Search Results (106)

When fabricating custom-made mouthguards for children, tooth replacement is an important factor for dentists to consider. In addition, orofacial myofunctional disorders and deleterious oral habits—such as incompetent lip seal and tongue thrusting—are relatively common among children and are associated with an increased risk of oral and dental trauma. Therefore, individual oral functional characteristics should be taken into account when designing custom-made mouthguards for pediatric patients. This report presents a case involving the design, fabrication, and appliance management of a custom-made mouthguard for a Japanese boy exhibiting incompetent lip seal and tongue thrusting. In this case, the anterior palate region of the mouthguard was left uncut, and multiple holes were created using a carbide bur to permit tongue–palate contact and provide sensory feedback related to tongue elevation. Over a 20-month follow-up period, no oral or dental trauma was observed. During appliance use, the patient demonstrated improved tongue elevation and an increased frequency of lip seal at rest. This case illustrates a custom mouthguard design that incorporates individual oral functional characteristics in a pediatric patient. Full article

Aim: This cross-sectional study aimed to evaluate and compare parents’ and children’s preferences for full-coverage restorative treatment options of primary molars, including stainless steel crowns (SSCs), zirconia crowns (ZCs), and BioFlx crowns. Additionally, the study evaluates the influence of providing a brief overview of the advantages and disadvantages of each full-coverage restorative treatment option on parental preference. Methods: The study was conducted at the pediatric dental clinics at King Abdulaziz University Faculty of Dentistry (KAUFD) in Jeddah, Saudi Arabia, from January to May 2024. Healthy Arabic-speaking children aged 6–12 years attending KAUFD for routine dental treatment, along with at least one parent who agreed to participate, were included. Three typodont models with a SSC, a ZC, and a BioFlx crown were prepared and cemented by an expert pediatric dentist. The participating children and their parents were simultaneously and independently shown the prepared typodont models and asked to indicate which treatment option they preferred most. Subsequently, a trained pediatric dentist presented a brief overview of the advantages and disadvantages of each treatment option to the parents. Then, parents were asked to re-evaluate their preferences. The threshold for significance was set at p < 0.05. Results: A total of 172 children and their parents were included. The most preferred full-coverage restorative treatment among children was SSC (39.0%), while among parents, ZC (60.5%) was the most preferred. After providing a brief overview, the most preferred option among parents was SSC (39.5%), with ZC and BioFlx crowns being equally preferred (30.2%). Significantly more children with no history of dental pain or discomfort (49.1%) (p = 0.023) or with a history of previous dental treatment involving SSC (40.2%) (p = 0.045) preferred SSC. The ZC was significantly more preferred by parents of female children (70.65%) (p = 0.027) and by parents of children with a history of dental treatment (60.6%) (p = 0.018). Conclusions: The study revealed that parental demands and expectations often differ from those of their children, leading to notable differences between children’s and parents’ preferences. After a brief overview, parental preference shifted from ZC to SSC, highlighting the importance of effective communication and education when making treatment decisions for pediatric patients. Full article

Background/Objectives: Accurate drug dosage calculation in pediatric dentistry represents an essential component of everyday clinical practice. However, manual calculation methods, reliance on memory, and inconsistent pharmacological education often lead to uncertainty among practitioners. Methods: To support clinicians in this process, a mobile application—Dent.IN CALC—was developed as a rapid, evidence-based, and user-friendly tool. The app allows the input of age and weight to instantly generate recommended and maximum safe dosages of commonly prescribed antibiotics, analgesics, and local anesthetics. Additionally, it includes a list of corresponding pharmaceutical preparations available on the local market. A preliminary evaluation among sixty dentists revealed significant variability in dosage knowledge and confirmed the need for digital tools that facilitate accurate and efficient prescribing. Results: Most users rated the app as intuitive, time-saving, and highly beneficial for daily practice (mean satisfaction score 4.7 ± 0.4; 95% would recommend the app). Conclusions: The Dent.IN CALC app shows strong user acceptance and demonstrates how digital solutions can streamline workflow and support clinicians in routine pediatric pharmacological decision-making. Full article

Background: X-linked hypophosphatemic rickets (XLH) is a rare hereditary disorder characterized by renal phosphate wasting and impaired bone mineralization. Oral manifestations such as spontaneous periapical lesions and dental abscesses in the absence of caries or trauma may precede systemic features in XLH due to underlying dentin hypomineralization and enamel–dentin junction defects, and could serve as early diagnostic indicators. Case Report: We report on the case of a 4-year-old boy referred to our pediatric dental unit with recurrent intraoral fistulas persisting over the past year. Clinical examinations and an orthopantomogram revealed extensive root resorption and periapical pathology affecting multiple primary molars without evident caries or trauma. Laboratory investigations showed hypophosphatemia, elevated renal phosphate loss, and raised inflammatory markers (CRP (C-reactive protein) and granulocytes). Genetic testing of the child and his mother confirmed a diagnosis of X-linked hypophosphatemic rickets. Management: Due to behavioral challenges, treatment proceeded with difficulty over multiple visits. Endodontic treatment was initiated using a formalin–resorcinol technique; however, several primary molars developed progressive necrosis and required extraction. Orthodontic space maintainers were placed to preserve arch integrity and support future eruption. The patient remains under follow-up and is currently awaiting Burosumab therapy. Despite systemic management, spontaneous necroses of the primary molars persist, highlighting the refractory nature of dental involvement in XLH. Conclusions: This case underscores the pivotal role of pediatric dentists in recognizing systemic diseases through oral findings and demonstrates the challenges of managing XLH-related dental pathology, even under targeted systemic therapy. Early interdisciplinary collaboration is essential to optimize both dental and systemic outcomes in affected children. Full article

Background and Objectives: Dental treatments of children with previous negative dental experiences are challenging and frequently require sedation or general anesthesia. Therefore, this study aimed to identify treatment pathways and factors associated with dental treatment under general anesthesia, nitrous oxide sedation, and chairside management among pediatric dental patients with adverse dental experiences. Materials and Methods: A retrospective cohort analysis was conducted on all new children aged 2–12 years with negative dental experience and treatment need visiting the Pediatric Department of the Dental Clinic, University of Greifswald, between 1 January and 31 December 2021. Results: Of the 640 newly presenting patients, 78 cases met inclusion criteria and were analyzed (mean age 6.7 ± 2.19 years, baseline dmft 4.5 ± 3.0 and DMFT 0.6 ± 1.2), with 88.5% having caries as chief complaint and 61.5% having a referral from other dentists. Eventually, only 25.6% received general anesthesia (mean age 5.1 ± 1.9 years, mean dt 5.6 ± 2.6), while 56.4% were managed with nitrous oxide sedation (mean age 7.3 ± 1.7 years, mean dt 3.3 ± 2.4), and 18% with chairside treatment (mean age 6.9 ± 2.8 years, mean dt 1.9 ± 2.4). Children of younger age, with higher dmft/dt scores and lower behavior ratings, were more frequently treated under general anesthesia. However, none of these variables could be identified as independent predictors for treatment under general anesthesia. Conclusions: Minimally invasive caries management, combined with appropriate behavior guidance and conscious sedation when indicated, can drastically reduce the need for general anesthesia in children, even among those with dental anxiety or previous negative dental experience. Full article

(1) Background/Objectives: Obstructive Sleep Apnea (OSA) in childhood is a significant health concern with potential adverse effects on daytime function, behavior, education, and overall development. Early intervention is crucial to ease these consequences. Myofunctional therapy (MT) has emerged as a treatment modality, particularly in young children, to address OSA. This highlights the importance of early detection and intervention by pediatric dentists and other healthcare providers who frequently interact with the pediatric oral and facial structures. This study aimed to investigate the knowledge, attitudes, and practices of Lebanese pediatric dentists regarding pediatric OSA and MT. (2) Methods: A cross-sectional survey was distributed to 103 Lebanese Pediatric dentists registered with the Lebanese Society of Pediatric Dentistry (LSPD). The survey assessed familiarity with OSA, diagnostic practices, treatment approaches, and utilization of MT. (3) Results: Out of 103 pediatric dentists, 62 responded (60.2%). Most respondents were familiar with OSA (86.8%). However, the number of diagnostic symptoms used varied. MT was not pediatric dentists’ primary choice in treating OSA. (4) Conclusions: Lebanese pediatric dentists demonstrate a good understanding of OSA, but there is potential for improvement in diagnostic comprehensiveness and exploration of MT as a treatment option. Full article

Background: Timely dental care is essential to prevent complications and preserve natural teeth, yet inefficient referral practices, low reimbursement rates and systemic barriers continue to disproportionately affect Medicaid-enrolled children. This study assessed the appropriateness of root canal therapy (RCT) referrals to a University-based Advanced Education in General Dentistry (AEGD) program and examined diagnostic and treatment characteristics of referred cases. Methods: A retrospective review was conducted of pediatric patients aged 6–17 years who were referred by external dental providers to two AEGD clinics in Nevada, United States, between February and August 2024 for endodontic evaluation of carious permanent teeth. Demographic, tooth-type, pulp-status, and treatment outcome data were analyzed using descriptive statistics, chi-square tests, Kruskal–Wallis comparisons, and multivariable logistic regression models. Results: Among 154 referred patients, 96.8% (n = 149) were Medicaid beneficiaries. A total of 247 teeth were evaluated; 74.1% were molars. Pulp testing showed that 41.3% had healthy pulps and 16.6% had reversible pulpitis, while only 37.2% of teeth required RCT. Age differed significantly across pulp diagnoses (p = 0.0012), and older age independently predicted appropriate referral (adjusted OR = 1.18, 95% CI 1.07–1.31). Gender was not associated with follow-up compliance (p = 0.47). By November 2024, 53.4% of referred teeth had completed treatment, and 9.3% had no follow-up. Conclusions: More than half of the referral teeth did not require RCT, indicating a high rate of potentially avoidable referrals and highlighting gaps in diagnostic confidence and decision-making at the primary care level. Practical Implications: Enhancing diagnostic training and decision support for general dentists, particularly in vital pulp therapy for young permanent teeth, along with improving Medicaid reimbursement and standardizing referral protocols, may reduce inappropriate specialty referrals. In combination with broader policy reforms, these measures can improve system efficiency and expand access to timely, equitable pediatric dental care. Full article

Background: Interprofessional collaboration is vital for comprehensive, patient-centered care. Despite growing recognition of oral–systemic health links, the integration of dentists into healthcare teams remains limited. This scoping review mapped existing evidence on dental professionals’ roles within interprofessional healthcare, identifying key benefits, barriers, and facilitators. Methods: A systematic search of PubMed, SCOPUS, and Web of Science identified English-language studies (2014 to 2024) focused on collaboration between dental and non-dental providers. Studies addressing oral–systemic health without team-based integration were excluded. Screening and data charting followed the PRISMA-ScR framework using JBI data extraction and critical appraisal tools. Data were synthesized thematically by collaboration model, outcomes, and influencing factors. Results: Nine studies met the inclusion criteria. Integrating dental professionals into healthcare teams improved patient outcomes, quality of life, and satisfaction. Effective models included nurse practitioner–dentist partnerships and medical–dental collaboration in pediatrics and chronic disease care. Barriers included poor communication, lack of interoperable electronic health records, role ambiguity, and limited interprofessional training. Key facilitators were supportive policies, integrated care structures, professional education, and strong team communication. Conclusions: Integrating dentists into interprofessional teams enhances healthcare delivery and patient outcomes. However, significant barriers remain. Addressing communication gaps, implementing shared health records, and expanding interprofessional education are essential steps toward more cohesive care. Future research should evaluate scalable integration frameworks and incorporate patient perspectives to inform team-based care. Full article

Background and Objectives: Early Childhood Caries affect children’s quality of life and overall health. This study aimed to assess the involvement of dentists in implementing early preventive measures, including fluoride use, for children aged 6–33 months. Materials and Methods: a multiple-choice questionnaire was distributed in six German states, consisting of two sections: Section I covered participant demographics and Section II included items on dental preventive measures for children. The questionnaire was adapted from a validated German-language source, reviewed by five experts at Kiel University, and tested in a focus group of 30 dentists. Descriptive statistics (mean ± SD or median [IQR]) and Mann–Whitney U tests were used to assess pediatric dentists (PD) and general dentists (GP) involvement in early dental preventive measures. Results: A total of 511 eligible questionnaires were returned (mean age 47 ± 11 year, 63.8% females, 36.7% PD). Both GP and PD routinely recommended a diagnostic dental visit (1 = never, 5 = always), with PD reporting higher frequency (GP: 4 [3–5], PD: 4.5 [4–5]; p = 0.001). Parental training in oral hygiene was performed significantly more often by PD (p < 0.01). PD also recommended tooth brushing with fluoridated toothpaste after the eruption of the first tooth more frequently than GP (GP: 5 [3–5], PD: 5 [4–5]; p = 0.06). Surprisingly, fluoride-free toothpaste was still recommended by a relevant number of respondents in both groups. Conclusions: PDs showed greater involvement in early caries prevention than GP. While most recommended fluoridated toothpaste, many still advised fluoride-free options, highlighting gaps in guideline adherence. Full article

Background/Objectives: Vascular Malformation—Osteolytic Subtype (VMOS) is an exceptionally rare autosomal recessive disorder caused by homozygous pathogenic variants in the ELMO2 gene, with fewer than ten genetically confirmed pediatric cases reported worldwide. This report presents the longitudinal dental management and clinical course of a child with VMOS, emphasizing the challenges of preventive and restorative care in such cases. Methods: A four-year-old child with a confirmed diagnosis of VMOS and a history of urgent bilateral coil embolization and surgical excision of mandibular aneurysmal bone cysts presented for dental care. The patient was followed for three years (2022–2025). Management focused on staged oral rehabilitation, preventive strategies, and restorative interventions adapted to changes across dentition stages. Results: At initial presentation, the child exhibited mandibular swelling, gingival hypertrophy, and a history of spontaneous intraoral bleeding. The postoperative course had been complicated by cerebral abscesses requiring prolonged intravenous antibiotics. During the primary dentition stage, full oral rehabilitation and strict preventive protocols were implemented to minimize caries and infection risk. In the mixed dentition period, the permanent incisors and molars erupted with enamel hypoplasia and developmental defects, necessitating composite restorations. Ectopic eruption and suboptimal oral hygiene, partly related to parental fear of bleeding, were also managed with reinforced preventive counseling. Conclusions: This case highlights the long-term dental implications of VMOS, underscoring the crucial role of the pediatric dentist in early preventive planning and individualized restorative management. Effective multidisciplinary coordination remains essential to preserve oral health and minimize complications in rare vascular syndromes with craniofacial involvement. Full article

Background and Objectives: This study retrospectively investigated the impact of regenerative endodontic treatments (RET) on the healing of periapical lesions in young permanent molars with open apices. Our objective was to evaluate the relationship between treatment outcomes and changes in the fractal dimension (FD) of the periapical bone before and after RET. The study was conducted at the Department of Pediatric Dentistry, Necmettin Erbakan University between January 2020 and December 2024. Materials and Methods: We examined panoramic radiographs from systematically healthy patients aged 6–16 years who underwent RET in the posterior mandible between January 2020 and December 2024. Changes in periapical bone were assessed using fractal analysis before treatment and after a 6-month follow-up. Additionally, mental index (MI), mandibular cortical width (MCW), mental length (ML), and periapical index (PAI) values were evaluated. Radiographs were taken with a Planmeca ProOne^® device and analyzed using ImageJ v1.54 software. Results: Comparison of FD values between treated and contralateral tooth areas, as well as before and after RET, revealed an average FD value of 1.27 ± 0.05 after regeneration, increasing to 1.29 ± 0.27 at the 6-month follow-up. Significant increases were observed in MCW (p = 0.005/p = 0.049) and ML (p = 0.022/p = 0.001) in the 35–36 and 45–46 regions post-RET, though MI values showed no significant change. Importantly, PAI scores demonstrated significant improvement after RET. Conclusions: The findings suggest that RET is effective in promoting the healing of periapical lesions in young permanent molars. The observed increases in cortical width and improvements in PAI scores support the positive impact of this treatment on bone healing. Furthermore, FD analysis, when combined with radiomorphometric indices, could provide a valuable and objective tool for evaluating RET outcomes. Full article

Background: Early preventive dental visits are critical to reducing oral diseases in children and establishing lifelong oral hygiene behaviors. The American Academy of Pediatric Dentistry (AAPD) recommends that a child’s first dental visit occur by age one. However, in Saudi Arabia, limited evidence exists on parental awareness, attitudes, and barriers toward this recommendation. Objective: This study aimed to evaluate the timing of the first dental visit among Saudi children and to identify parental knowledge, barriers, and sociodemographic factors associated with compliance with AAPD guidelines. Materials and Methods: A cross-sectional survey was conducted between April and July 2025 at the Pediatric Dental Clinic, King Saud University, Riyadh. A validated, self-administered Arabic questionnaire was distributed both online and in-clinic to Saudi parents of children under 12 years. A total of 465 completed responses were analyzed using descriptive statistics, chi-square tests, logistic regression, and Spearman correlation to assess associations between parental awareness, socioeconomic variables, and compliance. Results: Of the 465 respondents, 39.6% were aware of AAPD guidelines, yet only 30.5% reported compliance with the recommendation of a dental visit by age one. The most cited barriers were lack of time (42%), difficulty accessing clinics (22%), shortage of pediatric dentists (20%), and lack of awareness (16%). Higher parental education (p = 0.003) and income (p < 0.001) were significantly associated with compliance. A moderate positive correlation was observed between early dental visits and regular annual check-ups (ρ = 0.319). Conclusions: Compliance with AAPD guidelines among Saudi parents remains low, largely due to limited awareness and access barriers. Strengthening parental education, community-based programs, and affordable pediatric dental services is essential to promote preventive care and improve oral health outcomes in children. Full article

Background/Objectives: The diagnosis of pediatric dental conditions from panoramic radiographs is uniquely challenging due to the dynamic nature of the mixed dentition phase, which can lead to subjective and inconsistent interpretations. This study aims to develop and rigorously validate an advanced deep learning model to enhance diagnostic accuracy and efficiency in pediatric dentistry, providing an objective tool to support clinical decision-making. Methods: An initial comparative study of four state-of-the-art YOLO variants (YOLOv8, v9, v10, and v11) was conducted to identify the optimal architecture for detecting four common findings: Dental Caries, Deciduous Tooth, Root Canal Treatment, and Pulpotomy. A stringent two-tiered validation strategy was employed: a primary public dataset (n = 644 images) was used for training and model selection, while a completely independent external dataset (n = 150 images) was used for final testing. All annotations were validated by a dual-expert team comprising a board-certified pediatric dentist and an experienced oral and maxillofacial radiologist. Results: Based on its leading performance on the internal validation set, YOLOv11x was selected as the optimal model, achieving a mean Average Precision (mAP50) of 0.91. When evaluated on the independent external test set, the model demonstrated robust generalization, achieving an overall F1-Score of 0.81 and a mAP50 of 0.82. It yielded clinically valuable recall rates for therapeutic interventions (Root Canal Treatment: 88%; Pulpotomy: 86%) and other conditions (Deciduous Tooth: 84%; Dental Caries: 79%). Conclusions: Validated through a rigorous dual-dataset and dual-expert process, the YOLOv11x model demonstrates its potential as an accurate and reliable tool for automated detection in pediatric panoramic radiographs. This work suggests that such AI-driven systems can serve as valuable assistive tools for clinicians by supporting diagnostic workflows and contributing to the consistent detection of common dental findings in pediatric patients. Full article

Background/Objectives: Migraine affects approximately 3–10% of school-aged children and up to 28% of adolescents, with prevalence increasing during adolescence. For pediatric specialty providers, increased awareness of this condition may influence patient care. This study examined pediatric dentists’ education, clinical exposure, and perceived knowledge gaps related to pediatric migraine, with the goal of identifying barriers to recognition and referral, as well as informing future training to support accurate diagnosis and interdisciplinary care. Methods: A 28-item electronic questionnaire was distributed to all members of the American Academy of Pediatric Dentistry, including pediatric dentists and postgraduate pediatric dental residents, assessing knowledge, beliefs, clinical experience, and interest in further training regarding pediatric headache/migraine management. Respondents with and without previous training were compared in terms of general understanding using t-tests; a linear regression model analyzed predictors of provider awareness regarding links between oral conditions and headache/migraine. Results: Among 315 respondents, the mean self-perceived awareness score was 2.7 ± 1.3 (on a 0–5 scale). The most frequently identified contributing factors were clenching (73.7%), bruxism (72.4%), and temporomandibular disorders (65.7%). Nearly all respondents (95.2%) reported no formal education on headache/migraine prevention, yet 78.1% agreed on the importance of understanding the relationship between oral health and headache/migraine. Respondents with prior training were significantly more aware (p < 0.001) than those without prior training. Educating families (p < 0.001), frequency of patient encounters with headache (p = 0.032), coordination with healthcare providers (p = 0.002), and access to appropriate management resources (p < 0.001) were significant predictors of providers’ awareness. Conclusions: Pediatric dental providers expressed strong interest in enhancing their knowledge of headache/migraine management, highlighting the value of integrating headache/migraine-related education into training programs and promoting greater interdisciplinary collaboration. Full article

This study aimed to evaluate and compare the performance of four advanced artificial intelligence-powered chatbots—ChatGPT-4 Omni (ChatGPT-4o), DeepSeek, Gemini Advanced, and Claude 3.7 Sonnet—in responding to questions related to traumatic dental injuries (TDIs) in the primary dentition. The assessment focused on accuracy, completeness, readability, and response time, aligning with the 2020 International Association of Dental Traumatology guidelines. Twenty-five open-ended TDI questions were submitted to each model in two separate sessions. Responses were anonymized and evaluated by four pediatric dentists. Accuracy and completeness were rated using Likert scales; readability was assessed using five standard indices; and response times were recorded in seconds. ChatGPT-4o demonstrated significantly higher accuracy than Gemini Advanced (p = 0.005), while DeepSeek outperformed Gemini Advanced in completeness (p = 0.010). Response times differed significantly (p < 0.001), with DeepSeek being the slowest and ChatGPT-4o and Gemini Advanced being the fastest. DeepSeek produced the most readable outputs relatively, though none met public readability standards. Claude 3.7 generated the most complex texts (p < 0.001). A strong correlation existed between accuracy and completeness (ρ = 0.701, p < 0.001). These findings emphasize the cautious integration of artificial intelligence chatbots into pediatric dental care due to varied performance. Clinical accuracy, completeness, and readability are critical when offering information aligned with guidelines to support decisions in dental trauma management. Full article