Pain during primary molar local anaesthesia with SleeperOne5 computerized device versus conventional syringe: A randomized, split-mouth, crossover, controlled trial.

BACKGROUND: Because of controversial results from clinical studies comparing different dental local anesthesia methods in children, the primary objective of this randomized, split-mouth, crossover, controlled trial was to compare pain intensity during local anaesthesia (LA) performed with a computer-controlled LA delivery system (C-CLADS) versus a conventional syringe (CONV). Secondary objectives included comparisons during dental treatment. METHODS: Participants (4-8 years) with tooth pair requiring similar treatment were recruited from five French hospitals. The right primary molar, which was treated at the first visit, was randomly allocated to one of the anaesthesia groups (either intraosseous with C-CLADS or infiltration with CONV), whereas the contralateral molar (treated at the second visit) was assigned to the other group. Pain intensity and behaviour outcomes, assessed with the Faces Pain and Venham revised scales, respectively, were compared between groups using Proc mixed. Stratified analyses were performed on dentition and location. RESULTS: Among 107 participants, the analysis revealed reduced pain perception during LA in the C-CLADS group compared with the CONV group (-0.72, 95% CI: -1.43, -0.006), but not during dental treatment. Stratified analyses showed that this effect was observed only in primary dentition (p = .006) and mandibular molars (p = .005). Behavioural issues were fewer in the C-CLADS group than in the CONV group (p = .05) only during injection. CONCLUSION: C-CLADS emerged as the preferable system in primary dentition.

[Knowledge, attitudes and practices in oral health of breastfeeding women]. / Connaissances, attitudes et pratiques en santé orale des femmes allaitantes.

The benefits of breastfeeding on the health of infants and mothers are no longer in doubt. On the other hand, the advantages in terms of maxillofacial development and the risks of prolonged breastfeeding on oral health are much less discussed. An exploratory qualitative study, carried out within the pediatric dentistry functional unit of the dental care service of the Lille University Hospital Center in 2022, aimed to analyze the knowledge, attitudes and practices in oral health of breastfeeding women. This article will discuss the gaps in prevention as well as the obstacles and levers to improving care.

[Therapeutic education and oral health, an opportunity for the child]. / Éducation thérapeutique et santé orale, une opportunité pour l'enfant.

Early childhood caries is an infectious disease of bacterial origin. It is mainly associated with social inequalities in oral health and affects children from the least privileged backgrounds. Because of its recurrent nature, it is the most common chronic disease in preschool children. Since it shares common risk factors with a number of other chronic conditions (diabetes, obesity), promoting global oral health is essential to achieving a favorable general health status.

[Therapeutic education in pediatric dentistry: analysis of obstacles and levers to the development of programmes in France in 2016]. / Éducation thérapeutique en odontologie pédiatrique : analyse des obstacles et leviers au développement de programmes en France en 2016.

OBJECTIVE: Over recent years, therapeutic patient education has become part of dental medicine. Management of early childhood caries, known to be a very common chronic disease, has evolved to include an educational dimension. The objective of this study was to identify the levers and barriers to the development of formalized therapeutic education programmes and alternatives. METHODS: A comprehensive exploratory qualitative study was conducted between November 2015 and June 2016 on a targeted sample of 15 people aware of the problem of TPE in dentistry. RESULTS: The study showed that TPE training in dentistry is underdeveloped, despite its numerous benefits: change of the healthcare professional's approach, implementation of structured educational programmes, development of research, etc. There are many obstacles to the development of TPE programmes: insufficient resources, rigid legislation or lack of knowledge of TPE practices. The dental profession is an obstacle itself because of its lack of understanding and variable degrees of integration the medical community. There are multiple levers, but the main ones are changing attitudes of the profession and the provision of resources to develop TPE. Although alternatives to TPE programmes exist (accompanying measures, short educational strategies, connected health), they cannot replace TPE. CONCLUSION: More educational strategies must be developed in the field of dentistry. However, the framework of TPE must be adapted to the profession to ensure good uptake.

[A therapeutic education tool in paediatric dentistry]. / Un outil d'éducation thérapeutique en odontologie pédiatrique.

Therapeutic education for children is developing in the treatment of dental caries. The Elmy pathway, a pedagogical game aiming to improve children's oral health skills, has been designed. The qualitative assessment of this tool seems to confirm its benefit for use in therapeutic education sessions.

[Amelogenesis imperfecta and anterior open bite: how to optimize patient management? A review of the literature]. / Amélogenèse imparfaite héréditaire et béance antérieure : comment optimiser la prise en charge ? Une revue de la littérature.

INTRODUCTION: Amelogenesis imperfecta is a genetic disease, characterized by a structural defect of the enamel and has variable clinical expressions. It can be isolated or associated as part of a syndrome. Three clinical forms exist: hypoplastic, hypomature and hypomineralized. DISCUSSION: Enamel fragility involves dentin exposure and dental hypersensitivity as frequent consequences. Some severe forms are mainly associated with an anterior open bite. The care of these patients constitutes a real challenge for the dentist. Materials et Methods: A literature review was carried out using the PubMed, Web of Science and Scopus interfaces over the past ten years in order to highlight the different treatment options available. CONCLUSION: From conservative to surgical treatment, it is necessary to develop a collaboration between the orthodontist and the pediatric dentist in order to offer multidisciplinary care adapted to the patient's needs.

Efficacy of perioperative immunonutrition in visceral surgery: an umbrella review protocol.

INTRODUCTION: Immunonutrition (IN) is generally used before major visceral surgery with the intent to reduce postoperative complications, especially infectious ones. However, the conclusions of published meta-analyses are conflicting. The purpose of this review is to synthesise the data of published systematic reviews on the effectiveness of IN. METHODS AND ANALYSIS: This protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocols guidelines. This is an umbrella review of systematic reviews comparing IN (delivered orally 5-7 days preoperatively) with normal diet or isocaloric isonitrogenous feeding before visceral surgery performed on any of several viscera (colorectum, stomach, pancreas, liver, oesophagus). We search the systematic reviews included in the main bibliographic databases. To assess the efficacy of IN, several outcomes will be considered: the main outcome is infectious complications (surgical site infections, pulmonary infections or urinary infections) and secondary outcomes are overall morbidity, hospital length of stay and mortality. Identified reviews will be screened by two independent assessors. The methodological quality of relevant included reviews will be assessed using A MeaSurement Tool to Assess systematic Reviews (AMSTAR) instrument. The data extracted from included reviews will be synthesised using the r-Metafor package considering separate groups according to the viscus of interest. Publication bias will be evaluated, and subgroup analyses will be performed according to the quality of studies and preoperative nutritional status. ETHICS AND DISSEMINATION: An umbrella review based on published data from systematic reviews needs no ethical approval. Furthermore, no patient will be involved in the review. Once terminated, the review will be submitted for publication in an open access journal to ensure wide dissemination of the findings. PROSPERO REGISTRATION NUMBER: CRD42021255177.

Which determinants should be considered to reduce social inequalities in paediatric dental care access? A cross-sectional study in France.

Better access to dental care through systemic and educational strategies is needed to lessen the burden of disease due to severe early caries. Our study aims to describe family characteristics associated with severe early caries: parental knowledge, attitudes, practices in oral health and socio-demographic factors. For this cross-sectional study, 102 parents of children aged under 6 years with severe early caries and attending paediatric dentistry service in France completed a questionnaire during face-to-face interviews. Caries were diagnosed clinically by calibrated investigators, using the American Academy of Paediatric Dentistry criteria, and dental status was recorded using the decayed, missing, and filled teeth index. The majority of children were from underprivileged backgrounds and had poor oral health status, with a median dmft index of 10. Parents highlighted the difficulty of finding suitable dental care in private practices. Parents appeared to have good oral health knowledge and engaged in adapted behaviours but showed a low sense of self-efficacy. They perceived the severity of early caries as important but the susceptibility of their child as moderate. The study affirmed the importance of improving the accessibility of paediatric dental care and developing educational strategies to enhance the knowledge, skills, and oral health practices of families.

The use of FDI criteria in clinical trials on direct dental restorations: A scoping review.

OBJECTIVES: A scoping review was conducted to explore the use of FDI criteria 10 years after their introduction. The first aim was to compare the amount of studies using the FDI and/or the modified USPHS criteria. The second aim was to analyse the use of the FDI criteria in clinical trials evaluating direct dental restorations. DATA: Listing of studies using FDI and/or USPHS criteria per year since 2007. Clinical studies related to the assessment of direct restorations using FDI criteria. SOURCE: Two systematic searches - regarding the use of FDI and modified USPHS criteria - were carried out on Medline/Pubmed in order to identify the studies published between 2007 and 2017. Authors of the included articles were contacted to clarify their choice of FDI criteria in their studies. ClinicalTrials.gov database was also queried for the on-going studies that use FDI and modified USPHS criteria. STUDY SELECTION: In the first review, all the clinical trials (randomized/non-randomized, controlled, prospective/retrospective studies) that used FDI criteria to evaluate direct restorations on primary or permanent teeth were included. CONCLUSIONS: 16.3% of the studies used FDI criteria. The percentage of studies using them increased from 4.5% in 2010 to 50.0% in 2016. In average, 8.5 FDI criteria were used. The most employed criteria were: marginal adaptation (96.7%), staining (90.0%), fracture of material and retention (90.0%), recurrence of caries/erosion/abfraction (90.0%), post-operative sensitivity/tooth vitality (86.7%) and surface luster (60.0%). In addition, among the 27 on-going studies from ClinicalTrials.gov database, 51.9% use FDI criteria (including 87.5% with an open recruitment status). CLINICAL SIGNIFICANCE: FDI criteria were reported as practical (various and freely selectable), relevant (sensitive as well as appropriate to current restorative materials and clinical studies design), standardized (making comparisons between investigations easier). Investigators should go on using them for a better standardization of their clinical judgment, allowing comparisons with other studies.