Is There an Increase in Possible Sleep Bruxism in Children Over Time? A Longitudinal Study.

BACKGROUND: Bruxism is a behaviour that has several consequences in an individual's life, especially when it starts in childhood. However, bruxism can be a potential protective factor, which is an attribute that reduces the chance of a negative health outcome. OBJECTIVES: To evaluate the incidence of sleep bruxism (SB) and dental wear in children and adolescents. MATERIALS AND METHODS: This longitudinal study began in 2014 and 2016 (baseline) with initial 1816 children followed for 5 and 3 years, respectively. The follow-up data collection started in 2019. The diagnosis of SB was parents report (baseline) and self-report (follow-up) due to age groups of each phase, and questions related to symptoms of SB were collected. Five calibrated examiners (kappa >0.7) collected the clinical data. The clinical variables were dental erosion and dental wear. Contextual, individual, behaviour and clinical characteristics were collected. A multilevel logistic regression model was used to investigate the association of contextual, individual, behaviour and clinical characteristics with SB. Poisson regression for repeated measures was performed to evaluate the incidence of SB and dental wear (incidence rate ratio-IRR and confidence interval-95% CI). RESULTS: Two hundred and fifty-three children and adolescents answered questionnaires and were clinically examined. The mean age of the follow-up in 2019 was 11.25 years old (±2.19). There was no increase in the incidence of SB (95% CI: 0.74-1.35). Children/adolescents had a 2.2 higher risk to present dental wear (95% CI: 1.89-2.60). SB at the follow-up was associated with the contextual variable, earache, erosion and awake bruxism. CONCLUSIONS: In this population, children with SB remained with this behaviour and showed higher dental wear over the years.

Assessment of space changes in the lower dental arch after the premature unit loss of a primary molar: A randomized clinical trial.

BACKGROUND: Premature loss of primary teeth presents a significant challenge in oral health, with conflicting views on using space maintainers. AIM: To assess mandibular arch space changes associated with premature lower primary molar (PM) loss with or without a space maintainer. DESIGN: A randomized clinical trial with children (6-9 years old) with premature loss of a lower PM divided into two groups: control group (CG), without a space maintainer, and intervention group (IG), with a space maintainer. Dental casts were measured at baseline, 3 months, and 6 months. Linear distance; intercanine width and length; and arch width, length, and perimeter were measured. ANOVA and t-test were applied (p = .05). RESULTS: Twenty-six patients (mean: 7.3 years; standard deviation [SD]: 0.92) were included: 14 in CG and 12 in IG. CG had a greater space loss (-0.9 mm; SD: 0.45) than IG (-0.4 mm; SD: 0.61) at 3 months (p < .05). No difference between the groups was observed after 6 months (p = .610). CG decreases space at 6 months, especially with the first permanent molars without intercuspation (-2 mm; SD: 0.71; p = .007). CONCLUSION: Premature lower PM loss resulted in reduced arch space loss after 6 months, regardless of a space maintainer use. CG showed more loss of space when the first permanent molars lacked intercuspal relationship.

Research interest on dental sealant in dentistry based on the 100 most cited articles: bibliometric analysis.

The aim of this study was to identify and analyze the characteristics of the 100 most cited articles about dental sealants (DS) in dentistry. In September 2023, a search was performed in the Web of Science Core Collection (WoS-CC) database. The following information was extracted from each article: number and density of citations, year of publication, authorship, journal, impact factor, keywords, study design, theme, continent, country, and institution. The citations of the WoS-CC were compared with those of the Scopus and Google Scholar databases. The VOSviewer software was used to generate collaborative networks. The number of citations ranged from 33 to 205. The articles were published between 1961 and 2016. Buonocore MG (7%) was the most prominent author among the most cited. The Journal of the American Dental Association was the most frequent journal (25%) and Journal of Dental Research (7.6) had the highest impact factor. Most studies had interventional (41%) and laboratory (31%) designs, mainly addressing DS effectiveness in the prevention and control of dental caries (86%). There was a predominance of publications from North America (46%) and the USA was the country with the highest number of articles (44%). The most frequent institutions were the Centers for Disease Control and Prevention (USA) and the University of Rochester (USA) (6% each). "Retention" was the most frequent keyword. In conclusion, the 100 most cited articles were mostly interventional and laboratory studies, addressing the retention and efficacy of DS. Most of the articles were concentrated in North America and Europe, demonstrating a little collaboration from other continents.

Research interest on dental sealant in dentistry based on the 100 most cited articles: bibliometric analysis

Abstract The aim of this study was to identify and analyze the characteristics of the 100 most cited articles about dental sealants (DS) in dentistry. In September 2023, a search was performed in the Web of Science Core Collection (WoS-CC) database. The following information was extracted from each article: number and density of citations, year of publication, authorship, journal, impact factor, keywords, study design, theme, continent, country, and institution. The citations of the WoS-CC were compared with those of the Scopus and Google Scholar databases. The VOSviewer software was used to generate collaborative networks. The number of citations ranged from 33 to 205. The articles were published between 1961 and 2016. Buonocore MG (7%) was the most prominent author among the most cited. The Journal of the American Dental Association was the most frequent journal (25%) and Journal of Dental Research (7.6) had the highest impact factor. Most studies had interventional (41%) and laboratory (31%) designs, mainly addressing DS effectiveness in the prevention and control of dental caries (86%). There was a predominance of publications from North America (46%) and the USA was the country with the highest number of articles (44%). The most frequent institutions were the Centers for Disease Control and Prevention (USA) and the University of Rochester (USA) (6% each). "Retention" was the most frequent keyword. In conclusion, the 100 most cited articles were mostly interventional and laboratory studies, addressing the retention and efficacy of DS. Most of the articles were concentrated in North America and Europe, demonstrating a little collaboration from other continents.

Fluoride Varnish in Dentistry: A Bibliometric Analysis of the 100 Most-Cited Papers.

A highly cited paper is a milestone and might impact research and clinical practice. The present study analyzed the 100 most-cited papers on fluoride varnishes in dentistry. A search was performed on July 20, 2022, on the Web of Science Core Collection. Two independent researchers extracted the following data: number and citation density; year and journal of publication; study design; main topic; authors; institutions; keywords; countries and continents. Scopus and Google Scholar were consulted to compare the number of citations. Bibliometric networks were generated in the VOSviewer. The number of citations ranged from 36 to 351, and thirteen papers were cited more than 100 times. The papers were published between 1977 and 2018, most of which were published after 2008 (48%). The most prevalent journal was Caries Research (17%). Intervention studies were the most common design (41%). The most discussed topics were dental caries prevention (48%) and dental remineralization (31%). Europe was the continent with the highest number of publications (46%), mainly from Sweden (14%), and Umea University had the most substantial number of studies (8%). Petersson L.G. was the author with more papers in the top 100 (6%). The most used keywords were "dental caries" (34%) and "fluoride varnish" (31%). It can be concluded that the top 100 cited papers on fluoride varnish primarily originated from Europe, with the majority consisting of intervention studies focusing on the utilization of fluoride varnish for the prevention of dental caries.

Tooth Bleaching: A bibliometric analysis of the top 100 most-cited papers.

This study analyzes the characteristics of the top 100 most-cited papers related to tooth bleaching. A literature search was performed on the Web of Science up to March 2022. The number of citations was cross-matched with the citation count on Scopus and Google Scholar. The following data were collected: number and density of citations; authorship; year and journal of publication; study design and thematic; keywords; institution and country of origin. Spearman's correlation and Poisson regression were used to determine associations between the number of citations and study characteristics. The VOSviewer software was used to generate collaborative network maps for the authors and keywords. The number of citations ranged from 66 to 450. Papers were published between 1981 and 2020. The most frequent study design and topic were laboratory-based studies and 'interaction of the bleaching agent with dental tissues', respectively. Cochran M, Loguercio AD, Matis B, Reis A, and Suliman M were the authors with the highest number of papers. The countries with the most papers were the United States of America (USA) (28%) and Brazil (20%). Indiana University and State University of Ponta Grossa were the institutions with the most papers (6% each). There was a very strong correlation among the number of citations of the three databases. The 100 most-cited papers related to tooth bleaching were mainly published by the USA and Brazil, with laboratory-based studies addressing topics related to the effects of bleaching agents on tooth structure being the most prevalent.

A Bibliometric Analysis of the Top 100 Most-Cited Papers Concerning Dental Fluorosis.

A high number of citations can indicate the potential of any specific paper to influence other research and generate changes in clinical practice. Analyzing the most-cited papers in a certain scientific field may assist researchers to identify the influential papers as well their main characteristics. The present study aimed to analyze the 100 most-cited papers concerning dental fluorosis (DF) through a bibliometric review. A search was performed in the Web of Science Core Collection (WoS-CC) database in November 2021. The papers were displayed in descending order according to the number of citations in WoS-CC. Two independent researchers performed the selection. Scopus and Google Scholar were used to compare the number of citations with WoS-CC. The following data were extracted from the papers: title, authors, number and density of citations, institution, country, continent, year of publication, journal title, keywords, study design, and theme. Collaborative networks were generated using the VOSviewer software. The top 100 most-cited papers were published between 1974 and 2014 and were cited 6,717 times (ranging from 35 to 417). Community Dentistry and Oral Epidemiology (24%), Journal of Dental Research (21%), Journal of Public Health Dentistry (17%), and Caries Research (13%) published the most papers. Observational studies (60%) and literature reviews (19%) were the most common study designs. The main topics were epidemiology (44%) and fluoride intake (32%). The countries with the highest number of papers were the USA (44%), Canada (10%), and Brazil (9%). The University of Iowa (USA) had the most papers (12%). Levy SM was the author with the highest number of papers (12%). The 100 most-cited papers on DF were mainly observational studies focused on epidemiology and originated in North America. There were few interventional studies and systematic reviews among the most-cited papers concerning this topic.

Anterior open bite self-correction after cessation of non-nutritive sucking habits: a systematic review.

BACKGROUND: Non-nutritive sucking habits likely may cause occlusal changes such as anterior open bite (AOB) if they persist over extended time. OBJECTIVES: To assess if there is self-correction of AOB after cessation of non-nutritive sucking habits in children older than 4 years old, through a systematic review. SEARCH METHODS: Data sources included PubMed, Scopus, Web of Science and Latin American and Caribbean Health Sciences (LILACS) databases, gray literature as Google Scholar, the database System for Information on Gray Literature in Europe (OpenGrey) and ProQuest Dissertations and Theses Database, also hand searches of the included studies references. SELECTION CRITERIA: Studies assessing occlusal changes in children aged 4-12 years with AOB traits and non-nutritive sucking habits after the discontinuation of the habit were included. DATA COLLECTION AND ANALYSIS: Two authors independently assessed eligibility and extracted data. The risk of bias was assessed using the Newcastle-Ottawa Quality Assessment Scale and the Joanna Briggs Critical Appraisal Checklist for quasi-experimental studies. The confidence in cumulative evidence was assessed using the GRADE criteria. RESULTS: Over 3100 studies, only 5 met the inclusion criteria. There is often self-correction of AOB after discontinuing the non-nutritive sucking habit, even in cases older than 4 years old. The improvement ranged between 50 and 100%. The overall quality of evidence was very low. CONCLUSIONS: AOB self-correction after discontinuing a non-nutritive sucking habit is possible, even after 4 years old, although with very low certainty in the body of evidence. It is not clear after what age the removal from the habit is unlikely to facilitate AOB self-correction. REGISTRATION AND CONFLICT OF INTEREST: International Prospective Register of Systematic Reviews code: CRD42016052171. There was no conflicting interest from the review authors.

Evaluation of pH and calcium ions release of two tricalcium silicate-based sealers through roots of primary teeth.

Background: This study aimed to evaluate the pH and calcium ions (Ca2+) release from two tricalcium silicate-based sealers (Sealer Plus BC and Bio-C Pulpecto) through roots of primary teeth. Methods: Forty root canals of primary incisors were prepared and distributed into four groups according to the filling material: GPlusBC (Sealer Plus BC); GBioC (Bio-C Pulpecto); GUltra (Ultracal); and GC (no filled). pH measurement was performed with a digital pH meter, and the Ca2+ release was measured in an atomic absorption spectrophotometer at baseline, 24 h and 1, 2, 3, and 4 weeks later. The data were analyzed using two-way ANOVA and Tukey's post hoc tests. Results: The results did not reveal significant differences between the groups in terms of pH in 24 h, 1-, and 2-weeks' periods. After 4 weeks, there was a significant difference, with the highest mean pH values in GUltra, followed, respectively, by GPlusBC and GBioC. Regarding the Ca2+ release, the GUltra showed greatest mean values at all evaluated times, and the other groups showed no difference between them. Conclusion: Both sealers were able to promote the elevation of the pH and Ca2+ release through roots of primary teeth, which brings favorable properties for their use as a filling material.

Tooth Bleaching: A bibliometric analysis of the top 100 most-cited papers

Abstract This study analyzes the characteristics of the top 100 most-cited papers related to tooth bleaching. A literature search was performed on the Web of Science up to March 2022. The number of citations was cross-matched with the citation count on Scopus and Google Scholar. The following data were collected: number and density of citations; authorship; year and journal of publication; study design and thematic; keywords; institution and country of origin. Spearman's correlation and Poisson regression were used to determine associations between the number of citations and study characteristics. The VOSviewer software was used to generate collaborative network maps for the authors and keywords. The number of citations ranged from 66 to 450. Papers were published between 1981 and 2020. The most frequent study design and topic were laboratory-based studies and 'interaction of the bleaching agent with dental tissues', respectively. Cochran M, Loguercio AD, Matis B, Reis A, and Suliman M were the authors with the highest number of papers. The countries with the most papers were the United States of America (USA) (28%) and Brazil (20%). Indiana University and State University of Ponta Grossa were the institutions with the most papers (6% each). There was a very strong correlation among the number of citations of the three databases. The 100 most-cited papers related to tooth bleaching were mainly published by the USA and Brazil, with laboratory-based studies addressing topics related to the effects of bleaching agents on tooth structure being the most prevalent.

Resumo Este estudo analisa as características dos 100 artigos mais citados relacionados ao clareamento dental. Uma pesquisa bibliográfica foi realizada na Web of Science até março de 2022. O número de citações foi cruzado com a contagem de citações na Scopus e na Google Scholar. Foram coletados os seguintes dados: número e densidade de citações; autoria; ano e periódico de publicação; desenho do estudo e temática; palavras-chave; instituição e país de origem. A correlação de Spearman e a regressão de Poisson foram usadas para determinar associações entre o número de citações e as características do estudo. O software VOSviewer foi utilizado para gerar mapas de rede colaborativa para os autores e palavras-chave. O número de citações variou de 66 a 450. Os artigos foram publicados entre 1981 e 2020. O desenho e o tópico de estudo mais frequentes foram estudos laboratoriais e interação do agente clareador com tecidos dentários, respectivamente. Cochran M, Loguercio AD, Matis B, Reis A e Suliman M foram os autores com maior número de artigos. Os países com mais artigos foram os Estados Unidos da América (EUA) (28%) e o Brasil (20%). A Universidade de Indiana e a Universidade Estadual de Ponta Grossa foram as instituições com mais artigos (6% cada). Houve uma correlação muito forte entre o número de citações das três bases de dados. Os 100 artigos mais citados relacionados ao clareamento dentário foram publicados principalmente pelos EUA e Brasil, sendo os estudos laboratoriais que abordaram tópicos relacionados aos efeitos dos agentes clareadores na estrutura dentária os mais prevalentes.

Association between dental caries and molar-incisor hypomineralisation in first permanent molars: A hierarchical model.

OBJECTIVE: To assess whether the prevalence of dental caries is associated with the presence of molar-incisor hypomineralisation (MIH) in first permanent molars (FPMs). METHODS: A cross-sectional study was conducted with a sample of 5368 FPMs from 1342 children aged 8-10 years from Florianopolis, Brazil. Dental caries was evaluated with the Decayed, Missing and Filled Teeth (DMFT) index and MIH was assessed according to the European Academy of Paediatric Dentistry (EAPD) criteria. The sociodemographic data were obtained with a questionnaire sent to caregivers. A hierarchical repeated measures Poisson regression, considering dependency among observations, was performed, since the unit of analysis was the tooth. RESULTS: The presence of MIH was associated with a 6.15 times higher prevalence of dental caries in FPMs (PR: 6.15; 95%CI: 4.18-9.04). A monthly family income ≤2 minimum wages and the caries experience in the primary teeth were also significantly associated with greater prevalence rates of dental caries in FPMs. CONCLUSION: The presence of MIH showed a significant association with the prevalence of dental caries in FPMs. Thus, dentists should be alert to cases of MIH. Once the condition is detected, preventive measures should be taken to prevent enamel breakdown and the development of dental caries lesions.

The top 100 most-cited clinical trials and systematic reviews related to children and adolescents' oral health: A bibliometric analysis / Os 100 ensaios clínicos e revisões sistemáticas mais citados relacionados à saúde bucal de crianças e adolescentes: uma análise bibliométrica

Aim: To identify and analyze the 100 most-cited clinical trials (CTs) and systematic reviews (SRs) related to children and adolescents' oral health. Methods: A search was conducted in the Web of Science Core Collection (WoS-CC), using a specific search strategy. Papers were ranked in descending order, considering number of citations. Only CTs and SRs were considered. Two reviewers selected the papers and collected the bibliometric data: year of publication; number and density of citations; study designs; journals; authors; countries and institutions; topics of study; and keywords. Poisson regression was performed to verify associations between the number of citations and bibliometric parameters. Results: The 100 most-cited papers were published between 1982 and 2018 and received a total of 8,702 citations in the WoS-CC (ranging from 52 to 177). Fifty-three papers were CTs and 47 SRs. The American Journal of Orthodontics and Dentofacial Orthopedics published the most papers (n=20). Twetman S contributed the highest number of papers (n=7). The United States of America was the most prolific country (n = 17), followed by the Netherlands (n=11). The University of Nijmegen (Netherlands) presented 8 papers among the most-cited. The main topic of interest was Cariology (n = 40). "Dental Caries" was the most frequent keyword (n = 20). The citations' number from WoS-CC decreased by 1.3% each year (RP: 0.987, 95%CI: 0.975­1.000, p = 0.048). Conclusion: This bibliometric study allowed an analysis of the most-cited CTs and SRs related to children and adolescents' oral health, highlighting the most prolific authors, institutions and countries based on the number of citations.

Objetivo:Esta revisão analisou os 100 ensaios clínicos (EC) e revisões sistemáticas (RS) mais citados relacionados à saúde bucal de crianças e adolescentes. Métodos: Realizou-se uma busca na base de dados Web of Science Core Collection (WoS-CC), utilizando uma estratégia de busca específica. Os artigos foram classificados em ordem decrescente, considerando o número de citações. Foram incluídos apenas ECs e RSs. Dois revisores selecionaram os artigos e coletaram os seguintes dados bibliométricos: ano de publicação; número e densidade de citações; desenhos de estudo; periódico; autores; países e instituições; tópicos de estudo; e palavras-chave. Regressão de Poisson foi conduzida para verificar associações entre o número de citações e os parâmetros bibliométricos.Resultados: Os 100 artigos mais citados foram publicados entre 1982 e 2018 e receberam um total de 8.702 citações na WoS-CC (variando de 52 a 177). Cinquenta e três artigos eram ECs e 47 RSs. O American Journal of Orthodontics and Dentofacial Orthopaedics publicou a maioria dos artigos (n = 20). Twetman S contribuiu com o maior número de artigos (n = 7). Os Estados Unidos da América foram o país mais prolífico (n = 17), seguido pelos Países Baixos (n = 11). A Universidade de Nijmegen (Holanda) apresentou 8 artigos entre os mais citados. O principal tema de interesse foi Cariologia (n = 40). "Cárie dentária" foi a palavra-chave mais frequente (n = 20). O número de citações na WoS-CC diminuiu 1,3% a cada ano (RP: 0,987, IC 95%: 0,975­1,000, p = 0,048).Conclusão: Este estudo bibliométrico permitiu analisar os ECs e RSs mais citados relacionadas à saúde bucal de crianças e adolescentes, destacando os autores, instituições e países mais prolíficos com base no número de citações.

Parental acceptance toward behavior guidance techniques for pediatric dental visits: a meta-analysis.

This study aimed to answer the following question: What is the proportion of acceptance reported by parents toward pediatric behavior guidance techniques (BGTs)? Observational studies that evaluated parental acceptance of BGTs during pediatric dental visits among parents of non-special health care need (non-SHCN) and SHCN children were included. A search of the Cochrane Library, Latin American and Caribbean Health Sciences (LILACS), MedLine/PubMed, PsycINFO, Scopus, and Web of Science databases, in addition to gray literature, was performed until October 2021. The Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross-Sectional Studies was used for quality assessment. The certainty of evidence was assessed using the Recommendation, Assessment, Development, and Evaluation (Grade). Fifty-three studies with 4868 participants were included, and 42 were retained for the random-effects proportion meta-analysis. The methodological quality varied from low to high. The agreement with the BGTs varied from 85.6% (95%CI: 77.5-92.1; p < 0.001; I 2 = 93.6%; 16 studies; n = 1399) for tell-show-do to 25.7% (95%CI: 17.8-34.4; p < 0.001; I 2 = 90.4%; 12 studies; n = 1129) for passive protective stabilization among non-SHCN children's parents; meanwhile, among the parents of SHCN children, it varied from 89.1% (95%CI: 56.1-99.7; p < 0.001; I 2 = 95.7%; 3 studies; n = 454) for tell-show-do to 29.1% (95%CI: 11.8-50.0; p = 0.001; I 2 = 84.8%; 3 studies; n = 263) for general anesthesia. The effect estimates varied greatly, as substantial heterogeneity across studies was observed, thus limiting the confidence in the results. Parents were more likely to agree with basic BGTs over advanced BGTs, with very low certainty of evidence. Dentists should discuss BGT options with parents. Protocol registration: PROSPERO CRD42018103834.

Efficacy of the Video Modeling Technique as a Facilitator of Non-invasive Dental Care in Autistic Children: Randomized Clinical Trial.

This study aims to evaluate the video modeling technique during the dental appointment. A blinded randomized clinical trial was composed of 2 groups, consisting of 20 autistic children (4 to 12 years) in each group: control (did not watch the video before the consultation) and intervention (watched the video before the consultation). The primary outcome was the mean number of visits to perform a dental appointment. The number of consultations was analyzed by T-test or Mann-Whitney test. The results showed that the mean number of consultations in the intervention group was 1.5 (± 1.53) and in the control group 2 (± 1.77) (p ≤ 0.05). The video modeling technique can be effective in minimizing the number of dental consultations in autistic children.

BURNOUT SYNDROME AMONG DENTISTS: A SYSTEMATIC REVIEW AND META-ANALYSIS.

OBJECTIVE: Burnout syndrome has negative consequences on the dentist's health and performance during work. This systematic review aimed to assess the prevalence of Burnout syndrome in dentists. METHODS: Searches were carried out in Medline, Scopus, Web of Science, PsycINFO, EMBASE, LILACS databases, and searches in the gray literature on January 27, 2021. There were no restrictions on language and search period. For the diagnosis of Burnout, only studies that used the Maslach burnout inventory questionnaire and its subscales emotional exhaustion (EE), depersonalization (DP), and reduced personal accomplishment (PA) were included. Proportion meta-analyses were performed using the Stata 13.0 software. RESULTS: A total of 37 articles were included in the narrative and 31 in quantitative syntheses. The overall prevalence of Burnout syndrome in dentists was 13% (95% confidence interval [CI]: 0.006-0.21; I²: 97.07%) and the total prevalence in the subscales EE, DP, and PA, were, respectively: 28% (95% CI: 0.24-0.32; I²: 20.70%), 18% (95% CI: 0.08-0.28; I²: 85.61%) and 10% (95% CI: 0.08-0.13; I²: 0%). About the levels of Burnout syndrome in the subscales, 25% (95% CI: 0.19-0.31; I² 92.58%) presented high EE, 18% (95% CI: 0.10-0.26; I² 96.62%) high DP and 32% (95% 0.20-0.45; I² 97.86%) low PA. About continuous data, the mean of EE, DP and PA was respectively 17.90 (95% CI: 9.36-26.43; I² 94.8), 6.93 (95% CI: 3.41-10.45; I² 80.2) and, 34.69 (95% CI: 23.82-45.55; I² 98.8). No study presented all the positive criteria of the Joanna Briggs Institute Critical Appraisal checklist. CONCLUSION: In conclusion, there was a considerable prevalence of burnout syndrome in dentists, mainly in the subscale of emotional exhaustion.

Persistent pain after successful endodontic treatment in a patient with Wegener's granulomatosis: a case report.

Wegener's granulomatosis (WG) is a condition with immune-mediated pathogenesis that can present oral manifestations. This report describes the case of a patient diagnosed with WG 14 years previously, who was affected by persistent pain of non-odontogenic origin after successful endodontic treatment. A 39-year-old woman with WG was diagnosed with pulp necrosis and apical periodontitis of teeth #31, #32, and #41, after evaluation through a clinical examination and cone-beam computed tomography (CBCT). At the first appointment, these teeth were subjected to conventional endodontic treatment. At 6- and 12-month follow-up visits, the patient complained of persistent pain associated with the endodontically treated teeth (mainly in tooth #31), despite complete remission of the periapical lesions shown by radiographic and CBCT exams proving the effectiveness of the endodontic treatments, thus indicating a probable diagnostic of persistent pain of non-odontogenic nature. After the surgical procedure was performed to curette the lesion and section 3 mm of the apical third of tooth #31, the histopathological analysis suggested that the painful condition was likely associated with the patient's systemic condition. Based on clinical, radiographic, and histopathological findings, this unusual case report suggests that WG may be related to non-odontogenic persistent pain after successful endodontic treatments.

Influence of the method for determining working length on the obturation level of primary molars.

Efficient working length determination is essential for a successful endodontic treatment. The purpose of the present study was to evaluate whether the method for determining the working length of root canals (radiographic or electronic) influences the obturation level of primary molars. Thus, a controlled, triple-blind, randomized clinical trial was conducted. Sixty-four children aged 6 to 9 years with an indication for primary molar pulpectomy were included. Participants were divided into two groups according to the method used to determine the working length of the root canals: (G1) radiographic and (G2) using an electronic apex locator. The study had 3 operators: #1 performed the clinical procedures, except the electronic measurement; #2 performed radiographic measurement and final evaluation of obturation level; and #3 performed eligibility criteria and electronic measurement. Adequacy of obturation level was evaluated based on the final conventional radiography and it was recorded as acceptable or unacceptable (short or overfilled). Data were analyzed with repeated measures logistic regression. There was no difference between the obturation level of primary molars measured by radiographic and electronic methods (p > 0.05). The other investigated variables (age, tooth type, dental arch position, last instrumentation file, and canal location) also did not influence the obturation level (p > 0.05). In conclusion, both measurement methods resulted in similar adequacy of obturation level in primary molars after pulpectomy.

Endodontic therapy in primary teeth: a bibliometric analysis of the 100 most-cited papers.

The purpose of this review was to identify and analyze the main characteristics of the 100 most-cited papers in the field of endodontic therapy in primary teeth. A search for the most-cited articles was conducted in the Clarivate Analytics Web of Science 'Core-Collection' (WoS-CC) database up to December 2020. Papers were ranked in descending order, by number of citations, and each paper was matched with the citation count on Scopus and Google Scholar. Two independent reviewers selected the most-cited papers and analyzed it according to the number and density of citations, year and journal of publication, authors, countries and contributing institutions, study design, topic of the paper, and keywords. Spearman's correlation and Poisson regression were used to determine associations between the number of citations and study characteristics. The citation count varied from 15 to 135 (WoS-CC), 8 to 141 (Scopus), and 14 to 317 (Google Scholar). Of the 306 contributing authors, most paper contributions were from Sakai VT, Oliveira TM, and Machado MAAM (5 each). Most of the papers originated from the USA (n=21) and Brazil (n=18). Randomized trials were the most common study design (n=32), and "pulpotomy" was the most frequently used keyword (n=35). Poisson regression showed that the number of citations decreased by 1.5% each year, and increased by 9.7% for each unit of impact factor. This bibliometric analysis highlighted papers, authors, and institutions that have contributed to endodontic therapy in primary teeth. Common terms of interest in this research area was also identified, representing the first bibliometric analysis on this subject.

Mental health effects prevalence in children and adolescents during the COVID-19 pandemic: A systematic review.

BACKGROUND: The COVID-19 pandemic health crisis has changed household and school routines leaving children and adolescents without important anchors in life. This, in turn, can influence their mental health, changing their behavioral and psychological conditions. AIMS: To systematically review the literature to answer the question: "What is the worldwide prevalence of mental health effects in children and adolescents during the COVID-19 pandemic?". METHODS: Embase, Epistemonikos database, LILACS, PsycINFO, PubMed, Scopus, Web of Science, and World Health Organization Global literature on coronavirus disease were searched. Grey literature was searched on Google Scholar, Grey Literature Report, and Preprint server MedRxiv. Observational studies assessing the prevalence of mental health effects in children and adolescents during the COVID-19 pandemic were included. Four authors independently collected the information and assessed the risk of bias of the included studies. RESULTS: From a total of 11,925 identified studies, 2873 remained after the removal of the duplicated records. Nineteen studies remained after the final selection process. The proportion of emotional symptoms and behavior changes varied from 5.7% to 68.5%; anxiety 17.6% to 43.7%, depression 6.3% to 71.5%, and stress 7% to 25%. Other outcomes such as the prevalence of post-traumatic stress disorder (85.5%) and suicidal ideation (29.7% to 31.3%) were also evaluated. LINKING EVIDENCE TO ACTION: Overall findings showed that the proportion of children and adolescents presenting mental health effects during the COVID-19 pandemic showed a wide variation in different countries. However, there was a trend toward mental health issues. Therefore, policymakers, healthcare planners, youth mental health services, teachers, parents, and researchers need to be prepared to deal with this demand.

Prevalence of sequelae after traumatic dental injuries to anterior primary teeth: A systematic review and meta-analysis.

BACKGROUND/AIM: Clinical and radiographic sequelae are common following traumatic dental injuries to primary teeth. The aim of this systematic review was to assess the prevalence of such sequelae. MATERIALS AND METHODS: Searches were conducted in the PubMed, Scopus, Embase, Web of Science, and BBO/LILACS databases as well as the gray literature. The outcome of interest was the prevalence of the most common sequelae following traumatic dental injuries to anterior primary teeth. Observational studies that evaluated such sequelae were included. Data were extracted, and methodological quality was appraised using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. The number of sequelae per tooth and the total number of teeth evaluated in each study were considered to calculate pooled prevalence rates with 95% confidence intervals (CI). The quality of the evidence was determined using the GRADE approach. RESULTS: Twenty-five articles were included in this systematic review and meta-analysis. The prevalence of each complication in descending order was as follows: 39.7% crown discoloration (95% CI: 29.52-50.32), 24.3% pulp necrosis with infection (95% CI: 17.34-32.06), 16.2% periapical radiolucency (95% CI: 8.88-25.49), 15.9% premature tooth loss (95% CI: 9.93-23.15), 14.8% pulp canal obliteration (95% CI: 8.46-22.73), 11.9% pathological root resorption (95% CI: 7.68-16.98), 7.1% abscess/fistula (95% CI: 4.4-10.6), and 1.8% ankylosis (95% CI: 0.82-3.17). The certainty of the evidence was very low. CONCLUSIONS: Crown discoloration was the most common sequela in injured primary teeth, but this should be interpreted with caution due to the very low certainty of the evidence. Considerable variation was found in the prevalence of each sequela.