UNASSIGNED: To evaluate and compare the effectiveness of Endoflas and Zinc Oxide Eugenol (ZOE) as root canal filling materials (RCFMs) for the pulpectomy of deciduous teeth by analyzing multiple clinical and radiographic success and failure follow-ups in previously published studies.
UNASSIGNED: All clinical studies that investigated the pulpectomy of the deciduous teeth of children aged 3-9 years.
UNASSIGNED: The databases used for source identification included MEDLINE (via PubMed), Scopus, Web of Science, and the Cochrane Library. No limitations were imposed on the publication year or language. The selection of studies and extraction of relevant study characteristics were conducted from December 26, 2021, to September 7, 2023. Additionally, the risk of bias (RoB) in the included studies was evaluated by using a RoB instrument (RoB 2). Eligible studies were then combined, and a random-effects model was applied by using the maximum likelihood estimations of log risk ratios and their corresponding 95% confidence intervals.
UNASSIGNED: Of the 3913 records found in the abovementioned databases, nine were eligible for systematic review and eight were eligible for meta-analysis. The studies included 628 pulpectomies of deciduous molar teeth in children. The overall results showed that compared with Endoflas, ZOE was associated with a higher risk ratio for clinical evaluation (LOG[RR] = 0.06, CI 0.03-0.09, p-value 0.001) and radiographic evaluation (LOG[RR] = 0.68, CI 0.35-1.00, p-value 0.001). This association was highly significant at 6- and 9-month follow-ups.
UNASSIGNED: Compared with ZOE, Endoflas was associated with a lower risk of the clinical and radiographic failure of deciduous teeth pulpectomy and a 6%-6.8% higher risk ratio, especially at 6- and 9-month follow-ups.
UNASSIGNED: This study suggests the superiority of Endoflas over ZOE as an RCFM for deciduous teeth.

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Early childhood is a critical stage for the prevention of dental caries. The prevalence of caries in preschool children is still high in Taiwan, where National Health Insurance covers 99% of the population. The effort to improve the oral health of preschool children should be based on conceptual model that encompasses more than individual-level factors. This study input nationwide survey data in a conceptual model to evaluate the effects of comprehensive factors related to the high prevalence of caries in preschool children.
This observation study examined factors related to the oral health of preschool children by employing a comprehensive multilevel model to analyse nationally representative data from the Taiwan Oral Health Survey of Preschool Children (TOHPC) 2017-2018. Individual-level, family-level and community-level contextual effects were evaluated through multilevel analysis in this study. The proportional change in variance (PCV) was used to compare the multilevel model with the null model and individual-level, family-level, and community-level context effects.
The estimated deft index for preschool children was 1.34 (1.22-1.47) at age 3, 2.20 (2.08-2.32) at age 4, and 3.05 (2.93-3.18) at age 5. The overall prevalence of caries in preschool children in Taiwan was 34.27% (30.76%, 37.78%) at age 3, 51.67% (48.99%, 54.35%) at age 4, and 62.05% (59.66%, 64.44%) at age 5. The model that included the individual-, family-, and community-context levels exhibited the highest reduction of variance (PCV = 53.98%). The PCV was further reduced to 35.61% when only the level of accessibility to dental services for individuals, families, and the community was considered. For the model in which no community-context cofactors were considered and the model considering only the individual level, the PCVs were 20.37% and 5.52%, respectively.
Our findings indicate the key components that affect oral health in preschool children and can serve as a reference for policy makers. The most notable finding of this study is that to improve the oral health of preschool children, community-level factors should be targeted. To rely solely on dentists for leading oral health education programs for children is impractical and inefficient. Training more professional oral health educators to provide additional community-based oral health promotion campaigns is critical. We suggest training more professional oral health educators to provide more community-based oral health promotion campaigns.

Physiological root resorption of deciduous teeth is a complex physiological process that is essential for the normal replacement of deciduous teeth and permanent teeth in clinical practice, but its importance is often overlooked due to the presence of permanent teeth. This physiological process includes not only the resorption of hard tissues of deciduous teeth, such as dentin and cementum, but also the elimination of soft tissues, such as pulp and periodontal ligament (PDL). However, the mechanisms of physiological root resorption are not yet clear. In this article, the advances of research on the mechanisms related to physiological root resorption will be reviewed in two main aspects: hard tissues and soft tissues of deciduous teeth, specifically in relation to the effects of inflammatory microenvironment and mechanical stress on the resorption of hard tissues, the repair of hard tissues, and the elimination and the histological events of soft tissues.

Early childhood caries has been designated as a serious public health problem. The traditional restoration method is very challenging, especially in uncooperative patients. Non-invasive therapy, like remineralization agents, which have been developed to reverse the demineralization progress at the early stage of caries, may be a better choice. This study aimed to evaluate the remineralization efficacy of different concentrations of 45S5 bioactive glass (BAG) on artifical carious lesions of deciduous enamel.
65 caries-like enamel lesions of the deciduous teeth were assigned to 5 groups (n = 13) and transported to a 14 days pH-cycling: Group A: 2%BAG, Group B: 4%BAG, Group C: 6%BAG, Group D: 8%BAG, and Group E: deionized water (DDW, negative control). 8 sound (Group F) and 8 demineralized teeth (Group G) were prepared for contrast. The recovery power of mechanical property was evaluated by Vickers hardness test through the recovery of enamel microhardness (%REMH). Surface morphology, mass fraction of Ca and P ions, and Ca/P atomic ratio were analyzed by scanning electron microscopy coupled with energy-dispersive X-ray spectroscopy (EDX). Moreover, Fourier transform infrared spectroscopy equipped with attenuated total reflectance was used to identify the chemical structure of newly formed compounds.
% REMH were (42.65 ± 1.35), (52.59 ± 2.96), (57.40 ± 1.72), (52.91 ± 2.55), (12.46 ± 2.81) in 2%BAG, 4%BAG, 6%BAG, 8%BAG, and DDW groups respectively. Micro-spherical particles were deposited in all BAG groups and 6% BAG showed the densest and most uniform surface. EDX analysis identified significantly higher Ca(wt%) and P(wt%) in four BAG groups than in the demineralized group (p < 0.005), while 6% BAG showed the highest mineral gain efficacy. The infrared spectrum demonstrated that newly mineralized crystals were consisted of type-B hydroxycarbonate apatite.
BAG possessed a promising remineralization effect on artificial lesions in deciduous enamel by recovering enamel surface mechanical property, morphology and chemical elements. Among them, 6% BAG performed the greatest overall efficacy. Acting as a new caries-arresting biomaterial, 45S5 BAG has the potential to facilitate the adaptation of better carious prevention strategies in children.

Isolation of high-quality human postnatal stem cells from accessible sources is an important goal for dental tissue engineering. Stem cells from developing organs are a better cell source but are hard to obtain. With extensive caries that are difficult to restore, the extracted deciduous tooth with an immature apex is a developing organ for investigation. In the present study, a cell population from the tip of apical pulp of human deciduous teeth with an immature apex was isolated and termed apical pulp-derived cells of deciduous teeth (De-APDCs). De-APDCs expressed STRO-1, CD44, CD90 and CD105 but not CD34 or CD45. Furthermore, De-APDCs demonstrated a significantly higher clonogenic and proliferative ability and osteo/dentinogenic differentiation capacity than dental pulp cells from exfoliated deciduous teeth (De-DPCs) (P < 0.05). Differentiation potential toward adipogenic, neurogenic and chondrogenic lineages was also observed in induced De-APDCs. In addition, after De-APDCs were seeded into hydroxyapatite/tricalcium phosphate (HA/TCP) scaffolds and transplanted into nude mice, they were able to regenerate dentin/pulp-like structures aligned with human odontoblast-like cells. In conclusion, De-APDCs, which are derived from a developing tissue, represent an accessible and prospective cell source for tooth regeneration.

Probiotics are considered valuable to human health since they improve intestinal microbial balance. Probiotics are orally taken and affect the oral microbiota, which is one of the most important parts of the human microbial community. However, there is little information on the effects of probiotics on the oral microbiota. Caries-free preschool children (N = 6) with complete deciduous dentition were enrolled and given 100 g probiotic yogurt daily for 1 year. Salivary samples were collected every 6 months and then sequenced by Illumina MiSeq system based on 16S rDNA V3-V4 hypervariable regions. The data were analyzed to obtain the changes in microbiota profiles before and after the probiotic yogurt consumption. The α diversity analysis showed that salivary microbial diversity and richness were similar between the groups. The β diversity analysis showed that salivary microbial community structure changed with the consumption of probiotic yogurt. The variation of the microbial community composition was mainly due to 9 genera; for 7 genera (Campylobacter, Haemophilus, Lautropia, Bacillus, Catonella, Lactococcus, and Solibacillus) increased, while 2 genera (Gemella, and Streptococcus) decreased. The variation of salivary microbiota structure and composition with the consumption of probiotic yogurt was revealed. This expands overall insights on the effects of probiotic products on oral microecology. It further provides a basis for predicting possible relations between probiotic interventions and oral health in preschool children.

Nanomaterials can enhance interactions with stem cells for tissue regeneration. This study aimed to investigate the biological effects of tricalcium silicate nanoparticle-containing cement (Biodentine™) during or after setting on stem cells from human exfoliated deciduous teeth (SHED) to mimic clinically relevant situations in which materials are adapted. Specimens were divided into four groups depending on the start of extraction time (during (3, 6 and 12 min) or after setting (24 h)) and extracted in culture medium for 24 h for further physicochemical and biological analysis. After cell viability in serially diluted extracts was evaluated, odontogenic differentiation on SHED was evaluated by ARS staining using nontoxic conditions. A physicochemical analysis of extracts or specimens indicated different Ca ion content, pH, and surface chemistry among groups, supporting the possibility of different biological functionalities depending on the extraction starting conditions. Compared to the \'after setting\' group, all \'during setting\' groups showed cytotoxicity on SHED. The during setting groups induced more odontogenic differentiation at the nontoxic concentrations compared to the control. Thus, under clinically simulated extract conditions at nontoxic concentrations, Biodentine™ seemed to be a promising odontoblast differentiating biomaterial that is helpful for dental tissue regeneration. In addition, to simulate clinical situations when nanoparticle-containing cement is adjusted, biological effects during setting need to be considered.

OBJECTIVE: To explore the histological structure of the deciduous teeth and the tooth germs of Tibetan miniature pigs for studies of dental tissue diseases and tooth regeneration.
METHODS: The structure of the deciduous teeth of Tibetan miniature pigs was observed by X-ray. The ultrastructure of the enamel and dentin of deciduous teeth was characterized by scanning electron microscopy. The jaws and teeth were three-dimensionally reconstructed using Mimics software based on Micro-CT scanning of the deciduous teeth. Image J software was used to calculate the gray value and the mineralization density of the deciduous teeth. Hisotological structure of the tooth germ and the pulp tissue of Tibetan miniature pigs was observed using HE staining.
RESULTS: The deciduous teeth of Tibetan miniature pigs were composed of enamel, dentin and medullary pulp tissue. The permanent tooth germ were formed during the deciduous dentition. The enamel and dentin ultrastructure of deciduous teeth were consistent with that of human deciduous teeth. The enamel and dentin mineralization densities were 2.47±0.09 g/cm3 and 1.72±0.07 g/cm3, respectively. The pathological structures of tooth germ and pulp tissue were similar to those of human teeth, and the pulp tissue of the deciduous teeth was in an undifferentiated state.
CONCLUSIONS: The deciduous teeth of Tibetan miniature pig have similar anatomy, ultrastructure and histopathological structure to human teeth and can serve as a good animal model for studying human dental tissue diseases and the mechanisms of tooth regeneration.

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