Effectiveness of a dental simulation game on reducing pain and anxiety during primary molars pulpotomy compared with tell-show-do technique in pediatric patients: a randomized clinical trial.

BACKGROUND: Dental simulation games are virtual educational games that help children get familiar with different dental procedures. This study aimed to evaluate the pretreatment exposure to the "Baby Panda Dental Care" game in reducing pain and anxiety in comparison with the tell-show-do (TSD) technique during primary molars pulpotomy for patients aged 6-10 years. MATERIALS AND METHODS: It was a triple-blinded, two-arm, parallel-group, randomized, active-controlled trial. It was done on 60 patients, who were randomly divided into two groups: the control group, TSD technique (n = 30), and the experimental group, "Baby Panda Dental" Care (n = 30). For the TSD technique, children were provided with a verbal explanation followed by a demonstration of the dental treatment in a non-threatening way. The "do" phase is then initiated during performing treatment. For the "Baby Panda dental care" game, children were asked to play for 5 min before treatment, selecting root canal therapy procedures. Pulse rate and RMS pictorial scale were recorded at four time points: (1) at the baseline (t0). (2) After conditioning the child (t1). (3) During treatment (t2). (4) After finishing the treatment (t3). Face, Legs, Activity, Cry, Consolability (FLACC) behavioral pain scale was recorded during treatment (t2). RESULTS: The pulse rate is higher in the control group at t1 (p = 0.012) and t2 (p = 0.015). There was a statistically significant difference in the mean RMS pictorial scale score at t1 (p < 0.001), t2 (p = 0.006), and t3 (p < 0.001), a statistically significant difference was noticed in FLACC behavioral pain assessment between the two groups (p = 0.033). CONCLUSIONS: The mobile dental game showed better results than the TSD technique, but neither technique did not reduce anxiety and pain effectively during dental treatment. TRIAL REGISTRATION: The trial was registered at the ISRCTN registry (ISRCTN30470866) on 19/04/2024.

Evaluation of the modified 3Mix-Simvastatin combination in non-instrumental endodontic therapy of necrotic primary molars: A two-arm randomized controlled trial.

OBJECTIVE: This study aimed to assess the clinical and radiographic outcomes of non-instrumentation endodontic treatment (NIET) using a modified antibiotic mix of cefixime, ciprofloxacin and metronidazole with simvastatin (an anti-inflammatory, bone regeneration drug) on necrotic primary molars compared to conventional pulpectomy to help preservation of necrotic primary teeth until its natural exfoliation. MATERIALS AND METHODS: Forty mandibular primary second molars with necrotic pulp tissue from 38 healthy patients aged between 4 and 8 years were randomly assigned to two groups with a 1:1 allocation ratio. Group A teeth underwent conventional root canal treatment. The procedure involved a two-visit approach, employing k-files and h-files during the initial visit, followed by the application of calcium hydroxide paste as canal dressing between visits, while Group B teeth were treated with 3Mixtatin. All teeth were clinically evaluated after 1, 3, 6, and 12 months, and radiographically at 3, 6, and 12 months. Two external examiners assessed the results. Data analysis was conducted using a chi-square test at a 0.05 significance level. RESULTS: At the end of the follow-up interval, 90% of teeth in each group exhibited no clinical signs or symptoms. Additionally, inter-radicular radiolucency healing occurred in 75% of cases in the NIET group and 89.5% in the conventional pulpectomy group. However, no statistically significant difference was found between the two groups. CONCLUSION: NIET using 3Mixtatin seems to be a good alternative choice to conventional pulpectomy, offering a less complex treatment approach that may help avoid the complications associated with traditional pulpectomy and could be suitable for teeth with shorter roots.

The Management of Hyperplastic Pulpitis in Immature Permanent Molar Using Vital Pulp Therapy: A Case Report with 12 Months Follow-Up.

Hyperplastic pulpitis is an irreversible type of pulpitis that primarily affects young patients. It occurs when an inflamed pulp becomes exposed due to factors such as dental caries, dental trauma, or other causes. Root canal treatment is commonly employed to manage hyperplastic pulpitis. However, vital pulp therapy can be considered as a less invasive option. The main objective of this treatment is to preserve the vitality and functionality of the remaining pulp tissue. This case report discusses the potential management of hyperplastic pulpitis in an immature molar using vital pulp therapy instead of a full root canal treatment. The report includes clinical and radiographic follow-up at six and twelve months.

Effectiveness of Apple Cider Vinegar and Mechanical Removal on Dental Plaque and Gingival Inflammation of Children With Cerebral Palsy.

Background This study was designed to evaluate the effect of apple cider vinegar (ACV) 5% and mechanical plaque removal with a manual toothbrush on dental plaque and gingivitis. The objective was to study available, natural, and inexpensive ways to improve oral health status among the studied group. Materials and methods A randomized clinical trial was performed on 50 children with cerebral palsy aged from three to six years. Participants were divided into two groups (n=25, apple cider vinegar, manual brushing without toothpaste). Plaque accumulation and gingival status were evaluated using Turesky of the Quigley-Hein plaque index (TQHPI) and modified gingival index (MGI) seven times: pre-intervention baseline (T0), post-intervention at one month (T1), two months (T2), three months (T3), four months (T4), five months (T5), six months (T6). Results Plaque accumulation and gingivitis decreased significantly for the ACV group between T0 and T6 (p<0.05) and demonstrated significantly lower plaque accumulation and gingivitis compared to the manual brushing group (p<0.05) at T5 and T6. The manual brushing group showed decreasing in TQHPI between T0 and T3, then TQHPI increased significantly (p<0.05) at T4, T5, and T6. Conclusions To sum up, this in vitro study has demonstrated the possibility of using apple cider vinegar to reduce plaque and gingivitis. In addition, without additives, apple cider vinegar has both mechanical and chemical effects on dental plaque, and it may be a natural, available, inexpensive, and harmless substance that can improve the quality of oral care for difficult groups of children and people with special needs. Unlike toothbrushes, especially electric toothbrushes, they are effective, but they may be expensive and not available to all children.

Apert Syndrome: Dental management considerations and objectives.

Background: Apert syndrome (AS) is a rare congenital disorder that correlates with many craniofacial features, like craniosynostosis, midfacial malformation, and symmetrical syndactyly of the hands and feet. Aim: This paper describes the facial and oral manifestations in a 20-year-old female previously diagnosed with AS, discusses the complex dental treatment plan and treatments, including the use of a customized toothbrush handle to enhance the patient's brushing ability. Results: A satisfactory outcome was provided, and the patients quality of life improved significantly due to this comprehensive multi-disciplinary care process. Conclusions: Comprehensive examination, extensive medical history reviewed, parental and patient consent are needed to establish a comprehensive treatment plan regarding the special needs of these patients.

Efficacy of Aloe-Vera Use for Prevention of Chemotherapy-Induced Oral Mucositis in Children with Acute Lymphoblastic Leukemia: A Randomized Controlled Clinical Trial.

Oral mucositis can be caused by chemotherapy and can affect a patient's quality of life. Nowadays, to prevent chemotherapy-induced oral mucositis (CIOM) is a crucial point in palliative care centers. This trial aimed to assess the effectiveness of aloe-vera in that concept. The trial was accomplished at Hematology Department of Hospital of Children of Damascus University, Syria. Acute lymphoblastic leukemia (ALL) children were the population from which 26 children were enrolled in the study. They were aged between 3 and 6 years old and were randomly referred according to the intervention into two groups, Aloe-vera (AV) and sodium bicarbonate 5% (13 each). Spongeous sticks were used to help in applying the material on tongue, labial and buccal mucosa, lips, floor of the mouth, and hard palate. Two blinded external examiners evaluated oral mucosa weekly for up to 2 months using the World Health Organization grading scale. Mann-Whitney U test was used to analyze data. According to the observed findings, CIOM degrees were less severe in the aloe-vera group than in the sodium bicarbonate group. Statistically significant difference of occurrence of different CIOM degrees between groups was recorded in the 2nd, 3rd, 4th, and 7th weeks of follow-up period. Moreover, Mann-Whitney U test indicated that patients in the sodium bicarbonate group began CIOM sooner than those in the aloe-vera group with a statistically significant difference (p = .001). These findings show that topical application of aloe-vera solution is effective in the prevention of CIOM in ALL children.

Does Customized Handle Toothbrush Influence Dental Plaque Removal in Children with Down Syndrome? A Randomized Controlled Trial.

The present study aimed to evaluate the effectiveness of customized handle toothbrush in dental plaque removal in children with Down syndrome in comparison to children with no special needs. A randomized clinical trial was performed on 48 children aged 6-9 years old. Participants were divided into two groups (n = 24, children with no special needs or with Down syndrome). Each group was divided into two subgroups (customized and conventional toothbrush). Plaque accumulation was evaluated using Turesky modification of the Quigley-Hein plaque index (TMQHPI) at four times (pre-brushing (T0), post-brushing at baseline (T1), 1 week (T2) and 3 weeks (T3)), and the modified gingival index (MGI) was used to evaluate the gingivitis at three times (T0, T2 and T3). Data were statistically analyzed. Plaque accumulation and gingivitis decreased significantly for all groups between T0 and T3 (p < 0.05). Both customized groups demonstrated significant lower plaque accumulation compared to conventional groups (p < 0.05) at T1, T2 and T3 and significant lower gingivitis at T3. Customizing the toothbrush handle improved child's ability for plaque control, especially in children with Down syndrome.

Knowledge and awareness level of syrian dentists towards novel coronavirus pandemic: cross-sectional study / Nivel de conocimiento y actitud de los dentistas sirios sobre la nueva pandemia de coronavirus: estudio transversal

Objetive: An outbreak of a novel and alarmingly coronavirus disease (COVID-19) was announced in China in December 2019, which later affected about 180 countries worldwide. Thus, this study aims to assess the awareness and attitude of dentists towards COVID-19 in Syria. Materials and Methods: The questionnaire was an online survey; it contained 19 questions formulated based on the information given by WHO and CDC for COVID-19. Study participants were dentists practicing in Syria. The questionnaire was translated into Arabic and published on the internet into multiple platforms. Results:7233 dentists responded to the questionnaire; 64% of the participants were females. The majority of the respondents were general practitioner (78%), nearly half of the respondents had been practicing dentistry for at least 2-4 years (51%). The majority of the respondents has knowledge about COVID-19 and was aware it is contagious. Over half of the Syrian dentists received their information about COVID-19 from social media platforms (55%). Even though the majority of the dentists were aware that the incubation period could last up to 14 days, nearly half of the participants were not aware that symptomless patients can spread the virus (49%). Conclusions: Syrian dental practitioners were aware of COVID-19 definition, incubation period and prevention measures in the dental clinic. However, they had limited attitude regarding COVID-19 symptoms, mode of transmission and management.

Objetivos: En China se anunció en diciembre de 2019 un brote de una nueva y alarmantemente enfermedad por coronavirus (COVID-19), que luego afectó alrededor de 180 países en todo el mundo. Por lo tanto, este estudio tiene como objetivo evaluar el conocimiento y la actitud de los dentistas hacia COVID-19 en Siria. Material y Métodos: El cuestionario se aplicó como una encuesta en línea; contenía 19 preguntas formuladas en base a la información proporcionada por la OMS y los CDC para COVID-19. Los participantes del estudio fueron dentistas que practicaban en Siria. El cuestionario fue traducido al árabe y publicado en Internet en múltiples plataformas. Resultado: 7233 dentistas respondieron al cuestionario; El 64% de los participantes eran mujeres. La mayoría de los encuestados eran dentistas generales (78%), casi la mitad de los encuestados habían estado practicando odontología durante al menos 2-4 años (51%). La mayoría de los encuestados tiene conocimiento sobre COVID-19 y sabía que es contagioso. Más de la mitad de los dentistas sirios recibieron su información sobre COVID-19 de redes sociales (55%). Aunque la mayoría de los dentistas sabían que el período de incubación podría durar hasta 14 días, casi la mitad de los participantes no sabían que los pacientes sin síntomas pueden transmitir el virus (49%). Conclusion:Los odontólogos sirios conocían la definición de COVID-19, el período de incubación y las medidas de prevención en la clínica dental. Sin embargo, tenían una actitud limitada con respecto a los síntomas de COVID-19, el modo de transmisión y el manejo.