RESUMEN
Introduction: To investigate manifestations of developmental defects of enamel (DDE) in children born preterm (PT), and to explore possible neonatal morbidities related to DDE manifestation and severity. Methods: A cohort study of 52 children born before gestational week 32 and treated in the neonatal intensive care unit; and 55 children born at full term (FT) as a control group. All the children had a dental examination at age 1-4 years by a professional pediatric dentist. DDE was defined as an alteration in the enamel surface. Results: DDE were observed in 23 (44%) and 6 (11%) children, in the PT and FT groups, respectively, odds ratio (OR) = 6.47. The OR for damaged anterior teeth was 12.87 times higher in the PT group. DDE of molars was diagnosed in 19% and 11% of the respective groups. In the PT group, the OR of DDE was 4.1 higher among those with than without respiratory distress. The risk for DDE was 5.7 higher in those who received surfactant than in those who did not. Ventilation length, both invasive and non-invasive, was significantly related to DEE. Conclusions: DDE was higher in children born PT than FT. The DDE rate was lower than expected based on current literature, and considering the overall increase in survival; this suggests improvement in treatments affecting DEE. Respiratory distress syndrome, surfactant administration reflecting the need for intubation, longer ventilation and local oral trauma were risk factors for DDE. We recommend routine dental examinations in follow up of children born PT, particularly those exposed to assisted ventilation.
RESUMEN
Purpose: The purpose of this study was to determine the relative plaque reduction efficacy of powered versus manual toothbrushes in children. Methods: A systematic review and meta-analysis were conducted based on a literature search that included Medline, Embase, FDA publications, Cochrane Database of Systematic Reviews, Dentistry and Oral Science, and Berman Medical Library, Hebrew University. Studies were chosen that were randomized controlled trials and published between 1980 to 2019 in English that compared plaque reduction with manual and powered toothbrushes in children. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the quality of evidence. Results: From a search of 1,502 articles, nine articles were selected for meta-analysis. A statistically significant plaque reduction benefit for a powered toothbrush versus manual toothbrush (P<0.001): combined mean difference (MD) was 0.590 and the 95 percent confidence interval was 0.352 to 0.828 (random-effects model). Two tests revealed considerable heterogeneity (I² equals 96 percent; Cochran's Q, P<0.001). A low possibility of bias was indicated by Begg-Mazumdar and Egger tests (P>0.1 for both). Evidence quality was given a GRADE score of moderate. Conclusions: Powered toothbrushes were more effective than manual toothbrushes for plaque removal in children.
