OXIS contacts of primary molars: do they change over time?

PURPOSE: Although a series of studies on OXIS contacts have been performed, studies regarding changes in OXIS contacts over time are lacking. Therefore, this study aimed to evaluate the change in contact type between primary molars after 3 years in children aged 3-7 years. METHODS: This longitudinal study was conducted using 2922 sectional die models of 926 children. At baseline (T0), the contact type between the primary molars was scored using replication via the sectional die model method according to the OXIS criteria. After 3 years, the sectional die models of the same children were scored using the same criteria (T1). RESULTS: McNemar's tests revealed a significant change in contacts from baseline to 3 years. The post hoc test explained specific changes in the contacts that were observed to be significant. These were O to X (p < 0.001), O to I (p < 0.001), O to S (p = 0.035), and I to X (p < 0.001). CONCLUSIONS: A significant change in OXIS contact over time was observed. The O-type contact underwent the maximum change. The least and most stable contacts are the "O" and "I" types, respectively. This change in contact type with age may alter the risk of caries in children.

Association of parent-reported timing of first tooth emergence and ECC: a secondary analysis of a case-control study.

PURPOSE: Tooth eruption is a dynamic process. Appearance of any part of the cusp through gingiva may be a clinical marker of eruption. Early childhood caries (ECC) is a public health problem globally. This study aimed to assess the relationship between parent-reported timing of first tooth emergence and ECC in toddlers. METHODS: This study is a secondary data analysis of 627 toddlers involved in a case-control study on sleep-time feeding practises in children. The children were categorised into four groups based on the parent-reported timing of first primary tooth emergence (G1-when the first primary tooth emerged before 6 months of age, G2-between 7 and 9 months; G3-10 to 12 months and G4-when the first primary tooth emerged after 12 months of age). Univariate binary logistic regression analysis was performed to evaluate the association between timing of first tooth emergence and ECC. RESULTS: The mean age of the children was 24.4 ± 7.3 months (cases, that is children with ECC-25.4 ± 6.9 months, controls, that is children without ECC-23.6 ± 7.5 months). Of 60 children, whose first tooth erupted before 6 months of age, 35 (12%) were cases compared to 25(8%) controls. Amongst the cases, boys had more caries than girls (p < 0.05). Of the anterior teeth, 22% of the emerged teeth were decayed in the first group, followed by 19%, 16% and 10% in the second, third and fourth groups, respectively (p < 0.05). Analysis of the posterior teeth showed a lower percentage of decayed teeth with delayed emergence of the first primary tooth (p < 0.05). Children whose teeth emerged before 6 months of age had an odds ratio of 3.5 (95% CI 1.49, 8.42) (p = 0.004). CONCLUSION: This study concluded that the early emergence of the first primary tooth, as reported by the parent, was associated with an increased risk of developing ECC.

Child Temperament and Early Childhood Caries: A Systematic Review and Meta-Analysis.

Purpose: The purpose of this study was to perform a systematic review to assess current evidence for the association between child temperament and early childhood caries (ECC). Methods: A systematic search was conducted using MEDLINE® through PubMed®, EMBASE®, Scopus®, LILACS, Web of Science™, and EBSCO up to January 2023. Studies measuring ECC and child temperament for children younger than or equal to six years of age using questionnaires, interviews, and surveys through case-control studies, cohort studies, and cross-sectional studies were included. Literature reviews were excluded. Medical subject heading (MeSH) terms like "temperament" and "dental caries" were used by two authors who independently extracted the data, and a third author resolved disagreements. Risk of bias assessment was done using the Newcastle-Ottawa assessment scale for case-control and cohort studies and the Appraisal tool for Cross-Sectional Studies (AXIS). The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations approach (GRADE approach). A chi-square test and I-square index were used to evaluate heterogeneity. Results: A total of 5,072 records were screened, resulting in 15 included studies that yielded data for 6,667 participants; sevenstudies were high, and eight were of moderate quality. Seven studies qualified for meta-analysis, which revealed that persistence did not affectthe presence or absence of ECC. However, there was a strong association between difficult temperament and ECC (odds ratio equals 2.63). Conclusion: A positive association between a child's temperament and early childhood caries exists that is supported by quantitative findings, indicating a connection with very low certainty.

Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries.

BACKGROUND: Dental caries, a common chronic disease of childhood, is associated with adverse health and economic consequences for infants and their families. Socioeconomically disadvantaged children have a higher risk of early childhood caries (ECC). This review updates one published in 2019. OBJECTIVES: To assess the effects of interventions undertaken with pregnant women, new mothers or other primary caregivers of infants in the first year of life, for preventing ECC (from birth to six years). SEARCH METHODS: We searched Cochrane Oral Health's Trials Register, Cochrane Pregnancy and Childbirth's Trials Register, CENTRAL, MEDLINE (Ovid), Embase (Ovid), CINAHL EBSCO, the US National Institutes of Health Ongoing Trials Register (clinicaltrials.gov) and WHO International Clinical Trials Registry Platform (apps.who.int/trialsearch). The latest searches were run on 3 January, 2023. SELECTION CRITERIA: Randomised controlled trials (RCTs) comparing interventions with pregnant women, or new mothers and other primary caregivers of infants in the first year of life, against standard care, placebo or another intervention, reporting on a primary outcome: caries presence in primary teeth, dmfs (decayed, missing, filled primary surfaces index), or dmft (decayed, missing, filled teeth index), in children up to six years of age. Intervention types include clinical, oral health promotion/education (hygiene education, breastfeeding and other dietary advice) and policy or service. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed study eligibility, extracted data, assessed risk of bias, and assessed certainty of evidence (GRADE). MAIN RESULTS: We included 23 RCTs (5 cluster-randomised), involving 25,953 caregivers (mainly mothers) and their children. Fifteen trials assessed oral health education/promotion interventions against standard care. Six trials assessed a clinical intervention for mother dentition, against placebo, or a different type of clinical intervention. Two trials assessed oral health/education promotion plus clinical intervention (for mother's dentition) against standard care. At most, five trials (maximum of 1326 children and 130 mothers) contributed data to any comparison. Enamel-only caries were included in the diagnosis of caries in some studies. For many trials, the risk of bias was unclear due to lack of methodological details reported. In thirteen trials, participants were socioeconomically disadvantaged. No trial indicated receiving funding that was likely to have influenced their results. Oral health education/promotion interventions Child diet and feeding practice advice versus standard care: We observed a probable 15 per cent reduced risk of caries presence in primary teeth with the intervention (RR 0.85, 95% CI 0.75 to 0.97; 3 trials; 782 participants; moderate-certainty evidence), and there may be a slightly lower mean dmfs (MD -0.29, 95% CI -0.58 to 0; 2 trials; 757 participants; low-certainty evidence); however, the evidence is very uncertain regarding the difference between groups in mean dmft (MD -0.90, 95% CI -1.85 to 0.05; 1 trial; 340 participants; very low-certainty evidence). Breastfeeding promotion and support versus standard care: We observed little or no difference between groups in the risk of caries presence in primary teeth (RR 0.96, 95% CI 0.89 to 1.03; 2 trials; 1148 participants; low-certainty evidence) and in mean dmft (MD -0.12, 95% CI -0.59 to 0.36; 2 trials; 652 participants; low-certainty evidence). dmfs was not reported. Child diet advice compared with standard care: We are very uncertain about the effect on the risk of caries presence in primary teeth (RR 1.08, 95% CI 0.34 to 3.37; 1 trial; 148 participants; very low-certainty evidence). dmfs and dmft were not reported. Oral hygiene, child diet and feeding practice advice versus standard care: The evidence is very uncertain about the effect on the risk of caries presence in primary teeth (RR 0.73, 95% CI 0.50 to 1.07; 5 trials; 1326 participants; very low-certainty evidence) and there maybe little to no difference in mean dmfs (MD -0.87, 95% CI -2.18 to 0.43; 2 trials; 657 participants; low-certainty evidence) and mean dmft (MD -0.30, 95% CI -0.96 to 0.36; 1 trial; 187 participants; low-certainty evidence). High-dose versus low-dose vitamin D supplementation during pregnancy: We are very uncertain about the effect on risk of caries presence in primary teeth (RR 0.99, 95% CI 0.70 to 1.41; 1 trial; 496 participants; very low-certainty evidence). dmfs and dmft were not reported. Clinical interventions (for mother dentition) Chlorhexidine (CHX, a commonly prescribed antiseptic agent) or iodine-NaF application and prophylaxis versus placebo: We are very uncertain regarding the difference in risk of caries presence in primary teeth between antimicrobial and placebo treatment for mother dentition (RR 0.97, 95% CI 0.80 to 1.19; 3 trials; 479 participants; very low-certainty evidence). No trial reported dmfs or dmft. Xylitol compared with CHX antimicrobial treatment: We are very uncertain about the effect on caries presence in primary teeth (RR 0.62, 95% CI 0.27 to 1.39; 1 trial, 96 participants; very low-certainty evidence), but we observed there may be a lower mean dmft with xylitol (MD -2.39; 95% CI -4.10 to -0.68; 1 trial, 113 participants; low-certainty evidence). No trial reported dmfs. Oral health education/promotion plus clinical interventions (for mother dentition) Diet and feeding practice advice for infants and young children plus basic dental care for mothers compared with standard care: We are very uncertain about the effect on risk of caries presence in primary teeth (RR 0.44, 95% CI 0.05 to 3.95; 2 trials, 324 participants; very low-certainty evidence) or on mean dmft (1 study, not estimable). No trial reported dmfs. No trials evaluated policy or health service interventions. AUTHORS' CONCLUSIONS: There is moderate-certainty evidence that providing advice on diet and feeding to pregnant women, mothers or other caregivers with children up to the age of one year probably leads to a slightly reduced risk of early childhood caries (ECC). The remaining evidence is low to very-low certainty and is insufficient for determining which, if any, other intervention types and features may be effective for preventing ECC, and in which settings. Large, high-quality RCTs of oral health education/promotion, clinical, and policy and service access interventions, are warranted to determine the effects and relative effects of different interventions and inform practice. We have identified 13 ongoing studies. Future studies should consider if and how effects are modified by intervention features and participant characteristics (including socioeconomic status).

Genetic variations in exon 10 of ENAM and their association with early childhood caries.

OBJECTIVE: Enamelin is the largest enamel matrix protein encoded by the ENAM gene. The primary purpose of this study was to identify genetic variants in ENAM exon 10 that can alter susceptibility to early childhood caries (ECC). METHODS: This case-control study included 248 children aged 3-6 years, with 124 children diagnosed with ECC in the case group and 124 children without caries in the control group. Questionnaires were used to record demographic data, socioeconomic status, hygienic practices, and feeding practices, and a 24-h diet diary was kept. Seven polymorphisms (rs7671281, rs1738668322, rs3796703, rs3796704, rs759376039, rs775159311, and rs1738678483) in ENAM exon 10 were sequenced. RESULTS: The heterozygous CT genotype of rs7671281 was significantly more common in the case group compared to the control group (odds ratio [OR], 6.1765; 95% confidence interval [CI], 2.05-18.58; P = 0.0006). Under the dominant model, the TT genotype of rs7671281 was significantly more common in the control group (OR, 6.47; 95% CI, 2.15-19.39; P < 0.001). The AG genotype of rs3796704 was significantly more common in the case group than in the control group (OR, 5.705; 95% CI, 1.60-20.25; P = 0.006). Under the dominant model, the GG genotype of rs3796704 was significantly more common in children without caries than in children with caries (OR, 6.84; 95% CI, 1.96-23.90; P < 0.001). CONCLUSIONS: The C allele of rs7671281 and the A allele of rs3796704 can increase susceptibility to ECC.

A systematic search, heuristic evaluation and analysis of dental trauma mobile applications.

BACKGROUND: Despite the exponential growth of mobile device applications in promoting awareness on traumatic dental injuries (TDIs), the overall validity of existing applications in content, engagement, usability, functionality, esthetics, and user perception remains largely uncertain. AIMS: The primary aim was to systematically search and assess the quality, functionality, perceived impact and usability of available applications related to TDIs using the User Version of the Mobile Application Rating Scale (uMARS) and the Coventry, Aberdeen, and London-Revised (CA-LO-RE) scale. A heuristic evaluation was additionally performed. The secondary aim was to categorize existing mobile applications according to their target users, including general population, dentists, dental students, medical healthcare professionals, and researchers. METHODS: A systematic search for dental trauma applications (free and paid) was conducted using the AppStore and Google Play store. Two reviewers independently performed data extraction and quality assessment for all the included applications using uMARS and CA-LO-RE. A user experience architect conducted a heuristic evaluation. RESULTS: Only 6 of the 3061 initially screened applications were eligible for qualitative and quantitative assessments. These applications' average star uMARS rating was 12.5 (standard deviation [SD] 2.6). The mean and SD for the uMARS objective items were as follows: A-engagement (mean 12.1 [SD 3.3]), B-functionality (mean 15.5 [SD 1.4]), C-esthetics (mean 9.5 [SD 2.5]), and D-information (mean 13 [SD 4.5]). The severity rating for the heuristic evaluation criteria was low to moderate for all the included applications, excluding tooth emergencies with a high severity score. CONCLUSION: Despite moderate quality, functionality, user perception, behavioural impact and usability scores, the inclusion of advanced features to "engagement" and "usability" in existing trauma based apps will enhance their purpose. A design-thinking approach coupled with interactive features is recommended for future mobile applications on TDIs.

Bleaching techniques in primary teeth: a systematic review.

OBJECTIVE: Discolouration of primary teeth, often attributed to trauma and pulpal infection, is a prevalent concern that can significantly impact the esthetics and self-esteem of children. To address this issue, bleaching techniques have emerged as a viable treatment option. This systematic review aims to provide a comprehensive summary of the effectiveness of bleaching agents in managing discoloured primary teeth. METHODS: Two reviewers independently conducted an electronic database search using PubMed, EMBASE, LILACS, CINAHL via EBSCO, Scopus, and Web of Science until September 26,2023. In vitro studies and case reports that assessed the quantifiable success were included. The present review utilized Distiller SR software for data extraction. The protocol of this study was registered in PROSPERO (International Prospective Register of Systematic Reviews) (CRD42022329831). The quality of studies was analysed with Cochrane tool and the JBI checklist. RESULTS: The search retrieved 1845 references of which 14 studies were included for qualitative analysis. There were 8 in vitro studies and 6 case reports included in this systematic review. There were 299 teeth samples in the in vitro studies and 18 teeth were assessed in the case reports. All the 18 teeth (6 case reports) showed considerable shade improvement within 7-14 days. However, only 3 teeth were followed up for a period of 12-24 months. Substantial shade improvement was also observed in samples in the in vitro studies. CONCLUSION: This systematic review has comprehensively examined the various bleaching agents and methods for the management of discoloured primary teeth. However, it is crucial to recognize that the available evidence is from case reports and is insufficient to make a clinical recommendation.

Three-dimensional evaluation of interproximal contacts of permanent dentition: a cone beam computed tomography study.

PURPOSE: To assess the various patterns of the inter-proximal contact areas of the permanent dentition using the available cone beam computed tomography (CBCT) images. METHODS: A retrospective cross-sectional study was performed on existing CBCT images from a University hospital and teaching department. Three thousand two hundred and fifty inter-proximal contacts were assessed from 125 existing CBCT scans of patients (age range: 14 years 3 months-29 years 9 months) who had matched the eligibility criteria. The types of inter-proximal contacts of the permanent dentition were scored at occlusal, middle, and cervical thirds, according to the OXIS inter-proximal contacts classification. Chi-square test was used to assess the contacts and gender/arches. RESULTS: The most prevalent contact was type I for the posterior teeth contacts, and types S1 and S2 for the anterior teeth contacts. Statistical significance was not observed between the contacts on the left and right sides (P > 0.05), while statistical significance was observed between the inter-proximal contacts of the maxilla and mandible (P < 0.05). CONCLUSION: The CBCT-based three-dimensional assessment of the inter-proximal contact areas of the permanent dentition is representative of the OXIS classification. The occlusal level contact was predominantly representative of the overall type of the contact.

Global variations in eruption chronology of permanent teeth: A systematic review and meta-analysis.

OBJECTIVES: Population-based variations have been reported in permanent teeth eruption but only sparse literature exists on the same. A systematic review and meta-analysis were performed to assess the global variations in eruption chronology of permanent teeth in children and adolescents and the role of sexes, jaws and classes of socio-economic status (SES) on timing of eruption was explored. METHODS: The protocol for the systematic review was registered in PROSPERO. An extensive search of PubMed, EMBASE, Google Scholar, EBSCO, Cochrane library, and anthropology databases was carried out until April 2023. Additionally, grey literature search and hand-searching of relevant key journals was done. RESULTS: Overall, 3797 cross-sectional and longitudinal studies were retrieved from multiple databases. A total of 939, 191 participants were included from 80 studies of which, 41 were carried out in Asia, 26 in Europe, 5 in Africa, 4 in North America, and 4 in Oceania. The mandibular first molar eruption was found to be as early as 4.09 years while the maxillary second molar erupted as late as 13.45 years. Using a random effects model, 28 forest plots were generated. Meta-regression interpreted tooth eruption to be earlier in females and in the mandible. CONCLUSIONS: The findings of this study show that the ages of permanent teeth eruption was advanced in the European population followed by Africa and Asia.

Association of exposures to environmental chemicals estimated through primary teeth biomatrix and health outcomes in children and adolescents - A systematic review.

Children's heightened susceptibility to environmental exposure arises from their underdeveloped detoxification mechanisms and augmented per-unit body-weight absorption capacity for chemical compounds. Primary teeth are an emerging biomatrix, which aid in storing crucial data on early exposure to harmful substances and developmental illnesses. This systematic review aimed to evaluate the association between environmental chemical exposure and health outcomes in children and adolescents using primary teeth as a matrix. The study protocol was registered with PROSPERO (CRD42023428013). The review spanned studies published between 1974 and 2023, identified through an extensive literature search on databases like MEDLINE, EMBASE, LILACS, CINAHL, the Cochrane Oral Health Group Specialized Register, Scopus, and Web of Science. Distiller SR software was used to assess study quality and extract the outcome data. The NTP-OHAT scale assessed evidence quality, and case-control, cross-sectional, and cohort studies in English were included. Comprehensively reviewing 5287 articles resulted in 29 studies being included in the final analysis, comprising 15 cross-sectional, seven case-control, and seven cohort studies. All 29 studies qualified for qualitative analysis. Eleven studies analyzed lead (Pb) effects on health outcomes, four analyzed manganese (Mn), and 14 investigated other element groups. Primary teeth biomatrix assessed various health outcomes: neurobehavior, childhood behaviour, ADHD, birth outcomes, fetal alcohol syndrome disease, inflammatory bowel disease, and dental caries. This study contributes to existing evidence, reinforcing a link between environmental metal exposure and health consequences. The evidence extends to prenatal and postnatal periods, substantiated by primary teeth biomatrix analysis. Lead level fluctuations can influence neuropsychological functioning, potentially causing cognitive impairments. Altered manganese levels correlate with behavioral issues, adverse effects on visuospatial development, and birth weight changes. Primary teeth biomatrices aid fetal alcohol spectrum disorders diagnosis, and correlations between organo-chemical exposure and autism were observed.

AMELX gene association to early childhood caries in south-Indian children: a case-control study.

PURPOSE: Genetic variants of AMELX gene can affect the protein content, organization of enamel prisms, microstructure and microhardness of the enamel, thus altering the caries susceptibility. The present study aims to assess the association between polymorphisms rs17878486, rs5934997, and rs5933871 of AMELX gene and Early Childhood Caries (ECC). MATERIALS AND METHODS: This case-control study was conducted on 200 participants, aged 3-6 years, with 100 controls and 100 children with ECC. A questionnaire was used to collect demographic data, birth-weight, type of delivery, oral hygiene practices, feeding history and 24-h diet diary. DNA was isolated from blood and subjected to PCR followed by Sanger sequencing. RESULTS: The CC genotype of rs17878486 showed an OR of 1.93 (0.34-10.81; P = 0.73). In a recessive model, the CC genotype of rs17878486 reported an OR of 2.04 (0.36-11.40; P = 0.68); rs5593871 reported an OR of 1.00 (0.31-3.21). Statistically significant differences (P ≤ 0.05) between genotype and allele frequencies of rs17878486, rs5934997, and rs5933871 were not observed between children with ECC and the controls. CONCLUSION: Polymorphisms of AMELX gene did not show a significant association with ECC in this population. However, documentation of genetic data in a global context of ECC may be essential for the future.

Development and validation of a questionnaire to assess commonality knowledge of traumatic dental injuries and management of emergencies.

BACKGROUND: Dental trauma represents a significant public health problem, causing a burden for both individuals and society. The aim of this study is to systematically develop and validate a questionnaire on 'traumatic dental injuries and management of emergencies' (TIME) for assessing the knowledge, attitude and practice (KAP) for a commonality. METHODS: The scale development phases included conceptual framework, systematic development of an item pool, refinement of the item pool by Focus-group discussion (n = 23), validity-testing using Content Validity Index (n = 5), translation and back-translation, Cognitive interviewing (n = 30,45), and reliability testing (n = 40). The conceptual framework was built based on six broad constructs, such as broken teeth, knocked-out (avulsion) teeth, pushed/moved-in and loosened teeth (luxation injuries), soft tissue injuries, follow-up and management, and prevention and protection. RESULTS: Reviews of existing questionnaires significantly helped to generate an initial pool of 68 items (refined to 51 items). Lawshe's content validity was 0.92. High test-retest reliability was demonstrated (kappa value = 0.98). The questionnaire showed a high level of reliability (Cronbach's alpha = 0.86) with great internal consistency. CONCLUSION: TIME is the first validated scale for recording knowledge, attitude and practices on traumatic dental injuries and management of emergencies for non-dental professionals. The 51-tem tool will allow dentists to evaluate KAP of commonality. KAP measured across the globe would have a significant impact on planning awareness programs by dentists and dental associations.

Global variations in eruption chronology of primary teeth: A systematic review and meta-analysis.

OBJECTIVES: This systematic review aimed to assess global variations in the eruption chronology of primary teeth in children and the role of sexes, jaws, and socio-economic status on eruption timing. DESIGN: An extensive search of electronic databases, grey literature, and hand-searching was carried out until April 2023 RESULTS: A total of 42,109 children, with an age range of 0-83 months were included from 42 studies (22 in Asia, 7 in Europe, 5 in Africa, 4 in North America, 3 in Oceania and 1 in South America). The mandibular central incisor was the first tooth to erupt at 6 months in North America and 13.5 months in Asia while the mandibular second molar erupted at 20.1 months in Europe and 29 months in South America. CONCLUSIONS: The age of primary teeth eruption was advanced in the European population followed by North America, Africa, Oceania, and Asia while it was delayed in the South American population. Meta-analysis showed that tooth eruption was earlier in the left quadrant than the right but the role of other factors (sexes, jaws, and socio-economic status) was insignificant. Population-specific data on primary teeth emergence may serve as a baseline for future research. In clinical practice, these population-based eruption charts can serve as a valuable asset for diagnosis and treatment planning in children.

Six Root Canals in Primary Mandibular Second Molar: Report of Two Cases.

Anatomical variations in root morphology have been frequently encountered in pediatric endodontic practice. Due to insufficient knowledge of canal anatomy in primary teeth, having unusual canal morphologies is possibly more prone to endodontic treatment failures. Advanced investigations have given the clinician an open handed chance to recognize those variations and thus effectively manage them to achieve desired results. This paper describes the mandibular primary second molar requiring pulp therapy having three separate and distant canals in the mesial and distal root. Such additional canals were labeled as the middle mesial (MM) canal in the mesial root and the middle distal (MD) canal in the distal root. Additional canals were identified on clinical examination and multiangled radiographs and verified with the help of cone-beam computed tomography (CBCT) imaging. In primary second molars such additional canals are bizarre. This paper describes the bizarre variations that were seen on second deciduous molars. How to cite this article: Bhattad MS, Muthu MS, Wani V, et al. Six Root Canals in Primary Mandibular Second Molar: Report of Two Cases. Int J Clin Pediatr Dent 2023;16(S-2):S224-S228.

Association between polymorphisms of immune response genes and early childhood caries - systematic review, gene-based, gene cluster, and meta-analysis.

BACKGROUND: Early childhood caries is a significant public health concern affecting about 600 million children globally. The etiology of early childhood caries can be explained as an interplay between genetic and environmental factors. Single nucleotide polymorphisms are the most common variations in the human genome. Genetic variations of immune response genes can modify the defense response of the host, and alter the susceptibility to bacterial colonization of the oral cavity and early childhood caries. The aim of this systematic review is to identify genetic variants of immune response genes associated with early childhood caries. RESULTS: A total of 7124 articles were identified by conducting an elaborate search across various electronic databases and genome-wide association studies databases. Subsequent to exclusion at various stages, fifteen articles qualified to be included into the present review. Risk of bias assessment was done with the Q-genie tool. Quantitative synthesis revealed that the odds ratio for TT and CC genotypes of rs11362 was 1.07 (0.67-1.71) and 1.16 (0.84-1.60), respectively. Gene-based analysis revealed a statistically significant association between variants of tumor necrosis factor-alpha gene and T-cell receptor alpha variable 4 locus with early childhood caries. Gene clustering showed the presence of three functional clusters. To comprehend the protein-protein interaction, the bioinformatic tool of "Search Tools for the Retrieval of Interacting Genes and Proteins" was used. Among the biological processes and the reactome pathways, complement activation through the lectin pathway showed the highest strength of association with early childhood caries. To understand the interaction and functionality of the genes, "gene function prediction using Multiple Association Network Integration Algorithm" was used, which revealed that the genes were linked by physical interaction (39.34%) and through co-expression (34.88%). CONCLUSIONS: Genotype TT of rs7217186 of arachidonate 15-lipoxygenase gene was a risk factor for early childhood caries. Multiple genetic variants of T-cell receptor alpha variable 4 locus and tumor necrosis factor-alpha gene were associated with increased susceptibility to early childhood caries. Polymorphisms of genes regulating the lectin pathway of complement activation can modify the susceptibility to early childhood caries.

Variations in Primary Molar Contact and Approximal Caries in Children: A Three-Year Prospective Cohort Study.

Purpose: To evaluate the association between the contact areas of primary molar teeth and approximal caries after three years of observation. Methods: This prospective cohort study included 1,119 caries-free children, aged three to four years, from Puducherry, India. At base- line, 4,476 contacts were assessed using the OXIS criteria, which denotes O for open contact and X, I, and S for closed contacts. X contact represents a point contact, I is a straight contact, and S is a curved contact. Two calibrated dentists measured dental caries at one-year intervals following the International Caries Detection and Assessment System for three years. Poisson regression analysis with a multilevel approach was used to determine the association between contact type and approximal caries. Results: Of 3,848 contacts observed at the end of three years, 499 (13 percent) were carious. The adjusted analysis revealed a significant association between contact type and approximal caries (P<0.05). The risk ratios for the development of approximal caries were 2.3 for X-type contacts (0.5 to 11.4, P=0.307), 12.7 for I-type (4.1 to 39.6, P<0.05), and 22.5 for S-type (7.2 to 70.6, P<0.05) when compared with O-type. Conclusions: Compelling evidence suggests that variations in contacts between teeth are significant in the development of approximal caries. The S-type contact is the most susceptible to approximal caries, followed by the I-type.

Comparison of conventional preparation with modified access preparation on fracture resistance of primary molars - A finite element analysis.

Objective: To investigate the influence of Conventional Straight (CS) line and Modified Straight (MS) line access preparations with various restorative materials on the fracture resistance of primary molars using Finite Element Analysis (FEA). Methodology: Three FEA models for each of the primary molars were divided into Group I- Intact tooth model; Group II- Model with CS outline and Group III- Model with MS outline. Based on the restorative material used, Group II and III were further subdivided into subgroup 1- GIC restoration, subgroup 2 - composite resin with GIC base and subgroup 3- Stainless Steel Crown (SSC). Each model was subjected to 5 different force loads directed at the occlusal surface. Maximal von Mises (VM) stresses calculated from stress distribution patterns. Result: The maximum displacement, in all the models of primary molars were seen in GIC restored models in molars with both CS and MS access whereas the minimal displacement was seen in the SSC restored molars of MS group. Conclusion: In primary maxillary second molar and mandibular first and second molar with intact marginal ridges, the fracture resistance of tooth with MS outline restored with GIC base followed by Composite resin was comparable with the tooth restored with SSC and CS outline. Clinical outcome: Based on the results of this FEA analysis, composite restorations with MS outline would be appropriate for endodontically treated primary molars that have intact margins.

Single nucleotide polymorphisms of enamel formation genes and early childhood caries - systematic review, gene-based, gene cluster and meta-analysis.

Introduction: Genetic polymorphisms of genes regulating amelogenesis can alter susceptibility to Early Childhood Caries (ECC). This systematic review aims to analyze associations between single-nucleotide polymorphisms of enamel formation genes and ECC. Methods: Search was conducted across PUBMED, CINAHL, LILACS, SCOPUS, EMBASE, Web of Science, Genome-Wide Association Studies databases from January 2003 to September 2022. This was supplemented by hand search. Totally 7124 articles were identified and 21 articles that satisfied the inclusion criteria proceeded to data extraction. Quality assessment was done using the Q-Genie tool. Results: Quantitative synthesis revealed that homozygous genotype AA of rs12640848 was significantly higher in children with ECC with an odds ratio of 2.36. Gene-based analysis revealed significant association between six variants of AMBN, four variants of KLK4, two variants of MMP20, and a single variant of each of MMP9 and MMP13 genes and ECC. The Bonferroni corrected-log10 P value of amelogenesis gene Cluster was 2.25 (0.05/88 = 5.6 × 10-4). Search Tool for Retrieval of Interacting Genes and Proteins plot constructed to comprehend the protein-protein interaction revealed the presence of four functional clusters. Gene function prediction using Multiple Association Network Integration Algorithm revealed that physical interaction between these genes was 69.3%. Conclusion: Polymorphisms of genes regulating amelogenesis can influence the susceptibility to ECC. AA genotype of rs12640848 may increase the susceptibility to ECC. Gene-based analysis revealed a significant association between multiple polymorphisms of genes regulating amelogenesis and ECC.

Assessment of OXIS contacts-a comparison of three methods.

PURPOSE: To compare OXIS contacts by means of Replication using Sectional die Models (RSM) and Photographs of the Models (PM) with Direct Clinical Examination (DCE) in a sample of preschool children aged 3-4 years. METHODS: A retrospective cross-sectional study was performed using existing records of sectional die models and their photographs among 4257 contacts of 1104 caries-free pre-school children. Two calibrated examiners scored the contacts between the distal surface of the primary first molar and mesial surface of the primary second molar using OXIS criteria from the occlusal view using the RSM & PM methods. These were compared to the OXIS scores from DCE method which was available from previous records. Kappa agreement was used to compare results obtained RSM and PM methods with DCE. RESULTS: The kappa agreement between the RSM and DCE methods was 98.48%; and between the PM and DCE methods was 99.42%, both of which indicated perfect agreement. CONCLUSION: The RSM and PM methods were found to have an excellent agreement in scoring OXIS contacts when compared to the DCE method. PM was found to be slightly more accurate than the RSM method for scoring OXIS contacts.

Bite force of children and adolescents: a systematic review and meta-analysis.

This systematic review aimed to assess bite force measurements in children and adolescents and to study the various devices that measure Maximum Voluntary Bite Force (MVBF). This systematic review included observational studies and experimental studies in children and adolescents (upto 19 years of age) which evaluated MVBF using a bite force measuring device. Studies on participants with systemic conditions were excluded. Databases such as PubMed, Embase, LILACS, and the Cochrane library were searched until September 2022, for which screening and quality assessment were performed. Newcastle-Ottawa, modified Newcastle-Ottawa and ROBINS-I tools were used to assess the Risk-of-bias. All observational studies reporting overall bite force values of participants were included for meta-analyses. A total of 8864 participants (3491 males and 3623 females) were included from 61 studies. Meta-analyses were conducted to evaluate mean average bite force value for each included dentition using R software v2.4-0. Estimation was done to derive an average BF value for variables such as age (dentition), gender, side, site, device and ethnicity. MVBF values were reported as mean average in the form of MLN with 95% CI (Confidence Interval). Using a random-effects model, 29 forest plots were generated. I2 values varied between 90% and 100%. Bite force ranged from 246.22 N (220.47; 274.98) to 311.72 N (255.99; 379.59) and 489.35 N (399.86; 598.87) in primary, mixed, and permanent dentitions, respectively. Six different sites for recording bite force and 11 different types of devices were reported with portable occlusal bite force gauge being the most common device. Outcomes of this review provide useful baseline reference values of bite force for clinicians and researchers.