Search Results (504)

Objective: Due to the increasing esthetic demand among pediatric patients and different restorative materials, we focused on analyzing which of the options of restorations may provide superior clinical outcomes. Methods: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) using PubMed and Cochrane databases. Results: Five articles met all inclusion criteria from an initial pool of 359 articles identified in the initial search. Greater bond strength was observed when pulpotomized teeth were restored with Biodentine^® and resin composites compared to resin-modified glass ionomer cements (RMGICs). When comparing pulpotomies in primary teeth with MTA and Biodentine^®, the fracture resistance values were higher in the pulpotomized teeth with Biodentine^® than with MTA. Additionally, following a narrative synthesis in MTA-treated teeth, a higher risk of failure was observed using RMGICs or composite instead of stainless-steel crowns (SCCs) as the final restorative material. Conclusions: Variables such as the type of final restoration can affect the survival of primary teeth after pulpotomy reconstruction. Regardless of the pulp material, survival with SSCs is higher, but resin composites appear to be a viable restorative material after Biodentine^® application. Full article

Primary teeth play a crucial role in a child’s development, particularly in maintaining space for permanent teeth. The premature loss of a primary tooth can lead to orthodontic issues, making the use of space maintainers essential to ensure proper growth and development of permanent teeth. To preserve space, the fabrication of a space maintainer is necessary. Since conventional space maintainers do not restore masticatory function, this study presents an innovative solution for space preservation following the extraction of the first primary molar through the design of the functional space maintainer KOS&MET (Key Orthodontic System and Materials Enhanced Therapy). The space maintainer was designed using the 3Shape Dental Designer 2023 version software tool and manufactured via additive 3D printing, utilizing a metal alloy with high resistance to masticatory forces. The crown is supported by the primary canine, while an intraoral window is created to monitor the eruption of the successor tooth. This design does not interfere with occlusion and enables bilateral chewing. Masticatory performance was assessed using two-color chewing gum, and the results showed improvement after cementing the space maintainer. This innovative approach not only preserves space for permanent teeth but also enhances masticatory function, contributing to the proper growth and development of the jaws and teeth. Full article

Introduction: Dental caries and molar–incisor hypomineralisation (MIH) are prevalent conditions affecting children’s oral health, with functional, aesthetic, and psychosocial implications. In Spain, previous studies have highlighted geographic and sociodemographic disparities in their distribution, particularly among rural and migrant populations. Objective: To characterise oral health status, in terms of caries and MIH, among 6–7-year-old children from the towns of Palos de la Frontera, Mazagón, and San Bartolomé. Methods: A cross-sectional study was conducted involving 229 children recruited from public primary schools. Sociodemographic, anthropometric, and behavioural data were collected through clinical examination and interview. Statistical analysis included univariate and multivariate logistic regression. The study protocol was approved by the Ethics Committee of Huelva. Results: The prevalence of caries (DMFT ≥ 1) was 53.3%, with mean DMFT and dft indices of 1.78 and 0.31, respectively. MIH affected 32.8% of the cohort, with a predominance in the first permanent molars (teeth 36 and 26). Multivariate analysis identified independent predictors of caries: African (OR = 7.47; 95% CI: 2.84–23.8) and European (OR = 4.56; 95% CI: 1.26–22.3) parental origin, poor oral hygiene (OR = 3.07; 95% CI: 1.60–6.03), and the presence of MIH (OR = 3.20; 95% CI: 1.64–6.42). The municipality of San Bartolomé was associated with a higher risk of MIH (OR = 2.90; 95% CI: 1.21–7.45). Conclusions: The high prevalence of caries and MIH in the Condado-Campiña district, exceeding national averages, reflects oral health inequities linked to social determinants (migrant origin, locality) and clinical factors (MIH, oral hygiene). Targeted preventive interventions are urgently needed in high-risk populations, including culturally tailored education and policies ensuring equitable access to dental care services. Full article

Background: Although the prevalence of dental caries in children has been decreasing in recent years, many patients still visit tertiary dental institutions with dental caries as their chief complaint. In addition, the COVID-19 pandemic that occurred around the world in 2020 may have affected the lifestyle and oral condition of children. Methods: We investigated the oral condition of new patients whose chief complaint was dental caries, and compared the results for 3 fiscal years: 2013, 2018, and 2023. The caries status was evaluated using the dmft/DMFT index. Results: The number of subjects was 129 in 2013, 163 in 2018, and 127 in 2023. The number of preschoolers in 2023 was lower than in the other years, whereas the number of elementary school students was higher, showing a statistically significant difference (p < 0.05). For the 3 years investigated, there was no change in the incidence of dental caries in primary teeth in elementary school children; however, the incidence in permanent teeth increased over time. Additionally, in the age group, the df and DMF scores were higher in 2023 than in the other years. Conclusions: At this tertiary dental institution, the number of elementary school patients, especially females, increased over the 10-year period, and the amount of dental caries in their permanent teeth also increased. It is important for dental professionals to understand this trend and focus on providing oral hygiene education to this age group. Full article

Background: Early caries management is essential to enable reversal of white spot lesions without the further need for operative interventions, especially in primary dentition. Silver-based compounds can be quite effective in arresting caries lesions; however, a major drawback is teeth staining. This study aimed to evaluate the remineralization potential and aesthetic effects of novel, green-synthesized nano-silver fluoride (NSF) on artificial white spot lesions in primary teeth in comparison to 38% silver diamine fluoride (SDF) and silver diamine fluoride/potassium iodide (SDF/KI). Materials and Methods: NSF was synthesized using green tea extract. Sixty primary teeth specimens with artificial enamel lesions were randomly divided into five groups depending on the applied material: 38% SDF, 38% SDF/KI, single and double application of NSF, and control group. Treatments were followed by pH cycling. Surface microhardness and photographic analysis were conducted to assess remineralization and staining. Statistical analysis was conducted using non-parametric tests including Kruskal–Wallis and Mann–Whitney U tests with Bonferroni correction. Results: The greatest increase in microhardness was observed in the group receiving double NSF application. Its remineralizing potential was comparable to that of 38% SDF/KI, with no statistically significant difference (p = 1.000). Importantly, NSF-treated samples exhibited no teeth discoloration, unlike the black staining observed in SDF and SDF/KI groups. Conclusions: Green-synthesized NSF is a promising alternative to conventional SDF and SDF/KI, offering remineralization benefits without compromising aesthetics. The eco-friendly formulation and non-staining properties support its potential for clinical use in pediatric dentistry. Full article

This study presents an analysis of the electromagnetic noise and vibration in a surface-mounted permanent magnet synchronous machine (SPMSM), focusing on their excitation sources. To investigate this, the excitation sources were identified through an analytical approach, and their effects on electromagnetic noise and vibration were evaluated using a finite element method (FEM)-based analysis approach. Additionally, an equivalent curved-beam model based on three-dimensional shell theory was applied to determine the deflection forces on the stator yoke, accounting for the tooth-modulation effect. The stator’s natural frequencies were derived through the characteristic equation in free vibration analysis. Modal analysis was performed to validate the analytically derived natural frequencies and to investigate stator deformation under the tooth-modulation effect across various vibration modes. Furthermore, noise, vibration, and harshness (NVH) analysis via FEM reveals that major harmonic components align closely with the natural frequencies, identifying them as primary sources of elevated vibrations. A comparative study between 8-pole–9-slot and 8-pole–12-slot SPMSMs highlights the impact of force variations on the stator teeth in relation to vibration and noise characteristics, with FEM verification. The proposed method provides a valuable tool for early-stage motor design, enabling the rapid identification of resonance operating points that may induce severe vibrations. This facilitates proactive mitigation strategies to enhance motor performance and reliability. Full article

Background and Objectives: This is the first systematic review to focus exclusively on in vivo randomized controlled trials that compare bulk-fill and conventional incremental composite restorations in primary teeth. Our aim was to synthesize current evidence on their clinical performance, including retention, two-year survival rates, marginal integrity, and procedural efficiency. Methods: A comprehensive literature search was conducted in PubMed, Scopus, and the Elicit AI platform up to March 2025. Eligible studies were in vivo randomized controlled trials involving children aged 3–12 years with carious primary teeth, directly comparing bulk-fill and incremental composite restorations. Primary outcomes included retention rates, two-year survival, and marginal integrity, while secondary outcomes were postoperative sensitivity, secondary caries, and aesthetic outcomes. Two reviewers independently performed study selection, data extraction, and risk-of-bias assessments using the Cochrane RoB 2.0 tool. A narrative synthesis was undertaken due to substantial heterogeneity in study design and outcome reporting. The review protocol was registered in PROSPERO (CRD420251021433). Results: Thirteen randomized controlled trials met the inclusion criteria. Both restoration techniques demonstrated high short-term retention rates (>90%) and comparable two-year survival (85–90%). Marginal integrity was generally equivalent, though incremental techniques showed modest advantages in complex cavities. Secondary outcomes were inconsistently reported, with no significant group differences. Bulk-fill restorations consistently reduced the procedural time by 2–4 min per restoration, representing a meaningful advantage in pediatric clinical settings. Conclusions: Bulk-fill composites offer a clinically effective and time-efficient alternative to incremental layering in the restoration of primary teeth. This focused synthesis addresses a gap in existing reviews by concentrating solely on primary dentition and in vivo evidence. Despite similar clinical outcomes, the time savings associated with bulk-fill techniques may enhance their utility in pediatric dentistry. Further standardized and long-term trials are warranted to confirm these findings and inform clinical guidelines. Full article

Background: Dental eruption pathways could be influenced by several factors, both general and local, with different prevalence and morbidity. This study aims to report our experience of pediatric impacted teeth due to local factors, with the exclusion of the third molars, illustrating their prevalence, diagnostic and therapeutic pathways, and treatment outcomes. Methods: The inclusion criteria were minor age (<18 years) and the presence of impacted teeth due to a local cause, excluding wisdom teeth. The complete diagnostic and therapeutic procedures and their outcomes were described. The relationship between the treatment and the outcomes was assessed with a chi-square test. Results: One hundred twelve patients with a single impaction were included in the study. The local causes of single impaction were: 63 odontogenic cysts (57%), 24 supernumerary teeth (21%), 17 odontogenic tumors (15%), and eight primary bone lesions (7%). During the follow-up period, 83 teeth erupted spontaneously 12–36 months following surgery (74%), 12 were extracted during surgery (11%), and 17 needed orthodontic traction to achieve their aesthetic and functional position (15%). The relationship between mini-invasive surgery and spontaneous eruption was significant (p < 0.00001). Conclusions: Within the limitations of this study, mini-invasive surgical treatment preceded by a correct diagnosis may lead to a spontaneous eruption of permanent teeth, avoiding further orthodontic intervention and premature loss of permanent teeth. Full article

Background: Dental anxiety often poses a significant barrier to effective dental care in pediatric patients. This study evaluated the efficacy and safety of oral midazolam at two different doses for sedation and amnesia in preschool children undergoing dental procedures under 30 min, including primary teeth extraction, root canal treatment, dental filling, and stainless-steel crown. Methods: This prospective, double-blind, randomized controlled trial included 80 children aged 3–6 years with dental anxiety (Types 1 and 2 of the Frankl Behavior Rating Scale) at the National Hospital of Odonto-Stomatology, Hanoi. following the CONSORT guidelines. Participants were randomly assigned to receive oral midazolam at 0.3 mg/kg or 0.6 mg/kg. Sedation efficacy, onset time, procedure duration, cooperation level (Houpt Behavior Rating Scale), recovery time, and amnesia at 12 h, 24 h, and 1 week, as well as adverse events, were recorded and analyzed. Results: Both midazolam doses were effective for sedation (0.3 mg/kg: 95% vs. 0.6 mg/kg: 100%, p = 0.49). The higher dose (0.6 mg/kg) provided significantly longer effective procedural time (27.3 ± 4.1 min vs. 20.3 ± 4.0 min, p < 0.001) and better patient cooperation (95% vs. 78.9%, p = 0.045), but slightly prolonged recovery time (34.6 ± 4.6 min vs. 31.8 ± 4.4 min, p = 0.008). Both doses produced similar amnesic effects, with approximately 90% anterograde amnesia at 12 h post-procedure. Adverse events were minimal and mild. Conclusions: Both 0.3 mg/kg and 0.6 mg/kg doses of oral midazolam are safe and effective for sedation and amnesia in preschool children undergoing dental procedures. While the 0.6 mg/kg dose provides better procedural cooperation and prolonged sedation, it also requires a slightly longer recovery time. Full article

Background and Objectives: Periodontitis is an inflammatory disease that compromises the supporting structures of the teeth, leading to irreversible tissue damage and tooth loss. While subgingival professional mechanical plaque removal (PMPR) remains the gold standard treatment, there is increasing interest in adjunctive therapies. Platelet-rich fibrin (PRF) has gained attention as a promising biomaterial to enhance periodontal healing and regeneration. This study aimed to evaluate the clinical and immunological effectiveness of PRF as an adjunct to PMPR. Materials and Methods: Clinical studies published between January 2019 and August 2024 were included from the ProQuest, PubMed, PMC, ScienceDirect, Scopus, and EBSCO databases. Seven studies met the inclusion criteria, focusing on adults with periodontitis treated with PRF + PMPR compared to PMPR alone. Primary outcomes included changes in clinical and immunological parameters. Risk of bias was assessed using the Cochrane ROB2 tool. Meta-analysis was conducted using both fixed-effect and random-effects models, depending on heterogeneity. Results: The meta-analysis demonstrated significant improvements in clinical outcomes in the PRF + PMPR group, with reductions in probing pocket depth (SMD: −1.43 mm; 95% CI: −2.05 to −0.81; p < 0.00001), clinical attachment level (SMD: −1.34 mm; 95% CI: −1.95 to −0.73; p < 0.0001), bleeding on probing (SMD: −0.75 mm; 95% CI: −1.11 to −0.39; p < 0.00001), gingival recession (SMD: −0.79 mm; 95% CI: −1.33 to −0.25; p = 0.004), and gingival index (SMD: −0.82 mm; 95% CI: −1.37 to −0.28; p = 0.003). Favorable trends were also observed in IL-10, TGF-β, VEGF, PDGF-BB, periostin, and type I collagen levels. Conclusions: PRF enhances clinical and immunological outcomes and supports periodontal tissue stability when used as an adjunct to non-surgical therapy. Full article

Dental caries can cause premature loss of deciduous teeth, affecting children’s growth and development. Endodontic treatment using polymer posts is an effective solution. This study explores biodegradable root canal posts made from Polylactic Acid (PLA), Polycaprolactone (PCL), and amorphous calcium phosphate (ACP), aiming to enhance mechanical properties, minimize polymer degradation acidity, and prevent inflammation. A root canal post with a spherical head and serrated structure was designed and produced via micromolding and optimized using the Taguchi experimental method. The melt temperature, injection speed, and holding speed were analyzed for their influence on shrinkage, revealing an optimal rate of 2.575%, representing the sum of axial and radial shrinkage. The melt temperature had the highest impact (55.932%), followed by holding speed (33.575%), with there being minimal effect from injection speed. The composite exhibited a flexural strength of 21.936 MPa, a modulus of 2.083 GPa, and a hydrophilic contact angle of 73.73 degrees. Cell survival tests confirmed biocompatibility, with a survival rate exceeding 70% and no toxicity. These findings highlight the potential of PLA/PCL/ACP composites, combined with injection molding, for developing biodegradable root canal posts in primary teeth. Full article

Deciduous teeth accumulate toxic metals until fully mineralized, making them a stable biological matrix for assessing chronic exposure during fetal and early postnatal life. Their metal content is influenced by environmental factors (e.g., industrial areas, mining sites) and individual factors (e.g., maternal diet, early nutrition, passive smoking). The aim of this study was to evaluate the toxic metal content in deciduous teeth and to identify factors contributing to its accumulation, as well as possible health implications. A systematic review was conducted in accordance with the PRISMA guidelines and following the PICO framework. Quality assessment was assessed using the Joanna Briggs Institute (JBI) checklist for quasi-experimental studies. The literature search was carried out in the PubMed, Scopus, and Web of Science databases using the following keywords: deciduous, milk, primary, decidua, teeth, dentition, heavy metal, toxic metals. A total of 134 articles were initially identified, with 95 remaining after duplicate removal. After screening, 75 articles were excluded: 71 did not meet the inclusion criteria, 3 were not available in English, and 1 lacked full-text access. Ultimately, 20 studies were included in the review. Toxic metal concentrations were determined using various analytical techniques, mainly inductively coupled plasma mass spectrometry (ICP-MS) and atomic absorption spectrometry (AAS). Higher levels of metals, especially lead, were observed in the teeth of children residing in industrial areas, near mines, or in regions affected by armed conflict. Although two out of five studies indicated a possible link between fathers’ smoking habits and elevated lead concentrations, no definitive relationship was established between secondhand smoke exposure and the levels of lead and cadmium found in dental tissue. Similarly, no definitive relationship was identified between mercury and lead content and the prevalence of autism. However, lower manganese levels were associated with the presence of autistic traits, weaker verbal performance, and reduced memory capacity. In conclusion, deciduous teeth represent a valuable biological material for assessing chronic prenatal and early postnatal exposure to toxic metals, which may serve as a starting point for further research into diseases of unknown etiology, such as autism, and in the future may have clinical significance in their prevention and treatment. And it is also important for monitoring environmental pollution levels. Full article

Background/Objectives: Hypohidrotic ectodermal dysplasia (HED) is a rare hereditary disorder affecting ectoderm-derived tissues including teeth, hair, and sweat glands. The dental abnormalities associated with HED, such as oligodontia and conical teeth, often result in significant functional, esthetic, and psychosocial challenges, particularly during childhood. Methods: A 10-year-old child presented with psychosocial concerns related to missing and malformed teeth. Clinical examination revealed oligodontia, conical anterior teeth, and a resorbed mandibular ridge. Based on clinical findings and a positive family history, a diagnosis of HED with significant dental involvement was confirmed. Results: A conservative prosthodontic approach was selected. A maxillary overdenture was fabricated over the retained primary teeth to enhance retention and preserve the alveolar bone, and a resin-bonded bridge was placed in the mandible due to poor ridge anatomy. The treatment restored oral function and esthetics and improved the child’s self-esteem. A recall visit after three months confirmed good prosthesis adaptation and a positive response from the patient and parents. Conclusions: This case highlights the importance of early, conservative, and developmentally appropriate prosthetic rehabilitation in pediatric patients with HED. Interim prostheses can significantly improve oral function, appearance, and psychosocial well-being while preserving future treatment options as the child matures. Full article

The accurate identification and protection of the lingual nerve during oral surgery are critical to avoid complications such as a loss of taste or sensation and chronic pain. While numerous studies have described the nerve’s anatomy and injury outcomes, no consensus exists on the optimal method to trace its full course. This narrative review systematically examined the literature from 2010 to 2024, using databases like PubMed, MEDLINE, Embase, and Google Scholar. Keywords included “Lingual nerve,” “Course,” “Anatomy,” and “Clinical implications,” combined with Boolean operators. Studies were selected based on defined criteria, and findings were synthesized to highlight key challenges in diagnosing the nerve’s path. This review identifies difficulties at multiple anatomical sites: the foramen ovale, infratemporal fossa, pterygomandibular space, third molar and retromolar regions, premolar/molar areas, floor of the mouth, and anterior gingiva and tongue. Lingual nerve injury, especially during lower third molar surgeries, remains a major concern, often exacerbated by factors like patient age, unerupted teeth, and lingual surgical approaches. Effective prevention hinges on precise anatomical knowledge and meticulous surgical technique. Microsurgical repair remains the primary treatment but often yields unpredictable outcomes. Emerging regenerative therapies show early promise but require further clinical validation. Imaging tools such as magnetic resonance imaging (MRI) and ultrasound may enhance diagnostic accuracy and surgical planning; however, each has limitations in everyday practice. Ultimately, early identification, careful surgical handling, and appropriate imaging support are vital for improving patient outcomes and minimizing the risks of lingual nerve injury. Full article

Background: Early childhood dental decay remains a pervasive chronic condition, and environmental toxicants—particularly lead—may exacerbate its development. This systematic review was designed to synthesize evidence on how lead exposure correlates with both the occurrence of carious lesions and aesthetic alterations in children’s primary teeth. Methods: A comprehensive search was conducted in PubMed, Scopus, and Web of Science through April 2025, selecting observational investigations that assessed the link between lead levels and primary-tooth decay in pediatric cohorts. Thirteen eligible studies, encompassing 44,846 participants aged 2–19 years, were included for qualitative synthesis. Aesthetics were screened using author-defined enamel-defect or discoloration endpoints; however, only three studies reported compatible metrics, precluding quantitative pooling. Heterogeneity in exposure matrices likewise ruled out meta-analysis. Results: Most studies reported a statistically significant association between higher lead burden and greater prevalence or severity of caries in primary teeth. Blood lead concentrations across studies ranged from means of 1.53 μg/dL to geometric means of 7.2 μg/dL. Notably, elevated lead was linked to increased decayed, missing, or filled surfaces—with an adjusted risk ratio of 1.14 (95% CI: 1.02–1.27) at levels below 5 μg/dL—and adjusted mean ratios of up to 2.14 for decayed or filled teeth when blood lead reached 5–10 μg/dL. Conclusions: Current evidence suggests that children’s exposure to lead may heighten the risk of caries and detract from the aesthetic quality of primary teeth. However, variability in study design, lead quantification methods, and confounder adjustment limit the consistency of findings. Mitigating lead exposure in early life could represent a valuable preventive strategy against dental decay in susceptible pediatric populations. Full article