special Issue Oral Health Care in Paediatric Dentistry Volume 2)

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10 pages, 236 KiB

Open AccessProtocol

An International Investigation of Molar Incisor Hypomineralisation (iMIH) and Its Association with Dental Anomalies: Development of a Protocol

by Helen D. Rodd, Hani Nazzal, Clarissa Calil Bonifacio, Choe Wei Ruth, Felicity Crombie, Osama El Shahawy, Morenike Oluwatoyin Folayan, Karla Gambetta-Tessini, Ashima Goyal, Noren Hasmun, Ahmad I. Issa, Suhad Jundi, David J. Manton, Srinivasan Narasimhan, Samah Omar, Susan Parekh, Bamidele O Popoola, Mihiri Silva, Greig Taylor and Yang Qiyue Naomi

Dent. J. 2023, 11(5), 117; https://doi.org/10.3390/dj11050117 - 28 Apr 2023

Cited by 4 | Viewed by 2838

Abstract

Background: Molar incisor hypomineralisation (MIH) is a common disorder of tooth development, which has recently been found to be associated with a higher prevalence of hypodontia. The aim of this international multicentre study is to determine the association between MIH and other developmental [...] Read more.

Background: Molar incisor hypomineralisation (MIH) is a common disorder of tooth development, which has recently been found to be associated with a higher prevalence of hypodontia. The aim of this international multicentre study is to determine the association between MIH and other developmental anomalies in different populations. Methods: Investigators were trained and calibrated for the assessment of MIH and dental anomalies and ethical approvals obtained in each participating country. The study aimed to recruit 584 children with MIH and 584 children without MIH. Patients aged 7–16 years who attend specialist clinics will be invited to participate. Children will undergo a clinical examination to determine the presence and severity of MIH, using an established index. The presence of any other anomalies, affecting tooth number, morphology, or position, will be documented. Panoramic radiographs will be assessed for dental anomalies and the presence of third permanent molars. Statistical analysis, using a chi squared test and regression analysis, will be performed to determine any differences in dental anomaly prevalence between the MIH and non-MIH group and to determine any association between dental anomalies and patient characteristics. Conclusion: This large-scale study has the potential to improve understanding about MIH with benefits for patient management. Full article

(This article belongs to the Special Issue Oral Health Care in Paediatric Dentistry Volume 2)

13 pages, 4345 KiB

Open AccessEditor’s ChoiceCase Report

Temporomandibular Joint Ankylosis in a Girl Child: Immunochemical Evaluation of Tissue Material Obtained from Repeated Arthroplasty Surgeries

by Nityanand Jain, Mara Pilmane, Andrejs Skagers, Shivani Jain and Pavlo Fedirko

Dent. J. 2023, 11(1), 16; https://doi.org/10.3390/dj11010016 - 3 Jan 2023

Viewed by 1912

Abstract

Temporomandibular joint ankylosis (TMJA) is a rare, but debilitating, condition that leads to TMJ joint hypomobility. Surgery is the mainstay for treatment, which is accompanied by rehabilitative and psychological support. Despite the advances in surgical techniques, the recurrence of TMJA post-surgery has been [...] Read more.

Temporomandibular joint ankylosis (TMJA) is a rare, but debilitating, condition that leads to TMJ joint hypomobility. Surgery is the mainstay for treatment, which is accompanied by rehabilitative and psychological support. Despite the advances in surgical techniques, the recurrence of TMJA post-surgery has been reported as a common complication. Therefore, it becomes essential to investigate and understand the histo-morpho-pathological processes governing these ankylotic changes. Given the lack of such studies in the literature, herein we present a case of a girl child who underwent primary surgery at the age of six years, followed by a second surgery at the age of twelve years. Ankylotic tissue samples collected during both surgeries were studied using various immunohistochemical markers for tissue remodeling, inflammation, antimicrobial activity, and transcriptional regulation. The expression of MMP-2 and -9 was downregulated in repeated surgery materials, whilst MMP-13 was rarely detected in both tissues. Strong MMP-8, TIMP-2, and TIMP-4 expressions were noted in both tissues, showing their anti-inflammatory and protective roles. Moderately strong expression of bFGF, FGFR-1, IL-1α, and TNF-α could indicate sustained tissue growth in the background of inflammation (wound healing). Interestingly, the expression of β-defensin-2 was found to be constant in both tissues, thereby indicating possible ECM remodeling and collagen breakdown. Finally, a moderate expression of RUNX-2, coupled with a low expression of WNT-1 and -3a, could indicate a slow and delayed bone regeneration process. Our results showcase the complex myriad of pathways that could be involved in the progression of TMJA and post-surgery healing processes. Immunopathological studies could aid in improving the diagnosis, treatment, and prognosis for patients affected with TMJA. Full article

(This article belongs to the Special Issue Oral Health Care in Paediatric Dentistry Volume 2)

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