Influence of computerized intraosseous anesthesia compared with traditional mandibular nerve block on children's behavior: A randomized clinical trial.

BACKGROUND: Effective pain management is crucial for the successful completion of dental procedures in children. Research has examined whether computerized intraosseous anesthesia (CIOA) could serve as a safe and viable substitute for the conventional inferior alveolar nerve block (IANB) technique in pediatric patients. This study investigates the efficacy of CIOA, aiming to determine its effectiveness as an alternative anesthesia method. AIM: This study compared the efficacy of local intraosseous anesthesia using a computerized device (QuickSleeper 5) to conventional IANB anesthesia on cooperation and pain perception in children, using a randomized controlled trial design. DESIGN: The study included 88 healthy children, aged between 6 and 9 years, who required pulpotomy for their mandibular second primary molars. The study was approved by the local research ethics committee and registered at clinicaltrials.gov (NCT05193487). The heart rate and Venham behavior rating scale were recorded and analyzed. Categorical data were analyzed using Fisher's exact test. Age and heart rate were compared using an independent t-test for intergroup comparison. The intragroup comparison was carried out using repeated measures ANOVA, followed by the Bonferroni post hoc test. The Mann-Whitney U-test was used to analyze the Venham scale scores. The significance level was set at p < .05 RESULTS: The mean Venham score was slightly higher in the IANB group than in the CIOA group, but was not statistically significant (p = .852). One minute after anesthesia administration, the heart rate (beats per minute [BPM]) was significantly higher in the IANB group (92.30 ± 13.45) than in the CIOA group (83.20 ± 10.40) (p < .001). Additionally, there was a significant difference in heart rate values measured at different intervals within the IANB group. CONCLUSION: The QuickSleeper 5 device was found to be a feasible alternative for IANB in children over 6 years old.

Epidemiology of dental caries in permanent dentition: evidence from a population-based survey in Egypt.

BACKGROUND: In recognition of the risk factors common between oral diseases and various chronic conditions and the intersection between oral health and some sustainable development goals, the current cross-sectional study was designed to quantify the burden of dental caries and identify factors associated with its occurrence in permanent teeth. METHODS: Using data from Egypt's population-based survey (2013-2014), two individual-level outcomes; past caries experience (DMFT > 0) and presence of untreated carious lesions (DT > 0) were assessed using the WHO basic methods for oral health surveys. Information on potential explanatory variables including sociodemographic characteristics, exposure to fluoridated water, dental attendance, and dental anxiety was gathered using a structured questionnaire. Stratified multistage cluster random sampling was used to recruit survey participants. Multivariable logistic regression was performed to identify significant potential risk factors for caries in the permanent dentition of Egyptians. FINDINGS: A total of 9,457 participants were included of which 70.3% had at least one untreated carious lesion. After adjusting for all covariates, analphabetic Egyptians were found to have significantly higher odds of caries experience in permanent dentition DMFT > 0 (OR 1.54, 95% CI [1.20-1.98]), DT > 0 (OR 1.62, 95% CI [1.32-2.00]). Males, however, had significantly lower caries risk DMFT > 0 (OR 0.75, 95% CI [0.67-0.85]), DT > 0 (OR 0.81, 95% CI [0.73-0.89]) when compared to females. Regarding age, mean DMFT scores were significantly lower in age groups (6-15 years) (OR 0.03, 95% CI [0.014; 0.082]), (16- 20 years) (OR 0.09, 95% CI [0.037; 0.23]), and (21-35 years) (OR 0.22, 95% CI [0.09; 0.53]) than among people ≥ 60 years. CONCLUSION: Addressing individual-level caries risk factors should be complemented by addressing upstream factors to reduce burden of untreated dental caries among Egyptians.

The association between black stain and lower risk of dental caries in children: a systematic review and meta-analysis.

BACKGROUND: Previous literature shows that children with dental black stain might be less susceptible to dental caries. The aim of this study was to systematically review the available literature to determine whether black stain presence could influence the prevalence or severity of dental caries in primary dentition. METHODS: A systematic search of PubMed, Web of Science, Scopus, Google Scholar, OpenGrey, and Egyptian Universities Libraries Consortium was conducted up to December 2020. Quality assessment was done using a modified version of Down's and Black checklist. Meta-analyses were performed to assess the association between dental black stain and: (i) Likelihood of developing dental caries/being caries-free (ii) Number of teeth affected by dental caries (iii) Number of tooth surfaces affected. RESULTS: The database search yielded 2164 results, 14 of which matched the eligibility criteria. The meta-analysis showed that the likelihood of developing caries (Fixed effect model: OR [95% CI]: 0.67 [0.54; 0.82]; I2=37%; τ2=0.05), number of teeth affected (Random effects model: MD [95% CI]: -0.98 [-1.54; -0.42]; I2=79%; τ2 =0.44), and number of surfaces affected (Random-effects model: MD [95% CI]: -2.34 [-4.23; -0.44]; I2=85%; τ2 =2.93), were all lower in children with black stain. CONCLUSIONS: It is suggested that dental black stain is associated with lower dental caries experience in children with primary dentition. However, it is questionable whether black stain has a protective effect against dental caries, or whether children at low risk of dental caries are more likely to develop BS because their oral microbiome favors BS-forming organisms.

Investigation of the effect of breast milk, probiotic supplemented and plain milk formulas on some oral bacteria in infants: an observational and in-vitro study / Investigação do efeito do leite materno, fórmulas de leite puro e suplementado com probióticos sobre algumas bactérias orais em lactentes: um estudo observacional e in vitro

Objetivo: existem evidências inconclusivas sobre a potencial carogenicidade das fórmulas lácteas em comparação com o leite materno. O estudo teve como objetivo comparar a detecção e contagem de Streptococcus mutans(S. mutans) e lactobacilos da saliva entre lactentes alimentados com leite materno (B), com fórmulas de leite puro (France Lait-FL) e suplementada com probióticos (Nan 1 optipro-N), e avaliar crescimento in vitro dessas bactérias em amostras de leite materno e fórmulas lácteas. Material e Métodos: amostras salivares foram obtidas com swabs de algodão estéreis de 60 lactentes que foram agrupados de acordo com o tipo de leite. As amostras foram cultivadas para obter a frequência de detecção e contagens bacterianas. Para a investigação in vitro, sete amostras de leite materno doado e sete amostras recém-preparadas de ambas as fórmulas lácteas foram inoculadas por ambas as bactérias e então cultivadas para avaliar o crescimento bacteriano. Resultados:lactobacilos foram detectados em todos os lactentes, enquanto não foram encontradas diferenças significativas na detecção de S. mutans entre os grupos. As contagens de ambos os microrganismos na saliva foram menores em (B), enquanto uma diferença insignificante foi encontrada entre (B) e (N). Diferenças significativas foram evidentes nas contagens bacterianas in vitro sendo mais baixas em (B) seguido por (N) e (FL). Conclusão: o leite materno e as fórmulas lácteas com suplementos probióticos podem ter um papel protetor contra a cárie dentária em lactentes. (AU)

Objective: inconclusive evidence exists regarding potential cariogenicity of milk formulas compared to breast milk. The study aimed to compare Salivary Streptococcus mutans (S. mutans) and lactobacilli detection and counts among breastfed (B), plain formula (France Lait 1) (FL) and probiotic supplemented formula (Nan 1 optipro) (N) infants and to assess in-vitro growth of these bacteria in breast milk and milk formula samples. Material and Methods:salivary samples were obtained using sterile cotton swabs from 60 infants that were grouped according to nursing milk type. Samples were cultured to obtain the detection frequency and bacterial counts. For the in-vitro investigation, seven donated breast milk samples and seven freshly prepared samples of both milk formulas were inoculated by both bacteria and then cultured to assess bacterial growth. Results:lactobacilli were detected in all infants, while no significant differences were found in S. mutans detection among groups. Counts of both microorganisms in saliva were lowest in (B) while, insignificant difference was found between (B) and (N). Significant differences were evident in in-vitro bacterial counts being lowest in (B) followed by (N) and (FL). Conclusion: breast milk and probiotic supplement infants' milk formulas may have a protective role against dental caries in infants.(AU)

Periodontal diseases and potential risk factors in Egyptian adult population-Results from a national cross-sectional study.

BACKGROUND: Despite the interdependence of general and periodontal health, there is paucity of national representative data on the prevalence of periodontal diseases and their associated risk factors in Egyptian population. This cross-sectional study, thus, aimed to assess the prevalence of periodontitis and tooth loss among Egyptian adults and investigate the association between potential risk factors and periodontal diseases. METHODS: A total of 5,954 adults aged ≥ 20 years were included in this study as a subsample from Egypt's national oral health survey. Periodontitis was diagnosed with Community Periodontal Index 'CPI' scores ≥3 and tooth loss not due to caries was included in the analysis. Socio-demographic data and information on behavioral factors and history of diabetes were gathered in a face-to-face interview. Logistic regression was done to interpret the impact of potential predictors on the incidence of the two selected outcome variables. RESULTS: The overall prevalence of periodontitis was 26% and regression analysis revealed that higher odds of periodontitis existed among illiterate participants (OR = 1.74; 95% CI: 1.40-2.17), smokers (OR = 1.93; 95% CI: 1.69-2.20) and rural residents (OR = 1.16; 95% CI: 1.03-1.30). On the other hand, old age, frequency of dental attendance and history of diabetes were the main predictive factors for tooth loss. CONCLUSIONS: Among Egyptian adults, periodontal diseases were strongly associated with a multitude of modifiable and non-modifiable risk factors and inequalities in distribution of periodontal treatment needs were determined mainly by age, gender, level of education and residency location.

Effect of the addition of chlorhexidine and miswak extract on the clinical performance and antibacterial properties of conventional glass ionomer: an in vivo study.

BACKGROUND: Antibacterial restorations can increase the success rate of minimum invasive dentistry especially in young permanent molars with deep carious lesions as an attempt to preserve maximum dental structure and avoid pulp exposure. Further research is warranted to evaluate different antibacterial agents. OBJECTIVES: This study aimed to evaluate the efficacy of adding chlorhexidine gluconate (CHX) or aqueous miswak (Salvadora persica) extract on the clinical performance and in vivo antibacterial activity of conventional anhydrous glass ionomer cement (GIC). DESIGN: The study was a randomized clinical trial. Sixty young permanent molars, with deep carious lesions in 6- to 9-year-old children were included. After randomization, atraumatic restorative treatment (ART) or stepwise excavation was performed followed by bacterial sampling from the center of the remaining carious dentine in the floor of the pulp. GIC powder was mixed with 0.5% chlorhexidine gluconate liquid in group I; with 100% aqueous miswak in group II; and with deionized water in group III (control). Clinical performance for all groups was assessed at 3, 6, and 9 months. After 9 months, restorations were removed and a second bacterial sample was collected for Streptococcus mutans (S. mutans) quantification and analysis by real-time polymerase chain reaction (PCR) test. RESULTS: Results showed no statistically significant difference in the success rate of the three groups at the 3-month interval. At 6 and 9 months, however, restoration success was 75% then 60% in group I, 100% then 90% in group II, and 95% then 85% in control group. Group II and the control group showed statistically significant higher survival rates than group I. All groups showed reduction in S. mutans counts in underlying dentine, but the percent reduction was significantly higher in group I. (P < 0.001). CONCLUSIONS: The addition of CHX and miswak to GIC showed superior antibacterial properties than conventional GIC, without seriously affecting the clinical performance of the restoration until the 6-month follow-up, but failure significantly increased in terms of marginal defects at 9 months with CHX (group 1).