i-Dent: A virtual assistant to diagnose rare genetic dental diseases.

Rare genetic diseases are difficult to diagnose and this translates in patient's diagnostic odyssey! This is particularly true for more than 900 rare diseases including orodental developmental anomalies such as missing teeth. However, if left untreated, their symptoms can become significant and disabling for the patient. Early detection and rapid management are therefore essential in this context. The i-Dent project aims to supply a pre-diagnostic tool to detect rare diseases with tooth agenesis of varying severity and pattern. To identify missing teeth, image segmentation models (Mask R-CNN, U-Net) have been trained for the automatic detection of teeth on patients' panoramic dental X-rays. Teeth segmentation enables the identification of teeth which are present or missing within the mouth. Furthermore, a dental age assessment is conducted to verify whether the absence of teeth is an anomaly or a characteristic of the patient's age. Due to the small size of our dataset, we developed a new dental age assessment technique based on the tooth eruption rate. Information about missing teeth is then used by a final algorithm based on the agenesis probabilities to propose a pre-diagnosis of a rare disease. The results obtained in detecting three types of genes (PAX9, WNT10A and EDA) by our system are very promising, providing a pre-diagnosis with an average accuracy of 72 %.

Use of presence vs absence of symphyseal teeth in jaws for the forensic analysis of bites by large traumatogenic shark species.

Identifying the species of shark responsible for a bite on humans is both complex and important for understanding and managing the shark risk. Depending on the species, tiny teeth may or may not be present in the symphyseal space at the junction of the upper and lower half-jaws. In the case of bites, these tiny teeth (if present) often leave specific marks that may enable species to be quickly and reliably distinguished. We first present the anatomo-morphological characteristics of the jaws of the three most traumatogenic species for humans which are the white, tiger, and bull sharks. The white shark has no symphyseal teeth, while the tiger and bull sharks do. On the basis of three confirmed real case studies involving those species, we then show that for the white shark, the wide symphyseal space between the first two teeth of each jaw usually leads to wounds including the presence of (quite) large flesh flaps, without any tooth imprint. Conversely, wounds following bites made by the tiger and bull sharks will generally leave characteristic small imprints of symphyseal teeth, especially in the case of incomplete or superficial bites. Although not systematic, this diagnostic approach provides fast, reliable, and clean results. The discrimination between two species with symphyseal teeth can then be made on the basis of complementary anatomic information such as jaw curvature and details linked to the anatomy of the teeth themselves, as well as the ecological context.

Relationship of dietary nutrients with early childhood caries and caries activity among children aged 3-5 years-a cross-sectional study.

BACKGROUND: Early childhood caries (ECC) is a challenge for pediatric dentists all over the world, and dietary factor is an important factor affecting the occurrence of ECC. Currently, there is limited research on the impact of dietary nutrient intake from Chinese diets on ECC. The purpose of this study is to explore the correlation of dietary nutrients intake with ECC and caries activity (CA) among children aged 3-5 years, and to provide dietary guidance to slow down the occurrence and development of ECC. METHODS: A cross-sectional study was conducted in 2022. A total of 155 children were divided into three groups: caries-free group, ECC group and Severe early childhood caries (SECC) group according to the caries statues. And according to the caries activity test (CAT) value, they were also divided into three group: low CA group (L-CA), middle CA group (M-CA) and high CA group (H-CA). The 24-hour dietary intake information was collected by mobile phone application (APP). The intake of children's daily dietary nutrients were calculated referring to "China Food Composition Tables". RESULTS: In this study, 17, 39,and 99 children were diagnosed with caries-free, ECC, and SECC. There were 33, 36, and 86 children diagnosed with L-CA, M-CA, and H-CA. The risk of ECC was increased with the intake of cholesterol(OR = 1.005) and magnesium (OR = 1.026) and decreased with the intake of iron (OR = 0.770). The risk of SECC was increased with the intake of cholesterol (OR = 1.003). The risk of high CA was increased with the intake of cholesterol (OR = 1.002). The combined application of dietary total calories, carbohydrate, cholesterol, sodium, magnesium and selenium in the diagnosis of ECC had an area under ROC curve of 0.741. CONCLUSIONS: The increased dietary cholesterol intake may be a common risk factor for ECC and high CA in children aged 3-5. The combined application of dietary intake of total calories, carbohydrate, cholesterol, sodium, magnesium and selenium has a higher predictive value for the occurrence of ECC.

Anterior Maxillary Mesiodens Extraction in a Young Adult Male: A Case Report.

Mesiodens are classified as supernumerary teeth located in the maxilla, specifically in the palatal region between the central incisors. The prevalence of this condition varies between 0.15% and 1.9% among individuals. The presence of mesiodens can potentially affect the normal growth and development of teeth, leading to delayed eruption of permanent teeth, displacement or rotation of adjacent teeth, root resorption, and infectious pulpitis. This report discusses the case of a 14-year-old male patient who presented with a palatally placed mesiodens, which was completely erupted in the oral cavity. The patient underwent extraction for the removal of the mesiodens, and the procedure was successful with no complications reported during or after surgery. Early identification and surgical removal of mesiodens are crucial to preventing potential orthodontic and functional complications. This case highlights the importance of regular dental checkups for diagnosing supernumerary teeth. Timely intervention can lead to favorable outcomes, as demonstrated in this patient.

Post-endodontic pain following root canal treatment in permanent teeth among Indian paediatric patients.

Pulp status in permanent teeth and post endodontic pain (PEP) has not been assessed properly in pediatric patients. Therefore, it is of interest to assess the prevalence, severity of PEP in permanent teeth after root canal therapy and retreatment in paediatric patients. Hence, 127 pediatric patients who had root canal therapy (RCT) for permanent teeth with necrotic pulp, vital pulporendodonticre treatment were considered. Assessment of incidence intensity of PEP at 6 hours and 18 hours after therapy was completed. The incidence and intensity of PEP in permanent teeth in paediatric patients was greater in teeth with vital pulp. It was low in teeth with necrotic pulp. The incidence of spontaneous PEP was greater in all treatment groups as compared to stimulated PEP at 6 hours after treatment. Thus, root canal therapy of teeth with viable pulp produced a noticeably greater incidence and intensity of PEP in permanent teeth in paediatric patients.

Removal of mandibular third molars: An overview of risks, a proposal for international community and guidance.

The aim of this proposal is to (1) review the current literature, (2) shed light on the importance of creating universally accepted guidelines, (3) provide help and guidance in the decision-making process with regard to the removal of mandibular third molars (M3Ms), and (4) reduce the risk of exposing the patient to unnecessary harm and complications due to the inappropriate removal or retention of M3Ms.It is obvious that the indications for the extraction of M3Ms will continue to be an area of controversy and strong debate. The evidence for or against prophylactic extraction is ambivalent; there is evidence to accept or reject the stance against prophylactic extraction in some specific cases, and there are published articles to support both opposing views. The available guidelines on the extraction of third molars are limited in number, and are mostly tailored to fit specific settings or countries. There are no available guidelines that might be widely used to help in the decision-making process for the international community. We hope this proposal will constitute an important first step toward creating universally accepted guidance.

A randomised clinical trial to arrest caries using silver diamine fluoride therapy with two postoperative instructions.

OBJECTIVE: The objective of this study is to investigate the beneficial effect of not rinsing for 30 minutes in arresting early childhood caries after SDF therapy. METHODS: This randomised clinical trial recruited 3- to 4-year-old kindergarten children with active (soft) dentine caries. A questionnaire was sent to the parents to collect children's demographic data and oral health-related behaviours. A dentist conducted an oral examination and measured the caries experience using dmft index and oral hygiene using visible plaque index. After 38% SDF therapy, the children were randomly allocated into two groups. Children in group A were instructed to rinse with water immediately, whereas children in group B were asked to refrain from rinsing, drinking, or eating for 30 minutes. After six months, the same examiner determined the lesion activity (active/arrest) of the SDF-treated carious tooth surface. Generalized Estimating Equations was used to compare the proportion of caries arrest (caries-arrest rate) between the two groups. RESULTS: This study recruited 298 children with 1,158 decayed tooth surfaces receiving SDF therapy at baseline and evaluated 275 (92%) children with 1,069 (92%) SDF-treated tooth-surface at the six-month examination. The demographic background, oral hygiene and caries status of two groups were comparable at baseline (p>0.05). The caries-arrest rate for group A and group B were 65% (337/519) and 61% (338/550), respectively (p=0.28). CONCLUSION: This randomised clinical trial found the postoperative instructions of immediate rinsing or refraining from rinsing, drinking, or eating for 30 minutes after SDF therapy had no significant effect on caries arrest in primary teeth. CONCLUSION: This randomised clinical trial found not rinsing for 30 minutes after SDF therapy is not better than immediate rinsing in arresting early childhood caries. CLINICAL SIGNIFICANCE: Topical SDF application leaves an unpleasant taste in the mouth, which may affect the acceptance or even rejection of SDF therapy among young children. This study provides clinicians with information to make their decision on postoperative instruction after SDF therapy.

Lost and Found: A Case Report of the Journey of Two Teeth Into the Bronchus After a Road Tragedy.

Traumatic foreign body aspiration (FBA) in adults is a rare yet potentially life-threatening event that requires prompt recognition and management to prevent adverse outcomes. While less common in adults compared to paediatric populations, traumatic FBA incidents often occur in occupational settings, post-trauma, or during high-risk activities, presenting with acute respiratory symptoms and varying degrees of airway obstruction. Diagnosis can be challenging due to the lack of classic symptoms and the potential for delayed presentation, necessitating a thorough history, a focused physical examination, and appropriate imaging techniques such as computed tomography (CT) and bronchoscopy. Prompt intervention is crucial to mitigating complications such as airway obstruction, pneumothorax, and respiratory compromise. Here, we describe an interesting case of a patient with a road traffic accident who aspirated two teeth and thought he lost them in this process. Surprisingly, two lost teeth were found after undergoing diagnostic procedures for mild shortness of breath, further causing aspiration pneumonitis.

Maxillary Central Incisor Eruption Failure Due to Supernumerary Teeth and Pericoronal Hamartoma: A Report of a Rare Case.

Impaction of permanent teeth during the replacement period is a relatively common occurrence in clinical practice. Tooth impaction occurs in the presence of factors that inhibit tooth eruption, such as supernumerary teeth or tumors. This is a report of permanent tooth impaction due to supernumerary teeth and pericoronal myxofibrous hyperplasia (PMH), a type of pericoronal hamartomatous lesion. An eight-year-old girl was diagnosed with an unerupted right maxillary central incisor. An inverted supernumerary tooth was present on the palatal side of the impacted central incisor, and PMH developed on the labial side of the central incisor. Interestingly, the alveolar bone on the labial side had completely disappeared. After the extraction of the supernumerary tooth and the removal of the PMH, the central incisors erupted, and the labial alveolar bone regenerated normally. Treatment for impacted teeth typically involves the removal of any existing lesions. This case is unique in that the alveolar bone of the impacted tooth regenerated following the extraction of the supernumerary tooth and removal of the PMH.

Rare Germline Variants in the Adenomatous Polyposis Coli Gene Associated with Dental and Osseous Anomalies.

APC is a tumor suppressor gene that exerts its effect through the regulation of the Wnt signaling pathway. Loss of function mutations of the gene are associated with familial adenomatous polyposis (FAP). Early diagnosis in FAP patients is essential to prevent the development of colorectal cancer. Extraintestinal manifestations often precede the formation of the polyposis; therefore, these manifestations may serve as a clinical indicator for the condition. The aim of this study was to assess genotype-phenotype associations between the location of APC mutations and various extraintestinal features, mainly focusing on osseous and dental anomalies. Analyses of our cases and the mutations available in the literature with these manifestations revealed that mutations in the N-terminal region (amino acids 1-~1000) of the protein are more frequently associated with only osseous anomalies, whereas dental manifestations are more prevalent in mutations in the middle region (amino acids 1000-~2100). In addition, supernumerary teeth were found to be the most common dental feature. Since dental abnormalities often precede intestinal polyposis, dentists have a crucial role in the early identification of patients at risk.

Advanced Material Strategy for Restoring Damaged Endodontically Treated Teeth: A Comprehensive Review.

The restoration of endodontically treated teeth (ETT) remains a significant challenge in modern dentistry. These teeth often suffer from substantial structural damage due to both the original pathology and the invasive nature of endodontic procedures. Consequently, ETT are more susceptible to fractures compared to vital teeth, necessitating restorative strategies that can effectively restore both function and aesthetics while minimizing the risk of failure. In recent years, advances in adhesive dentistry and the development of high-strength ceramics have further expanded the restorative options for ETT. Bonded restorations have gained popularity as they preserve more tooth structure and enhance the overall strenght of the tooth-restoration complex. The choice of restorative material and technique is influenced by numerous factors, including the amount of remaining tooth structure, the functional requirements of the tooth, and the aesthetic demands of the patient. Despite the plethora of available materials and techniques, the optimal approach to restoring ETT remains a topic of ongoing research and debate. In this comprehensive review, the current state of and recent advances in restoring damaged endodontically treated teeth are explored. Numerous therapeutic options exist, involving a wide range of materials. This article aims to present the biomaterial advancements of the past decade and their applications, offering alternative approaches to treating damaged ETT with the goal of prolonging their retention on the dental arch and serving as a valuable resource for dental practitioners who face this issue daily.

Analysis of maxillary teeth and soft tissue profiles among Tibetan and Han Chinese females with facial symmetry for orthodontic treatment planning.

The evaluation of maxillary teeth and soft tissue profiles is a critical component of orthodontic diagnosis and treatment planning. This study aimed to evaluate the correlation between the sagittal position of maxillary anterior teeth and facial profile esthetics among Tibetan and Han Chinese adult females for optimizing orthodontic diagnosis and treatment planning. A total of 100 Tibetan Chinese and 100 Han Chinese adult females with good facial symmetry were recruited. The smiling facial profile images with the maxillary central incisors and forehead in full view were taken based totally on the same standard. The photo measurement and head position were adjusted using the picture-enhancing software. The reference traces associated with forehead inclinations were utilized to assess the anteroposterior (AP) positions of the maxillary central incisors. The results showed that a round forehead was the dominant forehead shape for Tibetan (93%) and Han (55%) Chinese females. In Tibetan females, 85% of the maxillary central incisors were found to be located between the forehead's anterior limit line (the Gall line) and the goal anterior limit line (the Fall line), with 15% located posterior to the Fall line. This distribution manifested a strong association with incisor position and forehead inclination (R2 = 0.742). In Han females, 83% of the maxillary central incisors were located between the Fall line and the Gall line, with 12% posterior to the Fall line and 5% anterior to the Gall line. The positions of the maxillary central incisors exhibited a strong relationship with forehead inclination (R2 = 0.827). The maxillary central incisors were close to the aesthetic line in both ethnic groups, while forehead inclinations were correlated with AP maxillary incisor position. These findings demonstrated that there was a close relationship between the incisor position of Tibetan and Han females with facial symmetry and the forehead FFA factor, indicating a reference in oral hard and soft tissues for optimizing orthodontic diagnosis and treatment planning in terms of facial contour.

Clinical and Radiographic Progression of Proximal Enamel Caries of Primary Molars Following the Application of Resin Infiltrant vs Tooth Mousse.

Background: Resin infiltration is a technique in which a low-viscosity resin penetrates the proximal carious lesions and stops caries progression. Aim: This study aimed to compare the progression of proximal enamel caries of primary molars following the application of resin infiltrant clinically and radiographically vs Tooth Mousse. Materials and methods: This case-control split-mouth study evaluated 64 proximal surfaces of primary molars in 32 patients. Each patient had one pair of noncavitated proximal caries in two primary molars from different quadrants with radiographic evidence of enamel involvement. The carious lesions in each patient were randomly treated with resin infiltrant and Tooth Mousse. Progression of carious lesions was evaluated clinically and radiographically after 12 months. The two groups were compared by Fisher's exact test. Results: No caries progression was noted in the resin infiltrant group at 12 months, and all 32 surfaces (100%) showed cessation of caries. Four surfaces (12.5%) in the Tooth Mousse group showed caries progression. The two groups were not significantly different in this regard (p = 0.242). Conclusion: Resin infiltrant and Tooth Mousse were both effective in stopping the progression of proximal enamel caries of primary molars. How to cite this article: Baniebrahim G, Seraj B, Ghonche Z, et al. Clinical and Radiographic Progression of Proximal Enamel Caries of Primary Molars Following the Application of Resin Infiltrant vs Tooth Mousse. Int J Clin Pediatr Dent 2024;17(4):385-389.

Success Rates of Antibiotic Sterilization, Indirect Pulp Treatment, and Pulpotomy in the Management of Primary Teeth with Deep Carious Lesions.

Background and aim: A new concept of antibiotic sterilization has come into existence which can be used to sterilize the demineralized portion of the teeth with minimal or ultraconservative excavation of caries in deep dentinal carious lesions as an alternative for indirect pulp therapy (IPT) and pulpotomy to avoid further complications. This study was undertaken to compare the success rates of antibiotic sterilization, indirect pulp treatment, and pulpotomy in the management of primary teeth with deep carious lesion. Materials and methods: Ninety teeth involving deep carious lesions approaching pulp in primary molars were selected and randomly divided into three groups containing 30 teeth. Group I was treated with antibiotic sterilization using 3Mix-MP paste, group II was treated with indirect pulp treatment using calcium hydroxide, and group III was treated with conventional pulpotomy using 15.5% ferric sulfate (FS) solution. Clinical and radiographic analysis of all three groups was performed at 1, 3, 6, 9, and 12 months to evaluate the success of treatment procedures using predetermined criteria. Pearson's Chi-squared test and McNemar test were used for statistical analysis. Results: At the end of the 12-month follow-up period, the overall clinical and radiographic success was determined to be 96.3% for group I, 100% for group II, and 96.4% for group III. There were no statistically significant differences observed between the success of three groups, suggesting that either of the procedures can be adopted for the management of deep carious lesions approaching pulp in primary teeth. Conclusion: Antibiotic sterilization can be introduced as a newer modality in the management of deep carious lesions approaching pulp in primary teeth which is ultraconservative in nature and reduces the risk of pulp exposure in comparison with indirect pulp treatment and pulpotomy procedures. How to cite this article: Saxena D, Garg N, Pathivada L, et al. Success Rates of Antibiotic Sterilization, Indirect Pulp Treatment, and Pulpotomy in the Management of Primary Teeth with Deep Carious Lesions. Int J Clin Pediatr Dent 2024;17(3):237-242.

Management of Root Fractures in Young Immature Permanent Teeth: Three Case Reports.

Aim: The aim of this case report is to present three different patients who had horizontal and vertical root fractures of young permanent teeth, its diagnosis, clinical and radiographic findings, treatment, and long-term follow-up and success rate. Background: Root fractures are relatively rare with the prevalence of 0.5-7% in permanent and 2-4% in deciduous dentition. Timely intervention and accurate treatment procedures are the main concerns for long-term success of root fractures. Case description: Case I and case II had horizontal fracture of immature permanent tooth. Patients reported with a chief complaint of pain in their upper central incisors. As a result of radiographic examination, horizontal root fractures were diagnosed. Teeth were treated with a mineral trioxide aggregate (MTA) plug (case I and case II) and repositioning and splinting (case II). Case III had vertical root fracture of immature permanent tooth. Tooth was treated with apexification (sectional obturation) and sealed with resin-modified glass ionomer cement (RMGIC) till the fracture site and flowable light cure restoration. Patients were scheduled for follow-up visits at different time intervals. Radiographic evidence indicated ongoing root development in these immature teeth. Normal color and mobility were observed, and no pain was noted during horizontal and vertical percussion tests. Conclusion: The present case report shows a favorable and stable outcome of timely treatment and sound healing of various types of root fracture. Long-term follow-up of patients with trauma is essential because pathological changes can occur several years following injury. Clinical significance: The latest treatment modalities and long-term follow-up showed clinical success. How to cite this article: Dhindsa A, Garg S, Poddar P, et al. Management of Root Fractures in Young Immature Permanent Teeth: Three Case Reports. Int J Clin Pediatr Dent 2024;17(3):352-356.

Evaluation of Salivary Immunoglobulin A Level and Its Correlation with Severity of Early Childhood Caries: An Original Research.

Background and objectives: Early childhood caries (ECC) remains one of the most prevalent diseases mutilating the primary dentition. It is a multifactorial disease that severely affects the quality of life of affected children. One of the risk indicators reported in the literature is the presence of viable mutans streptococci (MS) and protective factors such as salivary immunoglobulin A (SIgA). Hence, it is important to identify such risks and protective factors associated with ECC using simple yet reliable methods supported by advanced technology and a fully automated platform to improve the results. Materials and methods: A retrospective analysis was done on 40 children who were divided into two groups: group I (experimental) and group II (control). Group I comprised 30 healthy children who were further divided into three subgroups of 10 children each. Group IA with decayed, missing, filled teeth/decayed, extracted, filled teeth (dmft/deft) = 1-2, group IB with dmft/deft = 3-4, group IC with dmft/deft ≥5, and group II, comprising 10 healthy children having no caries by using World Health Organization (WHO) 2013 Oral Health Survey criteria. Unstimulated saliva was collected by drooling saliva into a sterile container. The samples were transported to the central research laboratory for SIgA by the immunoturbidimetry method by a fully automated Abbott Architect c system. The data obtained was subjected to statistical analysis. Results: On comparison of SIgA in between varying severities of dental caries and caries-free children between age-group of 3 and 6 years, it was found to be below the grand median 0.20 mg/mL for subgroups IA and control group II. A significant negative statistical correlation (r = -0.948) was present between the SIgA and varying severities of ECC and the control group. Interpretation and conclusion: The low dmft/deft group was found to be relatively closer to the caries-free groups as their mean dmft was 1.50, standard deviation (SD) ± 0.53. A slight change in dmft/deft score and SIgA could be used as a potential biomarker for assessing the severity of ECC in children between age-group of 3 and 6 years. How to cite this article: Sharma V, Bagchi A, Dutta B, et al. Evaluation of Salivary Immunoglobulin A Level and Its Correlation with Severity of Early Childhood Caries: An Original Research. Int J Clin Pediatr Dent 2024;17(3):316-320.

The effect of different intracanal irrigants on the push-out bond strength of dentin in damaged anterior primary teeth.

This experimental study investigated the effect of different intracanal irrigants on the push-out bond strength of dentin in damaged anterior primary teeth. The crowns of 90 anterior primary teeth were sectioned horizontally, 1 mm above the cementoenamel junction (CEJ). Following canal preparation with K-files, all groups except the negative control received normal saline irrigation. Canals were then irrigated with either 3% or 5.25% sodium hypochlorite (NaOCl), 2% or 0.2% chlorhexidine (CHX) solution (except negative and positive controls). The roots were filled with Metapex material and covered with a calcium hydroxide liner. In root canals, the bond was applied by self-etching and then light-cured for 20 seconds before canals were restored incrementally with composite. Stereomicroscopes were used to assess failure patterns. Push-out bond strengths (MPa ± SD) were: 3% NaOCl (16.92 ± 5.78), 5.25% NaOCl (8.96 ± 3.55), 2% CHX (14.76 ± 5.56), and 0.2% CHX (7.76 ± 2.93). Significant differences were seen across the irrigants regarding the push-out bond strength of dentin sections (P <0.001). The most frequent failures were adhesive and cohesive. NaOCl and CHX irrigants increased the push-out bond strength compared to controls. Compared to controls, both 3% NaOCl and 2% CHX irrigants significantly increased the push-out bond strength of dentin in non-vital anterior primary teeth.

Use of Proteomics for Dietary Reconstruction: A Case Study Using Animal Teeth from Ancient Mesopotamia.

This research examines animal teeth from Early Dynastic (2900-2350 BCE) Mesopotamia (Southern Iraq) to assess animal management practices and identify consumption patterns in animal diets. The objective to answer larger questions about food management and environmental resilience in ancient early complex societies in the Near East was achieved by the use of mass spectrometry-based proteomics for dietary reconstruction. Dietary MS, a revolutionary new methodology applying proteomics techniques to archeological sample sets to reconstruct ancient animal diet. A developed protein extraction technique followed by liquid chromatography tandem mass spectrometry allowed for the identification of the specific plant species consumed in order to highlight variable herd management strategies, resource optimization, for each taxon over time. It also provided information about overall health and indications of disease. This is the first study to apply a full suite of analyses to the region and provides the foundations of a necessary long-term view of human interaction within an environment, through both time and space.

Strategies for Pain Management after Extraction of Primary Teeth: A Systematic Review of Randomized Clinical Trials.

BACKGROUND: In dental extractions, particularly when local anesthesia is used, it usually offers analgesic relief for a few hours. However, pain can become a notable concern in the immediate postoperative period due to the trauma experienced by both soft and hard oral tissues. OBJECTIVES: This systematic review aimed to evaluate the most effective strategies for managing postoperative pain in primary tooth extractions. METHODS: Two examiners conducted a search across five electronic databases: MEDLINE (via PubMed), Embase, Scopus, Web of Science, CENTRAL, and OpenGray. Studies were included if they met the following criteria after reviewing their titles and abstracts: they involved children and evaluated pain management following primary tooth extraction. Subsequently, articles that described extractions performed under any form of sedation, were not conducted under local anesthesia, in an outpatient setting, and in children aged 0 to 12 years, or were not randomized controlled trials, were excluded. RESULTS: The search yielded 374 relevant articles, of which 9 were included. Among these, 5 utilized preoperative medications as a pain management strategy, one evaluated low-level laser therapy (LLLT) postoperatively, one assessed calendula drops postoperatively, and another explored virtual reality during the procedure and arnica in solution both pre and postoperatively. CONCLUSION: Among all the strategies evaluated, the strategy involving analgesics administered 30 minutes before tooth extractions was supported by better-designed studies. However, there is a high risk of bias.