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1.
Dent Traumatol ; 39(2): 109-118, 2023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-36317716

RESUMEN

BACKGROUND/AIM: Participation in sports activities is a source of dental injury. Despite recommendations for the use of mouthguards, athletes underutilize them. The aim of this study was to provide estimates of dental injuries, the mechanism of injuries and the utilization of mouthguards in high school sports. MATERIALS AND METHODS: This study was a secondary analysis of an existing dataset of a convenience sample of the National High School Sports-Related Injury Surveillance Study. Data of athletic exposures, dental injuries, mouthguard usage, and mechanism of injury from the 2005/2006 to the 2019/2020 academic years were analyzed. RESULTS: During the study period, there were 459 dental injuries in 49,987,927 athletic exposures resulting in a dental injury rate of 0.9 per 100,000 athletic exposures (AE). Slightly more than half of the traumatic dental injuries were sustained during competition (n = 256; 55.8%) and the rest (n = 200; 43.6%) were sustained during practice. The rate of dental injury in competition was 3.6 times higher than the rate in practice (RR: 3.6, 95% CI: 3.0-4.4). Dental injuries comprised 0.4% of the total 108,574 injuries sustained by athletes. Among girls' sports, field hockey had the highest rate (3.5 per 100,000 AE) and among boys' sports, basketball (2.4 per 100,000 AE) had the highest rate of dental injury. The most common mechanism of injury was contact with another player (276; 60.4%) followed by contact with apparatus (146; 31.9%). In the majority of dental injuries (308; 75.1%), the athlete was not wearing a mouthguard when the dental injury was sustained. CONCLUSIONS: Dental injuries were a small proportion of all injuries sustained by high school athletes. The majority of dental injuries were sustained when the athlete was not wearing a mouthguard.


Asunto(s)
Traumatismos en Atletas , Baloncesto , Traumatismos de los Dientes , Masculino , Femenino , Humanos , Estados Unidos , Traumatismos en Atletas/epidemiología , Instituciones Académicas , Atletas , Baloncesto/lesiones , Incidencia
2.
Dent Traumatol ; 39(3): 240-247, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-36645696

RESUMEN

BACKGROUND/AIMS: Avulsion of a permanent tooth is one of the most severe traumatic dental injuries, comprising an estimated 0.5%-16% of all dental injuries. The aim of this study was to estimate the direct financial costs of tooth avulsion in children based on stage of root maturity and the occurrence of ankylosis and to report patients' characteristics and outcomes of treatment. MATERIALS AND METHODS: A retrospective review of the dental records of children ages 6-18 who sustained a permanent tooth avulsion from 2010 to 2020 was completed. Relative Value Units (RVUs) were used to calculate the estimated cost of dental trauma care over the 2-year post-injury period for five different scenarios of avulsed teeth based on the stage of root maturity, the occurrence of ankylosis and whether the tooth was replanted. RESULTS: There were 452 avulsed permanent teeth in 348 patients. Of those, 157 teeth were included in the cost analysis. Overall, the average direct dental cost of avulsion was 46.4 RVUs equal to $1619 USD based on the 2021 conversion rate ($34.89 per RVU). Direct costs ranged between 40 RVUs ($1396) and 52.8 RVUs ($1842) depending on the root maturation and ankylosis status or whether the tooth was replanted; however, ANOVA test did not show any statistically significant differences between the mean RVUs of different groups (p = .85). Patients returned 9.5 times on average over the 2-year study period for dental trauma care after avulsion. CONCLUSION: The average direct cost of tooth avulsion within the limits of this study was $1619 USD. On average, patients returned for 9.5 follow-up visits after the avulsion. The stage of root maturity, the occurrence of ankylosis and whether the tooth was replanted or not were not significantly associated with the direct cost of dental care.


Asunto(s)
Anquilosis del Diente , Avulsión de Diente , Humanos , Niño , Avulsión de Diente/terapia , Reimplante Dental , Resultado del Tratamiento , Hospitales
3.
Int J Paediatr Dent ; 32(5): 693-701, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34923688

RESUMEN

BACKGROUND: Controversy exists on the acceptability of medical immobilization (MI). AIM: To identify regulations, professional conventions, and opinions on the acceptability of MI and to identify practice patterns through a pilot study of members of the International Association of Paediatric Dentistry (IAPD) and their colleagues. DESIGN: A 22-item questionnaire was developed and electronically distributed to 1191 members of the IAPD. RESULTS: Responses were received from 182 dentists in 45 countries. The majority (74.9%) of respondents use MI, and 29.1% use an immobilization device. MI with an immobilization device was reported as professionally acceptable (58.1%) and permitted by medicolegal regulations (70.8%) in their countries of practice. Dentists rated acceptability of MI higher than they perceived parents would overall and perceived MI to be more acceptable by parents for emergency situations and for children with special healthcare needs but 19.8% of respondents found it totally unacceptable in all scenarios. Use and opinions of acceptability varied by geographical location with respondents from North America being more accepting of MI. Most dentists felt that the use of an immobilization device could lead to lasting psychological trauma (72.3%) and violation of the rights of the child (55.4%) but that it improves access to care (58.5%). CONCLUSION: The acceptability of MI remains an area of controversy for paediatric dentists internationally.


Asunto(s)
Actitud del Personal de Salud , Odontología Pediátrica , Niño , Odontólogos/psicología , Humanos , Proyectos Piloto , Encuestas y Cuestionarios
4.
Dent Traumatol ; 37(1): 114-122, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33128842

RESUMEN

BACKGROUND/AIM: It is crucial that dentists who treat traumatic dental injuries rule out concomitant brain injuries. Despite anatomic proximity, controversy exists regarding association between facial trauma and head injury. The aim of this study was to examine the association between dento-alveolar trauma (DAT) and traumatic brain injuries (TBI) using a national dataset of emergency department (ED) visits. MATERIAL AND METHODS: Nationwide Emergency Department Sample (NEDS) data, one of the Healthcare Cost and Utilization Project (HCUP) datasets, were analyzed. Encounters of patients age 0-18 years with International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes associated with DAT and TBI in the 2010-2014 NEDS were identified. Data were analyzed using descriptive statistics, chi-square test, and logistic regression models to investigate the association between DAT and TBI and factors associated with TBI in DAT-positive patients. RESULTS: During the study period, 6 281 658 ED visits were associated with traumatic injuries. DAT was recorded in 93 408 (1.5%) and TBI was recorded in 996 334 (15.9%) of these traumatic injury visits. Within the group of DAT-positive encounters, 7035 (7.5%) had codes associated with TBI. Of trauma encounters where a DAT was not involved (6 188 250 encounters), 989 299 (16%) had an associated TBI code. Patients with DAT had 0.20 odds of having TBI (95% CI, 0.19-0.20, P < .0001) compared with patients who did not have DAT when all other confounding variables were kept constant. Having multiple injuries, being involved in motor vehicle crashes, and injuries due to assault were associated with higher odds of concomitant TBI in patients who sustained DAT. CONCLUSIONS: There was an inverse association between DAT and TBI in this study population.


Asunto(s)
Lesiones Traumáticas del Encéfalo , Lesiones Encefálicas , Traumatismos Craneocerebrales , Adolescente , Lesiones Traumáticas del Encéfalo/epidemiología , Niño , Preescolar , Bases de Datos Factuales , Servicio de Urgencia en Hospital , Humanos , Lactante , Recién Nacido , Estados Unidos/epidemiología
5.
J Clin Pediatr Dent ; 45(2): 67-73, 2021 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-33951173

RESUMEN

OBJECTIVES: This pilot study compared hemostatic pack (HP) application with no intervention following extraction of maxillary primary incisors in healthy children for effect on bleeding time and influence of patient or tooth variables utilizing a novel scale for assessment of bleeding following extraction. STUDY DESIGN: A novel scale was created to assess bleeding after extraction. This scale was utilized in a randomized, split mouth study of healthy children ages 2-7 years old requiring extraction of at least 2 primary maxillary incisors under general anesthesia. One extraction site was randomly assigned to receive HP and the other had no hemostatic measures. Post-operative bleeding was rated at 2, 10, and 15 minutes post-extraction. Other variables recorded included age, sex, periapical radiolucency, presence of fistula, swelling, discoloration, intraoral stabilization device used, and vital signs at two time intervals. Pre-operative radiographs were reviewed for root resorption and periapical radiolucency. RESULTS AND CONCLUSIONS: Twenty-five patients provided 50 teeth. Hemostatic pack had a significant effect on reducing bleeding at each time point and that effect did not change over time. Age, sex, tooth pain, post-extraction heart rate, blood pressure, discoloration, amount of resorption, and presence of a periapical radiolucency had no significant effect on bleeding. The proposed bleeding scale had good intra-rater reliability and could be useful in future studies, once validated.


Asunto(s)
Hemostáticos , Resorción Radicular , Niño , Preescolar , Hemostáticos/uso terapéutico , Humanos , Incisivo , Proyectos Piloto , Reproducibilidad de los Resultados , Extracción Dental
6.
J Clin Pediatr Dent ; 44(5): 323-331, 2020 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-33181841

RESUMEN

OBJECTIVE: To analyze gender differences in personal and professional demographics, job perceptions and work satisfaction between male and female pediatric dentistry academic leaders in the United States and Canada. STUDY DESIGN: A 40-question survey was sent electronically to department chairs requesting information about demographics, current circumstances of the position, professional history, and opinions about the position. Data was analyzed by the sex of the respondent. RESULTS: Eighty-eight surveys were distributed electronically and 55 chairs responded (response rate: 62.5%). Women comprised 29.5% of the sample, were younger and had less leadership training than men. Men had served longer in the position (t(41)=2.02, p=0.05) and had higher ranking academic titles. Women spent more time managing personnel (p=0.026), creating courses and programs (p=0.029), and teaching (p=0.006) than men. Female chairs perceived to have a difficult relationship with the faculty (p=0.027), felt they received less faculty support (p=0.002), and were significantly more dissatisfied in the job (p=0.037). Men were more stressed about a heavy workload than women (p=0.001). CONCLUSION: Gender was significantly related to the demographics, experience, perceptions of the skills and abilities required for job performance, time management and job satisfaction for pediatric dentistry department chairs in American and Canadian institutions.


Asunto(s)
Centros Médicos Académicos , Odontología Pediátrica , Canadá , Niño , Femenino , Humanos , Liderazgo , Masculino , Factores Sexuales , Estados Unidos
7.
Am J Dent ; 32(3): 152-156, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31295398

RESUMEN

PURPOSE: To investigate the effect of silver diamine fluoride (SDF) and fluoride varnish (FV) on human gingival fibroblasts (HGF) and bacteria. METHODS: HGF cell viability was assessed after exposure to various dilutions of SDF or FV. Hydroxyapatite (HA) discs treated with SDF, FV, or saline were rinsed in artificial saliva for 84 days. HGF were exposed to treated discs and viability assessed fluorescently. Oral bacteria were exposed to treated discs and survival quantified. RESULTS: At 0.01%, SDF was almost 100% cytotoxic to HGF. SDF and FV treated HA discs, induced near-complete cell death after 24 hours of contact. After rinsing FV discs for 21 days, cell survival exceeded 95%. SDF treated discs were toxic to HGF and bacteria after 9 weeks of rinsing. CLINICAL SIGNIFICANCE: SDF and FV can induce cell death. FV lost its cytotoxicity within 3 weeks, while SDF remained cytotoxic even after 9 weeks of rinsing. This research confirms that SDF has long lasting antimicrobial effects at very low concentrations although it does raise concerns regarding cytotoxicity. However, HGF cells are exposed to other cytotoxic substances in dentistry with little, if any, long-term effects.


Asunto(s)
Fluoruros Tópicos , Compuestos de Amonio Cuaternario , Compuestos de Plata , Fluoruros , Fluoruros Tópicos/toxicidad , Encía/citología , Encía/efectos de los fármacos , Humanos , Compuestos de Amonio Cuaternario/toxicidad , Compuestos de Plata/toxicidad
8.
Eur J Dent Educ ; 23(2): 184-189, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-30632253

RESUMEN

PURPOSE/OBJECTIVES: In addition to an established peer mentoring programme, the Louisiana State University Health Sciences Center, School of Dentistry introduced a faculty-student mentoring programme, the first-year dental student (D1)-Faculty Guide Program, in 2013. The intent of the D1-Guide Program was to provide faculty mentorship for D1 students. The purpose of this study was to evaluate the outcomes of the programme and identify areas for improvement. METHODS: Faculty members, D2 and D3 students were surveyed regarding their experiences and perceptions of the D1-Guide Program with a seven question and 12 question survey, respectively, via Survey Monkey® and data were analysed. RESULTS: The response rate for the students and faculty was 61% and 64%, respectively. The majority of faculty (92%) felt comfortable serving as a guide to the D1 students with 79% of those surveyed having served as a guide for 3 or 4 years. The majority of students (81%) felt that the D1-Guide Program provided mentoring that was not redundant to existing peer mentoring and valuable to their acclimation to dental school. CONCLUSIONS: Despite adding additional duties for faculty and students, the D1-Guide Program was considered valuable during the student's first year of dental school with encouragement to continue the programme. The programme helped establish a student-faculty rapport beyond the boundaries of the classroom.


Asunto(s)
Educación en Odontología/métodos , Docentes de Odontología/psicología , Tutoría , Evaluación de Programas y Proyectos de Salud , Facultades de Odontología , Estudiantes de Odontología/psicología , Femenino , Humanos , Louisiana , Masculino , Influencia de los Compañeros , Encuestas y Cuestionarios
9.
J Clin Pediatr Dent ; 43(6): 388-392, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31657991

RESUMEN

Background: The dentist has a responsibility to provide nutritional counseling and fluoride consumption recommendations. The purpose of this study was to measure and compare the concentrations of fluoride in a large number of alternative milk beverages and bovine milk. Study design: Thirty-three milk alternatives, including 9 diverse types and 11 different brands, were analyzed using a fluoride ion-selective electrode (ISE) and an ISE meter. Fluoride concentrations were then compared among different types and between different brands. Results: Fluoride concentration ranged from 0.01 ppm (Malk® Pure Cashew Milk) to 0.80 ppm (Almond Breeze® Original Unsweetened Almond Milk) with a mean concentration of 0.32 ppm. When compared, bovine whole milk (0.03±0.00 ppm) was found to be significantly lower in fluoride than all samples analyzed except Malk Pure Cashew Milk, Soy Milk Vanilla, Rice Milk, and Pecan Milk. Major differences also existed between the same milk alternative types of different brands. Conclusion: The amount of fluoride varies among different types of milk alternatives and different brands. To ensure that the dental team can provide proper recommendations regarding fluoride use, manufacturers should consider placing fluoride concentrations on nutrition labels.


Asunto(s)
Fluoruros , Fluorosis Dental , Animales , Bebidas , Bovinos , Leche
10.
J Clin Pediatr Dent ; 43(4): 263-268, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31094635

RESUMEN

Background: The objective of this study was to determine the effect of an adhesive layer and its photopolymerization on the microleakage of sealants. Study design: 0.5mm-deep standardized fissurectomies were performed on extracted molars (n = 72). Teeth were randomly assigned to 3 different sealant materials (n = 24/group). Teeth were further divided to receive sealants with or without an adhesive layer. Each sealant with adhesive was also divided into two groups: adhesive was light-cured separately or light cured together with the sealant. Following thermocycling, microleakage was assessed using dye penetration and image analysis. Data was analyzed using ANOVA and Tukey's studentized ranged HSD tests. Results: Microleakage was not affected by type of sealant material (p>0.05) but was significantly influenced by application (p<0.05). Overall, placement of sealants without adhesive displayed greater microleakage than sealants with uncured adhesive (p<0.05). Within individual sealant types, this difference was only significant for Ultraseal XT (p<0.05). Sealants bonded with and without prior light curing did not show a significant difference in levels of leakage (Tukey's Studentized Range Test, p>0.05). Conclusion: An adhesive layer should be placed beneath sealants, but whether it should be light cured or left uncured before sealant placement varies by the sealant type.


Asunto(s)
Filtración Dental , Selladores de Fosas y Fisuras , Cementos Dentales , Humanos , Ensayo de Materiales , Diente Molar
11.
Caries Res ; 52(1-2): 51-57, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29241218

RESUMEN

To evaluate the cariogenic properties of almond milk beverages, 6 almond milks, along with soy and whole bovine milk, were analyzed for their abilities to support Streptococcus mutans biofilm formation and acid production, and their capacity to buffer changes in pH. Biofilm formation by S. mutans was analyzed using an in vitro 96-well plate model and measured by crystal violet staining. Acid production by S. mutans was evaluated by a colorimetric L-lactate assay and pH measurement of bacterial cultures. Buffering capacity was assessed by a pH titration assay. Soy milk supported the most biofilm growth, while the least was observed with unsweetened almond milk (both p < 0.001). Among almond milks, sucrose-sweetened milk led to the highest level of biofilm formation (p < 0.001), while the least was observed with unsweetened milk (p < 0.05). Sucrose-sweetened almond milk yielded the lowest pH (4.56 ± 0.66), followed by soy milk and bovine milk; the highest pH was with unsweetened almond milk (6.48 ± 0.5). When analyzed by pH titration, the unsweetened almond milk displayed the weakest buffering capacity while bovine milk showed the highest (p < 0.001). These results suggest that the almond milk beverages, except those that are sweetened with sucrose, possess limited cariogenic properties, while soy milk exhibits the most cariogenic potential. As milk alternatives become increasingly popular, dentists must counsel their patients that almond milks, especially sucrose-sweetened varieties, have cariogenic potential. For patients who are lactose-intolerant or suffer from milk allergy, almond milks may be a better alternative than soy-based products.


Asunto(s)
Biopelículas/crecimiento & desarrollo , Cariogénicos/efectos adversos , Sustitutos de la Leche , Prunus dulcis/efectos adversos , Streptococcus mutans/crecimiento & desarrollo , Animales , Leche/efectos adversos , Leche de Soja
12.
Gen Dent ; 66(6): 39-45, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30444705

RESUMEN

Pediatric dentistry has evolved. Seasoned pediatric dentists believe that patients, parents, and behavior techniques have changed over their practice lifetimes. The purpose of this article is to provide dentists with a framework in which to adapt to the changes in society. Understanding cultural diversity, current societal values, technology and media influences, and contemporary parenting philosophies is essential to fostering communication with patients and their families. Building and honing behavior guidance skills are part of the process by which dentists help turn child patients into fearless adult patients with excellent oral health. This article reviews basic techniques and offers practical examples of implementing these in daily practice. The discussion also addresses changing parental and societal acceptance of various techniques and dentists' responsibility for informed consent regarding the risks and benefits of advanced behavior guidance techniques. Treating a patient from childhood to adulthood is the ultimate opportunity for the dentist to play a vital role in advancing the health and wellness of another human being.


Asunto(s)
Atención Dental para Niños , Conductas Relacionadas con la Salud , Higiene Bucal , Niño , Atención Dental para Niños/métodos , Atención Dental para Niños/psicología , Relaciones Dentista-Paciente , Humanos , Enfermedades Estomatognáticas/diagnóstico , Enfermedades Estomatognáticas/prevención & control
13.
J Clin Pediatr Dent ; 42(3): 208-211, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29698132

RESUMEN

OBJECTIVE: The purpose of this study was to determine if changes in dental development are associated with Attention Deficit Hyperactivity Disorder (ADHD) or ADHD medications. STUDY DESIGN: This retrospective chart review evaluated the dental age of 128 patients between 6 and 16 years of age using the Demirjian method from the following two groups a) children with ADHD b) unaffected children. The ADHD group was further stratified into four groups according to the medication type. The impact of ADHD on dental age difference (the difference between dental age and chronologic age) was analyzed using T-test and the association between medication type and dental age difference was analyzed through one way ANOVA. RESULTS: The mean difference between estimated dental age and chronologic age (dental age difference) for all subjects was 0.80 years. There was no significant dental age difference in subjects with ADHD and the control group (0.78±1.28vs. 0.84 ±1.09 years respectively; P=0.75) and there was no significant difference in dental age difference and type of medication (P=0.84). CONCLUSION: No significant difference was found between children with ADHD and unaffected children with respect to dental age difference. No significant differences were found in dental age difference in the four medication groups.


Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/fisiopatología , Diente/crecimiento & desarrollo , Adolescente , Determinación de la Edad por los Dientes , Niño , Femenino , Humanos , Masculino , Estudios Retrospectivos
14.
Dent Traumatol ; 33(2): 143-148, 2017 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-27943537

RESUMEN

The traditional dental curriculum presents limited opportunities for students to evaluate and treat patients with acute dental trauma. In an effort to increase student experiences, faculty at a dental school initiated and taught an interdisciplinary trauma course from 2014 to 2016. This course was elective, offered in the final year of dental school, and combined student-led and faculty-led case-based discussions of management of traumatic dental injuries with hospital trauma call shadowing. Modifications of the course were made based on student feedback. Preliminary data from student surveys showed a favorable opinion of the course. Attendees were exposed to a higher number of acute traumatic injuries and they expressed greater confidence in their diagnosis and management abilities than their peers.


Asunto(s)
Educación en Odontología , Odontología General/educación , Traumatismos de los Dientes/terapia , Competencia Clínica , Curriculum , Retroalimentación , Humanos , Estados Unidos
15.
Anesth Prog ; 61(1): 11-7, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24697820

RESUMEN

The purpose of this study was to document current practices of dentist anesthesiologists who are members of the American Society of Dentist Anesthesiologists regarding the supplemental use of local anesthesia for children undergoing dental rehabilitation under general anesthesia. A survey was administered via e-mail to the membership of the American Society of Dentist Anesthesiologists to document the use of local anesthetic during dental rehabilitations under general anesthesia and the rationale for its use. Seventy-seven (42.1%) of the 183 members responded to this survey. The majority of dentist anesthesiologists prefer use of local anesthetic during general anesthesia for dental rehabilitation almost always or sometimes (90%, 63/70) and 40% (28/70) prefer its use with rare exception. For dentist anesthesiologists who prefer the administration of local anesthesia almost always, they listed the following factors as very important: "stabilization of vital signs/decreased depth of general anesthesia" (92.9%, 26/28) and "improved patient recovery" (82.1%, 23/28). There was a significant association between the type of practice and who determines whether or not local anesthesia is administered during cases. The majority of respondents favor the use of local anesthesia during dental rehabilitation under general anesthesia.


Asunto(s)
Anestesia Dental , Anestesia General , Anestesia Local , Pautas de la Práctica en Odontología , Adulto , Anciano , Periodo de Recuperación de la Anestesia , Actitud del Personal de Salud , Niño , Atención Dental para Niños , Consultorios Odontológicos , Servicio Odontológico Hospitalario , Odontólogos/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Hemorragia Bucal/prevención & control , Grupo de Atención al Paciente , Práctica Profesional , Centros Quirúrgicos , Universidades , Signos Vitales
16.
J Dent ; 146: 105069, 2024 07.
Artículo en Inglés | MEDLINE | ID: mdl-38762077

RESUMEN

OBJECTIVES: This study aimed to systematically review the effect of sugar substitute consumption on caries prevention in permanent teeth among children and adolescents. DATA: Randomized controlled trials (RCTs) and controlled clinical trials (CCTs) comparing the clinical effect of sugar substitutes (both high- and low-intensity sweeteners) in preventing caries in permanent teeth among children and adolescents aged 6-19 were included. SOURCES: A systematic search was conducted in three databases (PubMed, Web of Science and Embase) without any restrictions on publication year. STUDY SELECTION: The initial search found 1,859 items, and finally, 15 studies (11 RCTs and 4 CCTs) with a total of 6325 participants (age: 6-18 years) were included. The Cochrane risk-of-bias assessment tools were used for quality assessment. Most (80%, 12/15) were graded as having a 'moderate' or 'high' risk of bias. All trials investigated sugar alcohol, which is a low-intensity sweetener. Xylitol was the most commonly investigated (73.3%, 11/15), followed by sorbitol (46.7%, 7/15), and erythritol (13.3%, 2/15). Results of the meta-analysis showed that both xylitol (standardized mean difference [SMD]: -0.50, 95% confidence interval [CI] -0.85 to -0.16, P = 0.005) and sorbitol (SMD: -0.10, 95% CI: -0.19 to -0.01, P = 0.03) had a significant effect in preventing dental caries compared to no treatment/placebo. No clinical trials on high-intensity sweeteners such as aspartame and saccharin were found. CONCLUSION: The consumption of xylitol or sorbitol is potentially effective in preventing caries in permanent teeth among children and adolescents. No clinical evidence is available regarding the role of high-intensity sweeteners in caries prevention. CLINICAL SIGNIFICANCE: The use of xylitol or sorbitol as sugar substitutes has a beneficial effect in preventing dental caries among children and adolescents.


Asunto(s)
Caries Dental , Dentición Permanente , Sorbitol , Edulcorantes , Xilitol , Humanos , Caries Dental/prevención & control , Adolescente , Niño , Xilitol/uso terapéutico , Sorbitol/uso terapéutico , Edulcorantes/uso terapéutico , Eritritol/uso terapéutico , Ensayos Clínicos Controlados Aleatorios como Asunto
17.
Am J Orthod Dentofacial Orthop ; 143(4 Suppl): S78-84, 2013 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-23540640

RESUMEN

INTRODUCTION: White spot lesions are often seen on the teeth after orthodontic treatment, resulting in unpleasant esthetics. The aim of this in-vitro study was to compare subjectively and objectively the esthetic outcomes of white spot lesions treated with 3 commercially available products that have been reported to have a positive effect on the remineralization of enamel. METHODS: Forty extracted premolars were randomly allocated into 1 of 4 groups (n = 10). The teeth were exposed to a demineralization solution at 37°C for 14 days to produce white spot lesions that were about 100 µm deep. Each group was then randomly assigned to receive either control treatment with artificial saliva or treatment with 1 of the 3 commercially available products: Restore toothpaste (Dr. Collins Inc, Orange County, Calif), which contains NovaMin (Dr. Collins Inc); Prevident 5000 (Colgate, New York, NY); and MI Paste Plus (GC America, Alsip, Ill). All groups were evaluated 5 times at 6 time points during the study. RESULTS: The subjective and objective results were mixed within groups and between groups for the products tested. CONCLUSIONS: We found no conclusive evidence that any of these 3 materials produced more favorable esthetic white spot lesion remineralization results.


Asunto(s)
Caries Dental/tratamiento farmacológico , Remineralización Dental/métodos , Pastas de Dientes/uso terapéutico , Análisis de Varianza , Color , Colorimetría , Caries Dental/etiología , Esmalte Dental/patología , Humanos , Variaciones Dependientes del Observador , Soportes Ortodóncicos/efectos adversos , Estadísticas no Paramétricas
18.
Gen Dent ; 61(2): 57-60; quiz 61, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23454324

RESUMEN

The median maxillary labial frenum (MMLF) is a normal anatomic structure with inherent morphologic variations. This study sought to evaluate the prevalence of those variations in a diverse ethnic population and to educate practitioners about the prevalence of MMLF variations to prevent unnecessary biopsies. This study included adult, adolescent, and child patients at the Louisiana State University Health Science Center School of Dentistry. Among the 284 subjects examined, frenum normale was the most common frenum classification, followed by frenum with nodule and frenum with appendix. Most nodules were found in the intermediate third of the MMLF, while appendices were mainly found in the labial third. The prevalence of an appendix was significantly higher (P < 0.001) in Caucasians compared to African-Americans. The prevalence of nodules was marginally higher (P = 0.096) in Caucasians than in African-Americans. No other statistically significant differences were found with regard to ethnicity. Additionally, nodules and appendices on the MMLF were identified in all age groups, and may become more common with increasing age. The authors determined that variations of the MMLF are inherent and do not represent a pathologic condition, nor do they require biopsy for diagnostic purposes.


Asunto(s)
Frenillo Labial/anatomía & histología , Adolescente , Adulto , Factores de Edad , Análisis de Varianza , Anatomía Comparada , Niño , Femenino , Humanos , Masculino , Grupos Raciales , Factores Sexuales
19.
J Am Dent Assoc ; 154(9): 805-813.e1, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37480926

RESUMEN

BACKGROUND: Children with traumatic dental injuries (TDIs) may simultaneously sustain a traumatic brain injury (TBI). The aim of this study was to investigate the risk of concomitant TBI in children with TDIs. METHODS: Children (≤ 18 years) who sought treatment at the emergency department of a major children's hospital for TDIs from 2010 through 2019 were identified. Children with a concomitant TBI were assigned as case patients (TDI and TBI). Two control patients (TDI only) were randomly age- and sex-matched with each case patient. Associations between variables of TDI and concomitant TBI were tested using 6 logistic regression models. RESULTS: Of 2,126 children with TDIs, 119 had concomitant TBIs (case patients). The control group consisted of 238 children with TDIs only who were age- and sex-matched with case patients. Mean (SD) age of children was 8.9 (4.8) years. Twenty-seven percent of case patients were female vs 32% of control patients. There was a statistically significant direct association between total number of injured teeth and concomitant TBIs (P = .01; odds ratio, 2.42; 95% CI, 1.22 to 4.79). For every tooth injured, the odds of concomitant TBI increased by 45% (P < .001; odds ratio, 1.45; 95% CI, 1.18 to 1.79). Number of displaced teeth, presence of avulsion or intrusion, number of fractured teeth, presence of complicated tooth fracture, and presence of alveolar fracture were not significantly associated with the odds of concomitant TBI. CONCLUSIONS: The total number of injured teeth was positively associated with higher odds of concomitant TBI in this setting. PRACTICAL IMPLICATIONS: In an emergency department setting, children with various types of TDIs sustained concomitant TBIs. For every tooth injured, the odds of concomitant TBI increased by 45%. Clinicians must systematically evaluate children with any TDI to rule out the possibility of concomitant TBI.


Asunto(s)
Lesiones Traumáticas del Encéfalo , Humanos , Niño , Femenino , Masculino , Estudios de Casos y Controles , Lesiones Traumáticas del Encéfalo/complicaciones , Lesiones Traumáticas del Encéfalo/epidemiología , Servicio de Urgencia en Hospital , Atención Odontológica , Modelos Logísticos
20.
J Dent Child (Chic) ; 90(3): 118-129, 2023 Nov 15.
Artículo en Inglés | MEDLINE | ID: mdl-38123934

RESUMEN

Purpose: To evaluate the knowledge, practices and attitudes of Ohio school nurses regarding school absenteeism (SA) for dental treatment. Methods: A 40-item questionnaire was generated and distributed to 246 attendees at an annual conference for Ohio school nurses in December 2019. Results: The response rate was 65.9 percent (n=162 out of 246 attendees) and 136 surveys were eligible for inclusion. The sample was female (100 percent), worked at public schools (86.0 percent, n=117) and trained as registered nurses (83.8 percent, n=114). Nurses reported no change in concerns over children missing school for dental appointments in the last five years (69.9 percent, n=95) and most agreed that SA for dental visits "almost never" negatively impacted the educational needs of children. The medical history of the patient was the most common factor when determining the duration of a school excuse (81.6 percent, n=111) and the potential for pain was the most common dental consideration (93.4 percent, n=127). Nurses reported that they "sometimes" had problems with a child after a dental visit (44.9 percent, n=61) and pain was the most reported problem (83.8 percent, n=114). Conclusion: Nurses did not feel that SA for dental treatment negatively impacted the educational needs of children.


Asunto(s)
Atención Odontológica , Instituciones Académicas , Niño , Humanos , Femenino , Ohio , Encuestas y Cuestionarios , Dolor
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