Search Results (92)

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

Background: Pericoronitis is defined as inflammation of the soft tissues around the crown of an erupting tooth or a tooth with incomplete eruption, most commonly during eruption of the third molars. Pediatric dentists frequently encounter pericoronitis of the first molar, most of which resolve spontaneously. We describe the case of a 7-year-old girl who was referred to our hospital with intractable swelling in the right buccal region. Case Presentation: Intraoral examination showed an erupting right mandibular first molar and facial examination revealed swelling and an accumulation of pus in the cheek region. Radiographic examination revealed no pathological findings; therefore, it was diagnosed as a cheek abscess, and the region was incised that day. However, the symptoms recurred 3 weeks later, and cone-beam computed tomography detected a bone defect in the right mandibular first molar region, confirming a diagnosis of dentoalveolar abscess caused by pericoronitis of the first molar. The swelling resolved after incision of the abscess, and bone recovery was confirmed by X-ray in the follow-up period. Conclusions: Erupting first molars is at risk of pericoronitis, which may sometimes progress to a dentoalveolar abscess. Dental professionals should be alert to this possibility and should advise pediatric patients and their guardians to maintain good oral hygiene around erupting molars. Full article

Background/Objectives: Early childhood caries (ECC) is a significant global public health issue with economic and psychosocial consequences, impacting families and pediatric dentists. It affects children’s quality of life, causing pain and infection. Despite increasing research on ECC cross-sectional studies worldwide, inconsistencies and gaps remain in terms of geographical disparities. This study aimed to conduct a bibliometric analysis of cross-sectional surveys on ECC by examining the co-authorship, citation analysis, co-citation networks, and keyword co-occurrence. Methods: An advanced search was performed using relevant terms in the Dimensions database from 2005 to 2024. Bibliometric parameters were retrieved through the database’s analytical view tool and VOSviewer software. Results: A total of 571 documents were identified, with the highest output between 2019 and 2023 (355 records). Saul Martins Paiva authored the most articles (10), with 294 citations and a total link strength of 19. Brazil and the U.S. had the highest numbers of publications (56 and 52) and total link strengths, i.e., a measure of collaborative ties (21 and 50). The Universidade Federal de Minas Gerais in Brazil had the most published documents (15). BMC Oral Health led in terms of citations (44 articles, 899 citations, average 20.43%). The frequently co-occurring terms included ECC (1147 occurrences), oral health (417), and preschool child (301). Conclusions: This bibliometric analysis highlights the global interest in cross-sectional ECC studies beyond pediatric dentistry, helping researchers understand the field’s scope and progress. Full article

Dental anxiety is an intense and irrational fear of visiting the dentist or of undergoing dental procedures. Background/Objectives: The aim of this study was to investigate the prevalence of dental anxiety in children aged 6–11 years and to identify the importance of communication in reducing anxiety in pediatric patients. Methods: The research was conducted through a questionnaire administered to 101 students (55.4% girls and 44.6% boys), aged 6–11 years, from the North-West Region of Romania. The data collected included the age and gender of the subjects, their previous experiences with the dentist, the identification of factors that trigger anxiety, and the way in which patients perceive future dental visits. Results: This study found that for the majority of participants, a visit to the dentist does not represent a source of fear. Moreover, most children are eager to visit the dentist again. Gender and age did not have a significant effect on the prevalence of anxiety. Elements such as sitting in the dental chair, observing dental instruments, having the teeth examined with a mirror, and hearing the sounds produced by the instruments were identified as factors that may cause anxiety in pediatric patients. Conclusions: It was found that pediatric patients who have good communication with the practitioner display lower anxiety levels compared to those of others. Full article

Background/Objectives: The objective of this study was to evaluate practice patterns among pediatric dentists for the management of permanent teeth needing endodontic treatment. Methods: An electronic nationwide survey was sent to all members of the American Academy of Pediatric Dentistry (AAPD). The survey assessed provider training on and confidence (0–100, with 100 = “most confident”) in treating pediatric patients needing endodontic treatment on permanent teeth, referral patterns, and preferred educational resources. A logistic regression identified significant predictors of confidence levels. Results: The final sample included 259 respondents, with 71% having over 10 years of experience in practice. A total of 47% of respondents reported performing endodontic treatments on permanent teeth in pediatric patients, with direct pulp capping (70%) and partial or full pulpotomy (62%) being the most common procedures. Although the respondents moderately agreed (53 ± 32) that they received sufficient training during their residency to perform endodontic treatment on permanent teeth, their reported comfort levels with performing these procedures were low (0.001 ± 33). The adequacy of the training received during their residency was identified as a significant predictor of a higher level of confidence (p < 0.001, 95% CI 0.437, 0.667). The respondents highlighted additional continuing education courses and training, dedicated lectures at the AAPD Annual Session, and annual joint symposia or meetings between the AAPD and the American Association of Endodontists as the most valuable educational resources for the endodontic management of permanent teeth in pediatric patients. Conclusions: The findings suggest that enhancing residency training and expanding access to targeted continuing education opportunities are critical for improving pediatric dentists’ confidence and competence in the endodontic management of permanent teeth in pediatric patients. Full article

Objectives: Children with nephrotic syndrome (NS) are prone to oral health issues due to immunosuppression and systemic inflammation, which may exacerbate their renal condition. The objective of this study was to evaluate the impact of a 12-year interdisciplinary collaboration between pediatric dentists and nephrologists on oral health in children with NS. Methods: A retrospective analysis of 80 NS patients—40 assessed in 2012 and 40 in 2024—was conducted using caries indices (dmft/DMFT), Plaque Index, and Gingival Index. Statistical tests assessed differences between groups (p < 0.05). Results: The prevalence of active caries significantly decreased (50% vs. 78%; p = 0.011), with fewer decayed permanent teeth (0.96 ± 1.56 vs. 2.66 ± 2.51; p = 0.003) and improved oral hygiene (good hygiene in 52.5% vs. 30%; p = 0.041) in the 2024 group. Gingivitis was less severe compared to 2012. Conclusions: Long-term interdisciplinary care significantly improved oral health in children with NS. These improvements may contribute to reduced systemic inflammation and better overall disease control. Integrating dental care into NS management is recommended to support long-term outcomes. Full article

Objective: The objective of this study is to highlight the critical role of pediatric dentists in promoting oral health prevention among leukemia patients. In fact, oral manifestations frequently serve as the initial clinical indicators of leukemia, occurring in up to 10% of cases. In acute myelomonocytic leukemia, oral lesions are observed in 65–90% of patients. Methods: A cohort of 63 patients (30 males and 33 females) with a mean age of 10 years participated in this study. All participants adhered to a standardized preventive dental care protocol, referred to as the “Preventive Iter”. This protocol focuses on individualized oral hygiene education, regular monitoring, and professional dental interventions aimed at preventing and managing oral health complications associated with systemic conditions such as leukemia. Results: The results demonstrated a statistically significant and progressive improvement across all evaluated oral health parameters as patients advanced through the Preventive Iter protocol. Conclusions: The Preventive Iter protocol has proven to be highly effective in improving oral health outcomes, as evidenced by notable reductions in plaque accumulation, microbial imbalance, and gingival inflammation. The structured, individualized approach—incorporating professional hygiene interventions and tailored educational strategies—appears to be a key factor in achieving and maintaining these improvements. These findings underscore the critical importance of early and ongoing preventive care, particularly for medically vulnerable populations. Full article

Background/Objectives: Dental plaque is a significant contributor to various prevalent oral health conditions, including caries, gingivitis, and periodontitis. Consequently, its detection and management are of paramount importance for maintaining oral health. Manual plaque assessment is time-consuming, error-prone, and particularly challenging in uncooperative pediatric patients. These limitations have encouraged researchers to seek faster, more reliable methods. Accordingly, this study aims to develop a deep learning model for detecting and segmenting plaque in young permanent teeth and to evaluate its diagnostic precision. Methods: The dataset comprises 506 dental images from 31 patients aged between 8 and 13 years. Six state-of-the-art models were trained and evaluated using this dataset. The U-Net Transformer model, which yielded the best performance, was further compared against three experienced pediatric dentists for clinical feasibility using 35 randomly selected images from the test set. The clinical trial was registered on under the ID NCT06603233 (1 June 2023). Results: The Intersection over Union (IoU) score of the U-Net Transformer on the test set was measured as 0.7845, and the p-values obtained from the three t-tests conducted for comparison with dentists were found to be below 0.05. Compared with three experienced pediatric dentists, the deep learning model exhibited clinically superior performance in the detection and segmentation of dental plaque in young permanent teeth. Conclusions: This finding highlights the potential of AI-driven technologies in enhancing the accuracy and reliability of dental plaque detection and segmentation in pediatric dentistry. Full article

In pediatric dentistry, antibiotics are currently prescribed for both therapeutic and prophylactic purposes. Antibiotic therapy can be prescribed for the treatment of diffuse dental or oral cavity infections, always as a complement to the most suitable dental procedure for the specific case. The aim of this study was to investigate the knowledge regarding the use and prescribing practices of antibiotics in pediatric patients in a sample of Italian dentists by using an anonymous and telematic questionnaire. Methods: A specially prepared questionnaire was electronically transmitted to a cohort of Italian dentists. The questionnaire consisted of two parts: demographic information and general knowledge of antibiotic prescription in pediatric dentistry. The statistical analysis of the obtained data was performed. Results: The study sample consisted of 242 Italian dentists. Poor statistically significant differences emerged between specialists in Pediatric Dentistry and dentists without specialization or specialists in other branches, as well as between dentists who, in their clinical activity, mainly treat children/adolescents or adults. For the complementary treatment of dental or oral cavity infections, Amoxicillin was the antibiotic indicated as the first choice for pediatric patients with no allergy to penicillins by most of the sample, while more than 20% of dentists would prescribe Clindamycin in patients with an allergy to penicillin. The knowledge regarding the dosage of administration of the chosen antibiotic appeared not to be sufficient. Conclusions: An improvement in the knowledge of the Guidelines in Pediatric Dentistry appeared necessary regarding the posology of the antibiotic of choice. More information about the adverse effects of Clindamycin is needed. Full article

Background: Knowing the oral-health-related quality of life (OHRQoL) status of pediatric patients would be helpful in analyzing their level of dental anxiety before their first visit to a pediatric dentist. However, few studies have analyzed OHRQoL and anxiety in early adolescent patients. The aim of this study was to describe the OHRQoL and anxiety levels of early adolescents, according to age and sex, at their first dental examination. Methods: A cross-sectional study was conducted on early adolescents (11–14 years old) attending their first dental examination in 2023–2024. OHRQoL was assessed using the Spanish version of the Child Perceptions Questionnaire 11–14 (CPQ-Esp11-14) and anxiety using the State–Trait Anxiety Inventory in Children (STAIC). Results: A total of 130 early adolescents were assessed, with an average age of 12.6 years (±1.06) and an equal sex distribution (65 boys and 65 girls). Among the analyzed sample, the OHRQoL dimension with the highest score was social well-being (15.01 ± 10.7), whereas the oral symptoms dimension (8.6 ± 4.25) had the lowest impact. There were no statistically significant differences between female and male early adolescents in the anxiety state or anxiety-trait dimensions or in the dimension of OHRQoL, except for oral symptoms, which were higher in boys (9.48 ± 4.51 versus 7.72 ± 3.81). Similarly, no significant differences were found based on age regarding anxiety or OHRQoL. Conclusions: Considering the limitations of this study, it can be concluded that higher levels of anxiety negatively impacted the OHRQoL of the early adolescent population studied. Full article

Background/Objectives: Children with special healthcare needs (SHCNs) face various physical, developmental, sensory, behavioral, or cognitive challenges affecting oral health and highlighting the need for specialized and more accessible oral and dental care. Mobile health (m-health) applications have emerged as a promising solution to bridge oral health education gaps and improve dental care access. This narrative review aimed to examine the available dental m-health applications designed for children with cognitive and physical impairments, exploring the perspectives of children, parents/caregivers, and dentists regarding their use and potential contribution to oral health. Based on these insights, a concept for a tailored dental m-health app is proposed, considering the interactions between children, caregivers, and dentists to support oral care. Methods: A literature search was conducted using MEDLINE/PubMed, Scopus, and Web of Science to identify studies on the use of m-health apps in pediatric dentistry for SHCN children. Results: Six studies were included in this review. M-health applications helped manage anxiety, behavioral issues, and compliance in children and were generally well received by parents and caregivers, thus improving oral hygiene practices and regular dental visits, and having the potential to reduce oral health disparities in children with cognitive and physical impairments and their families. However, current apps designed for children are limited and may not fully accommodate the diverse sensory needs of these SHCN children. Conclusions: The development of a tailored dental m-health app that adapts to the individual characteristics of SHCN children could enhance oral health awareness and support better compliance among children, parents/caregivers, and dentists. Full article

Background: Childhood obesity and overweight conditions impact systemic health and craniofacial development. Objectives: This review assessed the influence of elevated body mass index (BMI) on craniofacial morphology, considering age, sex, and ethnicity. Methods: A comprehensive search of Scopus, Web of Science, Embase, Cochrane, PubMed, and OpenGrey was conducted following PRISMA guidelines. Ten cross-sectional studies involving 1383 individuals aged 6 to 18 years were included. The sample comprised 812 females and 571 males, with most studies focusing on adolescents aged 12–18 years of different ethnicities depending on the study. Craniofacial structures were compared between overweight/obese and normal weight groups through cephalometric analysis. Study quality was assessed using the Newcastle–Ottawa Scale (NOS). Results: Overweight and obese individuals showed significant craniofacial changes, including increased anterior cranial base length, maxillary and mandibular dimensions, bimaxillary prognathism, and greater soft tissue thickness. These alterations may be influenced by differences in tissue composition, hormonal fluctuations, fat-to-bone ratio, and metabolic disorders. Variations in skeletal divergence, dental alignment, and airway space were also observed. The methodological quality ranged from moderate to high. Conclusions: Excess weight during growth is linked to distinct craniofacial alterations. Orthodontic diagnostics should integrate metabolic and hormonal considerations to optimize treatment outcomes. These changes should be carefully considered by orthodontists and pediatric dentists. Longitudinal studies are needed to understand the long-term effects of obesity on craniofacial development. Full article

Background: Oral appliance therapy (OAT) is an effective treatment alternative for obstructive sleep apnea (OSA). Understanding physicians’ knowledge and practices regarding OAT is crucial for improving OSA treatment, particularly in Southeast Asia, where there is limited research on this topic. Objectives: This study sought to survey physicians’ knowledge and practices regarding OAT for OSA treatment. Methods: A descriptive cross-sectional survey was conducted among Thai physicians attending the annual Sleep Society of Thailand meeting. The questionnaire included questions on demographics (six items), educational background (four items), OAT knowledge (two items), indications (three items), effectiveness (seven items), referral practices (five items), treatment planning (eight items), and the importance of OAT education (one item). Descriptive and comparative analyses were performed using SPSS to assess differences in knowledge and referral practices across various demographics. Results: This study achieved a response rate of 51.7% (30/58), with the respondents averaging 37.8 ± 6.0 years in age and 13.7 ± 6.7 years in practice. Although over 66.7% of the respondents recognized OAT’s effectiveness and understood its indications, only 36.7% regularly prescribed OAT, and 57.7% referred patients to specific dentists. Knowledge and referral practices differed significantly based on years of practice and postgraduate training in sleep medicine. Physicians with 11–20 years of practice demonstrated higher pediatric OAT knowledge scores compared to those with less experience. Those with postgraduate training achieved higher adult OAT knowledge scores and had greater referral experience. Conclusions: Despite the general awareness and good knowledge of OAT among physicians, clinical use and referral rates remain low. To bridge the gap between knowledge and practice, it is recommended that postgraduate training in dental sleep medicine is promoted and further research is conducted to identify barriers to the adoption of OAT. Full article