Visual Analysis of Panoramic Radiographs among Pediatric Dental Residents Using Eye-Tracking Technology: A Cross-Sectional Study.

The aim of this cross-sectional study was to explore the eye tracking (ET) performance of postgraduate pediatric dental students in correctly detecting abnormalities in different sets of panoramic radiographs. This observational study recruited postgraduate pediatric dental students to evaluate seven panoramic radiographs. RED-m® SMI software (Sensomotoric Instruments, Teltow, Germany) was used to track the participants' eye movements as they looked at the radiographs. The data collected for areas of interest (AOIs) included revisit counts, fixation counts, fixation times, entry times, and dwell times. Univariate and bivariate analyses were conducted to summarize the participants' characteristics and ET measures. The overall percentage of correctly located AOIs was 71.7%. The residents had significantly more revisits and fixation counts in AOIs located in one sextant than in multiple sextants (p < 0.001). Similar patterns were observed for fixation and dwell times (p < 0.001), but not for entry time. Heatmaps showed that the highest density of fixations was on the AOIs and the residents fixated more on dentition than on bony structures. In single-sextant radiographs, residents had significantly more revisits and fixation counts for AOIs compared to those of multiple sextants. Residents had slower entry times and dwelled less on AOIs located in multiple sextant(s). The reported findings can direct dental educators to develop a standardized scan scheme of panoramic radiographs to minimize misdiagnosis.

The Use of Eye-Tracking Technology in Pediatric Orofacial Clefts: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis assessed the quality of the peer-reviewed literature and evaluated the usefulness of eye-tracking technology in evaluating observers' perceptions of pediatric patients with orofacial clefts. PubMed, Science Direct, Wiley, and Web of Science were searched. Articles were screened in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines, and their methodological quality was assessed. Of the 10,254 identified studies, 12 were included. Eleven studies were cross-sectional, and one was a prospective cohort study. The main areas of interest analyzed were the eyes, nose, and mouth. Nine studies used assessment scales to analyze the link between perceived attractiveness and visualization patterns and measures. For the fixation duration outcome, six studies were eligible for inclusion in the meta-analysis. All studies reported on fixation duration in milliseconds and reported on a standard deviation. The meta-analysis demonstrated a significant difference in the measurements between the control groups and the patients with orofacial clefts. This might indicate the usefulness of eye-tracking technology as a metric for assessing the success of cleft repairs based on the perceptions of different populations. Future studies should be comprehensively reported on for comparability and reproducibility purposes.

Recurrent caries models to assess dental restorations: A scoping review.

OBJECTIVES: To review the literature on recurrent caries models used to evaluate restorative materials, compare reported methodology and parameters, and devise specific recommendations to be considered in future investigations. DATA: The following were extracted: study design, sample characteristics, source of teeth, name of restorations compared including controls, recurrent caries model type, type of demineralizing and remineralizing solutions, type of biofilm used, methods to detect recurrent caries. SOURCES: Literature searches were performed in OVID Medline, EMBASE, SCOPUS, and Cochrane Library. STUDY SELECTION: For a study to be included, it had to examine dental materials for tooth restoration purposes only with a valid control group and evaluate restorative dental materials regardless of the form of the teeth caries model used or nature of the tooth structure used. A total of 91 studies were included. Most of the studies presented were in vitro. Human teeth were the main source of specimens utilized. Around 88% of the studies used specimens without an artificial gap, and 44% used a chemical model. S. mutans was the main bacterial species used in microbial caries models. CONCLUSION: The findings of this review provided an insight into the performance of available dental materials assessed using different recurrent caries models, yet this review cannot be used as a guideline for material selection. Selecting the appropriate restorative material relies on several patient-related factors such as microbiota, occlusion, and diet that are not comprehensively taken into consideration in recurrent caries models and thus hinder reliable comparison. CLINICAL SIGNIFICANCE: Due to the heterogenicity of variables among studies on the performance of dental restorative materials, this scoping review aimed to provide insights for dental researchers concerning the available recurrent caries models, testing methods used, and aspects of comparison between these materials including their characteristics and limitations.

The effect of virtual reality distraction on anxiety level during dental treatment among anxious pediatric patients: a randomized clinical trial.

This study evaluated the effect of Virtual Reality Distraction (VRD) on dental anxiety among anxious children undergoing prophylactic dental treatment by utilizing both subjective (Venham Anxiety and Behavioral Rating Scale (VABRS)) and objective (heart rate (HR) and salivary cortisol level (SCL)) measures. This randomized controlled study included 36 (6- to 14-year-old) healthy and anxious children who needed prophylactic dental treatment and had a history of previous dental treatment. The eligible children's anxiety level was evaluated using a modified version of the Abeer Dental Anxiety Scale-Arabic version (M-ACDAS) and those who scored at least 14 or more out of 21 were included. Participants were randomly distributed to either the VRD or control group. In the VRD group, participants wore the VRD eyeglasses during prophylactic dental treatment. In the control group, subjects received their treatment while watching a video cartoon on a regular screen. The participants were videotaped during the treatment, and their HR was recorded at four time points. Also, a sample from each participant's saliva was collected twice, at the baseline and after the procedure. The mean M-ACDAS score at baseline in the VRD and the control groups was not statistically significant (p = 0.424). At the end of the treatment, the SCL was significantly lower in the VRD group (p < 0.001). Neither the VABRS (p = 0.171) nor the HR significantly differed between the VRD and control groups. Virtual reality distraction is a non-invasive method that has the potential to significantly reduce anxiety during prophylactic dental treatment among anxious children.

Clinical Effects of Dental Caries on the Quality of Life of Paediatric Patients Aged 8-10 Years: Utilisation of the PUFA Index.

PURPOSE: Saudi children have poor oral health; however, little data are available on the effects of dental caries and its clinical complications on the oral health-related quality of life (OHRQoL) in school-aged children. This study evaluated the impact of caries and its clinical effects on the OHRQoL of a sample of 8- to 10-year-old children attending King Abdulaziz University Hospital. MATERIALS AND METHODS: The following variables were assessed for each child: sociodemographic data, OHRQoL using an Arabic-validated Child Perception Questionnaire for 8- to 10-year-old children (CPQ8-10), and two global health rating questions. Caries and its clinical effects on oral health were also assessed using the decayed-missing-filled teeth (dmft/DMFT) and pulpal involvement, ulceration, fistula, and abscess (pufa/PUFA) indices. Descriptive statistics of the sociodemographic variables and responses to the CPQ8-10 questions are presented as absolute values and percentages. The CPQ8-10 scores between children with different dmft/DMFT and pufa/PUFA scores were compared. RESULTS: In total, 169 children participated in this study. The means ± SD of dmft and DMFT were 5.03 ± 2.5 and 2.35 ± 1.7, respectively. However, the pufa and PUFA scores were 1.03 ± 1.6 and 0.05 ± 0.2, respectively. The most common oral health complaint affecting OHRQoL was food stuck to the teeth. Participants with higher dmft and pufa/PUFA scores had statistically significantly higher CPQ8-10 scores than did their counterparts. CONCLUSION: High dmft and pufa/PUFA scores have a statistically signifcantly negative effect on the OHRQoL among healthy 8- to 10-year-old children. Worse global health ratings correlate with lower OHRQoL.

Access to dental care for children with special health care needs: a cross-sectional community survey within Jeddah, Saudi Arabia.

The aim of this study was to investigate the level of dental care access among children with special health care needs (CSHCN) in Jeddah, Saudi Arabia and the barriers hindering this access. Data of this cross-sectional study were obtained from self-administered surveys distributed through seven CSHCN centers. Children with autistic spectrum disorder (ASD), Down syndrome, cerebral palsy, and developmental delay were included. Univariate and bivariate analyses were conducted to describe the data. A total of 602 study participants were included in the analyses. Only 24.9% of the participated caregivers routinely visited the dentist for their CSHCN. Half of CSHCN caregivers found difficulties obtaining dental treatment. This trend was significantly greater in 12-18 years old children (p = 0.013) and in families commuting for more than one hour to dental clinics (p = 0.045). The most common reported barrier was fear of the dentist (61.6%) followed by child uncooperativeness (37.8%) and treatment costs (27.8%). CSHCN lack sufficient dental care for a variety of reasons, primarily fear of dentists, child uncooperativeness, and treatment costs. Dentists require more training and education to facilitate better access to dental care for CSHCN.