Search Results (47)

Background/Objectives: Excessive daytime sleepiness (EDS) has been suggested to negatively affect academic performance and behavior. Malocclusion is reportedly a risk factor for sleep-disordered breathing and may be associated with daytime sleepiness. This study investigated the age and sex of patients with malocclusion who are at increased risk of EDS and collected data for future EDS screening. Methods: We analyzed 556 patients with malocclusion aged 6–29 years to identify age- and sex-specific differences in the risk of EDS. Adults were surveyed using the Epworth Sleepiness Scale (ESS), and non-adults were surveyed using the Epworth Sleepiness Scale for Children and Adolescents. Results: The mean ESS score was 4.1 ± 4.1, and the median score was 3. The mean score tended to increase significantly with age. In adolescents, ESS scores increased gradually. In adolescents and young adults, ESS scores were significantly higher in females than in males, and the prevalence of EDS in young adults was 16.7% in men and 32.1% in women, with a marked sex-related difference. Conclusions: In patients with malocclusion, daytime sleepiness may gradually increase from adolescence to young adulthood and be more pronounced in females. The prevalence of EDS in young adults seems higher in women than in men. Our findings could aid in the early identification of EDS and facilitate multidisciplinary cooperation between dentists and sleep specialists. Early identification of sleep problems and prompt intervention during the high-risk period for developing EDS could improve the quality of life for many adolescents and contribute to improved public health. Full article

Background: Artificial intelligence (AI) is playing an increasingly important role in everyday dental practice and diagnosis, especially in the area of analysing digital pantomographic images. Through the use of innovative and modern algorithms, clinicians can more quickly and accurately identify pathological changes contained in digital pantomographic images, such as caries, periapical lesions, cysts, and tumours. It should be noted that pantomographic images are one of the most commonly used imaging modalities in dentistry, and their digital analysis enables the construction of AI models to support diagnosis. Objectives: This paper presents a systematic narrative review of studies included in scientific articles from 2020 to 2025, focusing on three main diagnostic areas: detection of caries, periapical lesions, and cysts and tumours. The results show that neural network models, such as U-Net, Swin Transformer, and CNN, are most commonly used in caries diagnosis and have achieved high performance in lesion identification. In the case of periapical lesions, AI models such as U-Net and Decision Tree also showed high performance, surpassing the performance of young dentists in assessing radiographs in some cases. Results: The studies cited in this review show that the diagnosis of cysts and tumours, on the other hand, relies on more advanced models such as YOLO v8, DCNN, and EfficientDet, which in many cases achieved more than 95% accuracy in the detection of this pathology. The cited studies were conducted at various universities and institutions around the world, and the databases (case databases) analysed in this work ranged from tens to thousands of images. Conclusions: The main conclusion of the literature analysis is that, thanks to its accessibility, speed, and accuracy, AI can significantly assist the work of physicians by reducing the time needed to analyse images. However, despite the promising results, AI should only be considered as an enabling tool and not as a replacement for the knowledge of doctors and their long experience. There is still a need for further improvement of algorithms and further training of the network, especially in identifying more complex clinical cases. 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

Background/Objectives: The rising popularity of e-cigarette use is creating new challenges for oral healthcare. Factors such as targeted marketing, appealing flavors, and the perception that e-cigarettes are a safer alternative to traditional smoking have contributed to their widespread adoption. This trend is particularly prevalent among young adults and teenagers, many of whom turn to e-cigarettes despite having no prior history of regular cigarette use. This study aimed to evaluate dentists’ knowledge and perceptions regarding e-cigarettes, focusing on their health effects, regulatory status, and potential risks to oral health. Assessing dentists’ knowledge of e-cigarette risks is important, as they guide patients on the potential oral health dangers of vaping. E-cigarette use has been linked to several oral health problems. Methods: A cross-sectional survey was conducted among 189 dentists in Kosovo, comprising both general dentists and specialists. The questionnaire assessed participants’ awareness of e-cigarettes’ FDA approval status, their perceptions of health impacts, and their understanding of e-cigarettes’ association with oral conditions such as caries, periodontal disease, and oral cancer. Data were analyzed using SPSS 22, with significance set at p < 0.05. Results: The findings revealed significant knowledge gaps, with 74.1% of respondents being uncertain about the FDA approval status of e-cigarettes and 82.0% recognizing their harmful effects on general and oral health. Nearly half (49.7%) of the participants identified e-cigarettes as a potential risk factor for caries, while 66.1% and 64.6% associated their use with oral cancer and periodontal disease, respectively. Gender and professional specialization did not significantly influence these perceptions. Conclusions: Dentists need better education on the risks of e-cigarette use, including their harmful effects on oral health. Incorporating this knowledge into dental curricula and professional training is essential to give dentists the information needed to advise patients effectively. Raising public awareness through dental health professionals can help mitigate the oral health risks associated with e-cigarettes. Full article

In spite of the development in technology and the recent innovations in dentistry, dental anxiety remains a common issue, and accurately assessing it is challenging due to reliance on patients’ self-reports, which are often biased. Hence, this study was undertaken to determine whether dental anxiety can be quantified objectively using the EDA parameters. EDA (skin conductance (SC), skin susceptance (SS), and skin potential (SP)) parameters and heart rate (HR) were recorded from 40 participants during two different sessions (baseline and anxiety). In addition, the Modified Dental Anxiety Scale (MDAS) scale was also used to record the level of anxiety. The physiological data from EDA and HR were compared with the subjective self-reports of anxiety provided on the MDAS to show whether higher EDA and HR readings correspond to higher scores on the MDAS. To elicit dental anxiety, participants were exposed to several film clips associated with dental treatment. EDA signals were compared between the two sessions for all clips and all EDA scores. SC and HR significantly (p < 0.05) increased during the anxiety session compared to the baseline session. The number of fluctuations per minute in the SC, SS, and SP notably increased during the anxiety session. The MDAS results revealed that the participants had dental anxiety when they were exposed to video clips of dental procedures. The study results imply that EDA parameters could be used as a useful tool to monitor dental anxiety, in particular in young children and non-verbal patients or those with intellectual disabilities, which may aid the dentist in the successful management of dental anxiety during treatment. The moment-to-moment EDA data on a patient’s anxiety levels throughout particular dental operations provides a clearer picture of anxiety variations than pre- or post-appointment surveys alone, in addition to offering unbiased tracking of dental anxiety levels over self-reports. This study seeks to encourage further research into the most effective EDA parameters for improving the management of dental anxiety. Full article

Tooth fractures represent a very common scenario, mainly among children and young adults, thus affecting permanent dentition most of the time. These fractures may involve either the tooth crown or the root or both, including the dental tissues as well. Their treatment can be very demanding for the majority of dentists, including Restorative Dentistry specialists, as reported by the literature. Therefore, the aim of this review article is to provide a decision-making procedure regarding the periodontal-restorative approaches of dental fractures in permanent dentition, based on the revision of the existing scientific evidence. Full article

Background and objectives: The role of parents and the family in promoting children’s oral health is increasingly acknowledged in the dental literature. This study aimed to investigate twelve-year changes in pre-schoolers’ oral health and parental involvement in children’s dental care using data from two repeated cross-sectional surveys. The objectives were (1) to assess the temporal changes in children’s dental health status and oral health-related behaviours, (2) to examine temporal changes in parental attitudes toward their children’s oral health care, and (3) to analyze the associations between observed changes. Materials and methods: Two identical cross-sectional surveys were conducted in 2010/2011 (n = 294) and 2023 (n = 304). In both surveys, parents answered questions regarding their children’s oral health care and completed the 38-item ‘Parental Attitudes toward Children’s Oral Health’ (PACOH) scale, while the dental health of their 3–7-year-old children was clinically assessed. Changes in the examined characteristics were analyzed using general linear models. Results: Significant positive changes (p < 0.001) were observed when comparing the surveys: the dmf-t (decayed, missing, filled teeth) score for deciduous teeth decreased from 5.56 to 3.31; the Silness–Löe Plaque Index decreased from 1.45 to 1.15; the percentage of children brushing their teeth regularly increased from 33.0% to 55.3%; the percentage of parents assisting their child with tooth brushing increased from 19.2% to 85.1%; and regular visits to a children’s dentist increased from 36.4% to 85.1%. Moreover, the study revealed better parental attitudes toward their children’s oral health care, as reflected by a change in the total score of the PACOH scale from 112 to 122. Conclusions: It was concluded that changes in parental attitudes played a crucial role in driving positive trends in oral health-related behaviours, which likely contributed to the improvement of dental health in children. Therefore, understanding and influencing parental attitudes can be essential for promoting good oral health skills and good oral health in young children. Full article

Prosthodontic treatment of developmental age patients presents a significant challenge to the dentist. The growth and development of the stomatognathic system must be considered in treatment planning. Temporary prosthetic restorations must be regularly inspected and recemented, and final prosthetic restoration should not be delivered until the growth of the body is complete. In addition, due to the complex nature of morphological and functional disorders during the developmental period, simultaneous prosthetic and orthodontic treatment may be required. The case presented in this article is a 16-year-old boy with severe tooth destruction caused by untreated caries disease and poor oral hygiene. The patient required conservative, endodontic, and surgical treatment to restore the occlusion and aesthetics to allow the proper development of the masticatory organ. This article also presents the treatment case of a young patient with damaged crowns in the upper arch, which were restored with standard root–crown posts and cores and temporary 3D-printed composite crowns. Full article

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

The aim was to objectively assess compliance in patients prescribed headgear and evaluate the impact of monitoring awareness, treatment duration, gender, and age on compliance levels. A total of 22 patients with Class II malocclusion wore the headgear integrated with the force and temperature sensitive Smartgear monitoring system (Smartgear, Swissorthodontics AG, Cham, Switzerland). Patients were instructed to wear the headgear for 13 h daily over a 3-month period. Randomly, 11 patients were informed that they monitored and 11 were not informed. Data were organized using Microsoft Excel and analyzed using R for statistical estimates, graphs, and hypothesis testing. Smartgear recorded an average daily compliance of 6.7 h. No statistically significant differences were found in cooperation between study group and control group over the 3 months of treatment, regardless of gender and age. However, there was slight greater cooperation in the first month than in the other months, and patients ≤10 years of age had almost 2 h more cooperation than their older counterparts. Moreover, the informed group exhibited an average of 1.1 more hours of cooperation per day than the uninformed group, which may carry clinical significance. This cooperation primarily occurred at night and was found to be statistically significant. Compliance among young patients typically remained lower than the prescribed level, regardless of their gender and psychological maturity. Although an awareness of monitoring does not seem to improve compliance, implementing such systems could still offer dentists a valuable means of obtaining objective information about their patients’ adherence. Full article

Background: Fear and anxiety are common psychological responses to unpleasant stimuli, with dental fear being the fourth most prevalent type of fear or phobia. However, not all dental procedures cause the same level of anxiety, with dental surgery and tooth extraction being among the top five most frightening procedures in the field. Tooth extractions are also the most common surgical procedure in dental surgery. It is important to manage anxiety in the dental office by identifying the main factors. Methods: The study was conducted on a group of 250 patients. The survey technique and the Beliefs about Pain Control Questionnaire (BPCQ) were used in the study. Pain and stress intensity on a Visual Analog Scale (VAS) were measured in each patient before and after tooth extraction procedures. Results: Young women and people from small towns had the highest levels of anxiety. The factor causing the highest level of anxiety was fear of complications. Patients undergoing extraction of retained teeth were characterized by higher levels of anxiety. Conclusions: Perioperative stress is strongly dependent on numerous factors. For patient comfort, it may be crucial for dentists to have knowledge about these factors and the ability to utilize them to reduce stress before and after tooth extractions. Full article

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

Hemophilia is a congenital disorder associated with impaired blood clotting. Routine dental intervention to prevent oral bleeding in patients with hemophilia is considered important, but its effectiveness remains unknown. In the present study, we evaluated the effect of continual dental support on periodontal status and oral health habits in young patients with hemophilia. Of the 168 young patients with hemophilia who visited our clinic for 5 years, we selected subjects who had visited annually since 2015 and were in the mixed and permanent dentitions. To evaluate the periodontal status of these subjects, Community Periodontal Index (CPI) values in the molars and anterior teeth were measured. In addition, a questionnaire regarding oral health habits, including floss use, frequency of brushing by parents, and attending a family dentist, was administered to the subjects and their parents. In the patients with mixed dentition, the CPI values for the upper right molars and lower left central incisor decreased significantly in later years compared with the first year (p < 0.05). In the patients with permanent dentition, only one year recorded a significant decrease in CPI values compared with the first year (p < 0.05), localized in the upper right molars. The results of the questionnaire revealed that continual dental support improved dental floss use and the frequency of brushing by parents only in the mixed dentition group. Furthermore, these oral health habits significantly affected CPI values only in the mixed dentition group (p < 0.01). These results suggest that continual dental support improves the periodontal condition and oral health habits of hemophilic patients, especially those with mixed dentition. Full article

Real-time stress distribution data for implants and cortical bones can aid in determining appropriate implant placement plans and improving the post-placement success rate. This study aims to achieve these goals via a parametric reduced-order model (ROM) method based on stress distribution data obtained using finite element analysis. For the first time, the finite element analysis cases for six design variables related to implant placement were determined simultaneously via the design of experiments and a sensitivity analysis. The differences between the minimum and maximum stresses obtained for the six design variables confirm that the order of their influence is: Young’s modulus of the cancellous bone > implant thickness > front–rear angle > left–right angle > implant length. Subsequently, a one-dimensional (1-D) CAE solver was created using the ROM with the highest coefficient of determination and prognosis accuracy. The proposed 1-D CAE solver was loaded into the Ondemand3D program and used to implement a digital twin that can aid with dentists’ decision making by combining various tooth image data to evaluate and visualize the adequacy of the placement plan in real time. Because the proposed ROM method does not rely entirely on the doctor’s judgment, it ensures objectivity. Full article

Twice daily parental supervised brushing (PSB) is recommended for the effective oral hygiene of children with toothpaste including fluoride. This cross-sectional study aimed to identify dentist mothers’ attitudes, challenges, and facilitators in the oral health promotion of their young children. An online questionnaire was prepared and distributed to dentists via e-mail with a link to the form. Of all the mothers, 46.50% started brushing their children’s teeth after the eruption of the first primary teeth. Nearly 50% of the mothers thought that they should brush their children’s teeth until at least the age of 7–8 years old. In terms of the main barriers to toothbrushing, 52.9% said children could fall asleep at home or in the car, while 27.5% of all mothers reported being tired as the main barrier to toothbrushing. Although dentist mothers have sufficient knowledge to promote oral and dental health, they do not always have ideal attitudes and behaviors and they may encounter various barriers regarding themselves and their children in practical applications. Providing oral care for young children goes beyond ‘knowledge’ and is sometimes ‘challenging’; however, it could be ‘possible’ by developing and implementing the most appropriate solution strategies suitable for each unique family and child. Full article