Increased surface roughness and discoloration of the direct restorative materials used in pediatric patients affect the longevity of restorations and impair children\'s oral health. Many factors can alter these properties. One of these factors is the intake of dietary supplements. It is crucial to predict the properties of restorative materials when exposed to dietary supplements to maintain the dental care of children. Thus, this study aimed to investigate the effect of various syrup-formed dietary supplements on the average surface roughness and color stability of current restorative materials used in pediatric dentistry. Seven different restorative materials (conventional glass ionomer [Fuji IX GP], resin-modified glass ionomer, [Fuji II LC], zirconia-reinforced glass ionomer [Zirconomer Improved], polyacid-modified composite resin [Dyract®XTRA], bulk-fill glass hybrid restorative [Equia Forte HT Fill], conventional resin composite [Charisma Smart], and resin composite with reactive glass fillers [Cention N]) were tested. The specimens prepared from each type of restorative material were divided into five subgroups according to dietary supplements (Sambucol Kids, Resverol, Imunol, Umca, and Microfer). These specimens were immersed daily in supplement solution over a period of 28 days. Surface roughness and color difference measurements were performed at baseline and at the 7th and 28th days. The color difference and Ra values showed that there was an interaction among the type of restorative material, type of dietary supplement, and immersion time factors (p < 0.05). Whereas lower Ra values were found in the composite resin group, the highest Ra values were found in the conventional glass ionomer group. All supplements caused increasing color difference values, and Resverol and Umca showed higher discoloration values above the clinically acceptable threshold. The intake of dietary supplement type, the immersion time of the dietary supplement, and the restorative material type affected the surface roughness and color stability of the tested direct restorative materials. All of the experimental groups showed higher Ra values than clinically acceptable surface roughness values (0.2 µm). The color difference values also increased with the immersion time.

Brazil\'s public healthcare system (SUS) offers specialized oral health services to Brazilians, but the productivity of specialists, such as Pediatric Dentists, has not been characterized. Therefore, the objective of this study was to characterize the outpatient dental procedures (ODPs) carried out by Pediatric Dentists within the SUS. An epidemiological study with an ecological, longitudinal, retrospective, and quantitative approach was conducted. The ODPs carried out by Pediatric Dentists within the SUS were characterized based on type of procedure, complexity level, and circumstance (urgent or elective). Data were analyzed using a descriptive and analytical approach, considering a significance level of 5%, as well as the impact of the COVID-19 pandemic (the 2020-2022 years were not included in secondary analyses). In the last 15 years, 29,234,972 ODPs were carried out by Pediatric Dentists within the SUS. Clinical procedures were the majority (55.4%), significantly more frequent than all other types of procedures (all p <0.05). Among these, restorative and periodontal procedures were the most common (30.7% and 21.0%, respectively). From 2008 to 2019, excluding COVID-19 pandemic years, the trend over the last 15 years was constant for all types of procedures (all p >0.05). In addition, low complexity ODPs were the majority (90.1%), significantly more frequent than medium (9.7%) and high complexity procedures (0.1%) (both p <0.05). At last, most ODPs were not characterized by circumstance in the outpatient production reports (96.9%). Therefore, it was possible to conclude that Pediatric Dentists carried out diverse ODPs within the SUS over the past 15 years, although there was a dominant pattern of type and complexity.

In pediatric and operative dentistry, caries treatment benefits from a therapeutic option based on the use of silver fluoride (AgF) associated with potassium iodide (KI) to avoid dark colorations on dental tissues. The objective of this in vitro study is to evaluate the retention of glass ionomer cement (GIC) on a dentin when treated with AgF and KI. Twenty-two healthy human permanent molars and eight human primary teeth, all free of any decay, were cut to obtain occlusal flat dentinal surfaces and were then treated with AgF for a duration of 60 s. For half of the teeth, a drop of KI was applied for a duration of 30 s. All samples were covered with a plot of GIC and their resistance to shear bond strength was measured. The fracture resistance in both permanent and primary teeth does not show any statistically significant differences whether KI was applied or not. For permanent teeth, the resistance is slightly higher in the group treated with KI than in the group treated with AgF alone. To our knowledge, these data are the first to describe the possible application of KI both on primary and permanent teeth. In any case, further studies are needed to investigate the bond strength between dentin and GIC on a wider range of samples.

UNASSIGNED: Pediatric dental treatment is challenging in patients with early childhood caries. For clinician its difficult to manage child and provide good work at the same time. Its necessity to have the best equipments as well as materials. Nowadays, aesthetics play an important role in managing decayed teeth. Zirconia crown is better option but requires excessive preparation. As Bioflx is newly developed crown and has combined stainless steel and zirconia properties.
UNASSIGNED: To assess the clinical performance and child and parental satisfaction of Bioflex crowns compared to zirconia and stainless steel crowns.
UNASSIGNED: In this comparative study of Bioflx crowns with zirconia and stainless steel crowns, children aged three to seven years old will be selected, and 72 primary teeth requiring crowns will be randomly distributed into three groups, n = 24: Group I: Preformed stainless steel crown, control; Group II: Preformed Bioflex crown; Group III: Preformed zirconia crown. Crowns will be evaluated for recurrent caries, plaque accumulation, restoration failure, gingival status opposing tooth wear, and clinicians and parental satisfaction at zero, three, six, and 12 months.
UNASSIGNED: Bioflx crown will have better clinical as well as parental satisfaction among zirconia and stainless steel crowns.
UNASSIGNED: The Bioflx crown can be used as an alternative economical esthetic full-coronal restoration for primary teeth.
UNASSIGNED: CTRI registration number: CTRI/2023/05/052256; Date of registration: May 03, 2023.
UNASSIGNED: Two; Date: April 22, 2023.

OBJECTIVE: Was to improve the quality of treatment in pediatric outpatient dentistry with the effective use of oral sedation.
METHODS: The study comprised 60 children aged 3-12 years who were undergoing therapeutic/surgical dental treatment. All children\'s somatic state was assessed as ASAI-II. All children met a number of psychological, anamnestic and procedural criteria. Midazolam and chloropyramine in a dose calculated for the patient\'s body weight were used as components of oral sedation. The estimated sedation depth was Ramsay II-III. The study included an analysis of objective (the time of comfortable treatment, the amount of treated or removed teeth per visit, the possibility of treatment without anesthesia during further visits) and subjective (the possibility of contact with the child during treatment, behavioral reactions at home and on further visits) criteria. Negative behavioral reactions and dental effects were also assessed.
RESULTS: The treatment features correlated with the age category and gender of the patient. In the older age group of 7-12 years, the amount of comfortable treatment time was higher, the possibility of contact with the child reached 100% (which is twice as much as in the younger one), and also a larger number of patients were treated during further visits without an anesthetic aid. At the same time, in the younger age group of 3-6 years, the volume of treatment per visit was higher, since it takes less time to treat a primary tooth than for a permanent one. Side effects (visual hallucinations, diplopia, hyperactivity, tearfulness and aggressiveness) were more often recorded in the younger age group, but emotional instability was equally manifested in both groups.
CONCLUSIONS: In order to maximize the effectiveness of using oral sedation as a method, it is necessary to take into account the duration and traumatism of the proposed procedure, the peculiarities of age psychology and the peculiarities of the psychological development of boys and girls.
UNASSIGNED: Улучшить качество лечения детей в амбулаторной стоматологии путем эффективного применения пероральной седации.
UNASSIGNED: В исследование вошли 60 детей в возрасте 3—12 лет, которым предстояло терапевтическое/хирургическое стоматологическое вмешательство. Все дети соответствовали по соматическому состоянию ASA I—II и отвечали ряду психологических, анамнестических и процедуральных критериев. В качестве компонентов пероральной седации использовались препараты мидазолам и хлоропирамин в дозе, рассчитанной на массу тела пациента. Предполагаемая глубина седации — Ramsay II—III. Анализировались объективные критерии: время комфортного лечения, объем лечения за один визит, возможность лечения без анестезиологического пособия при дальнейших визитах; а также субъективные: возможность контакта с ребенком в процессе лечения, поведенческие реакции в домашних условиях и на дальнейших визитах. Также оценивались негативные поведенческие реакции и стоматологические эффекты.
UNASSIGNED: Особенности лечения коррелировали с возрастной категорией и полом пациента. В старшей возрастной категории 7—12 лет была больше величина комфортного времени лечения, возможность контакта с ребенком достигла 100% (что в два раза больше, чем в младшей), а также большее количество пациентов было пролечено при дальнейших визитах без анестезиологического пособия. При этом в младшей возрастной категории 3—6 лет был больше объем лечения за один визит, так как для лечения одного временного зуба необходимо меньше времени, чем для постоянного. Побочные эффекты (зрительные галлюцинации, диплопия, гиперактивность, плаксивость и агрессивность) чаще регистрировались в младшей возрастной категории, однако эмоциональная нестабильность была равно проявлена в обеих группах.
UNASSIGNED: Для наибольшей эффективности использования пероральной седации необходимо учитывать длительность и травматичность предполагаемой процедуры, особенности возрастной психологии и особенности психологического развития мальчиков и девочек.

OBJECTIVE: To compare the effectiveness of two 5% sodium fluoride (NaF) varnishes containing casein phosphopeptide amorphous calcium phosphate (CPP-ACP) (ClinproTM White) or tricalcium phosphate (TCP) (MI Varnish TM) to the conventional 5% NaF varnish (Duraphat®) in preventing early childhood caries (ECC) in high-risk preschool children.
METHODS: A double-blinded, randomized controlled trial recruited healthy 3-4-year-old children (N= 582) having at least one carious lesion (pre-cavitated or cavitated) after obtaining written informed consent from parents. Using a computer-generated random-number table, children were assigned to one of the 3 groups: Control group (n= 196): 5% NaF varnish (Duraphat®) or two test groups: 5% NaF with TCP (ClinproTM White) (n= 193) and 5% NaF varnish with CPP-ACP (MI Varnish TM) (n= 193) to receive quarterly (every 3 months) application over 24 months.
RESULTS: Incidence of new caries over 2 years was 59.2% in MI Varnish TM group (n= 125), 65.1% in the ClinproTM White group (n= 129) and 66.1% in the Duraphat® group (n=127) (p= 0.466). The mean cavitated lesions increment was not significant among the 3 groups (p=0.714), as was the mean increment in non-cavitated carious lesions (p= 0.223). There was no significant difference (p= 0.630) in the distribution of total fluoride varnish applications among the three groups. Also, no significant difference was found in comparison of outcomes among the different number of fluoride varnish applications received by children in each group.
CONCLUSIONS: Both calcium- and phosphate-containing NaF varnishes showed similar efficacy against cavitated and non-cavitated carious lesions as compared to conventional NaF varnish in high-risk preschool children.
CONCLUSIONS: Randomized trial provided a crucial opportunity to advance the understanding of the clinical effectiveness of different fluoride varnishes in preventing early childhood caries. Varnishes containing tricalcium phosphate or casein phosphopeptide amorphous calcium phosphate when compared to sodium fluoride varnish, demonstrated a similar efficacy against early childhood caries in high caries-risk preschool children.

UNASSIGNED: Understanding the orofacial characteristics and growth patterns in children is essential for both orthodontics and research on children with orofacial abnormalities. However, a concise resource of normative data on the size and relative position of these structures in different populations is not available. Our objective was to aggregate normative data to assess the growth of the orofacial skeletal structures in children with a well-balanced face and normal occlusion.
UNASSIGNED: The MEDLINE, Embase, and Scopus databases were searched. Inclusion criteria included longitudinal and cross-sectional studies on cephalometric measurement of skeletal tissues and a study population ≤ 18 years with a well-balanced face and normal occlusion. Key study parameters were extracted, and knowledge was synthesized. A quality appraisal was performed using a 10-point scale.
UNASSIGNED: The final selection comprised of 12 longitudinal and 33 cross-sectional studies, the quality of which ranged from good to excellent. Our results showed that from childhood to adulthood, the length of the cranial base increased significantly while the cranial base angle remained constant; both the maxilla and mandible moved forward and downward. The profile becomes straighter with age.
UNASSIGNED: Growth patterns in children with a well-balanced face and normal occlusion follow accepted theories of growth.

UNASSIGNED: This randomized clinical trial aimed to evaluate the impact of DryShield isolation (DSI) and rubber dam isolation (RDI) system usage on vital signs, behavior, pain and discomfort, and chairside time required among children with different airway patencies based on the Modified Mallampati Classification (MMC).
UNASSIGNED: Healthy, cooperative children who required fissure sealant in at least two contralateral, fully erupted, permanent first molars were included. Airway patency was determined by two trained and calibrated dentists using the MMC. The participants were categorized based on their MMC scores into patent airways (classes I and II) and non-patent airways (classes III and IV). The dental procedure was videotaped during treatment, and vital signs, including arterial oxygen saturation, heart rate, and blood pressure, were recorded every 3 min. The participants\' subjective pain and discomfort were evaluated using a previously validated Arabic interview questionnaire and a validated Arabic version of the Wong-Baker Faces Pain Rating Scale. The participants\' behavior and behavioral pain were evaluated utilizing the Frankl Behavior Scale and the face, legs, activity, cry, and consolability scales, respectively.
UNASSIGNED: There were no significant differences in any of the vital signs between DSI and RDI. DSI use yielded a significant reduction in chairside time (P < 0.001) and was more bothersome (P < 0.001) than RDI use among all participants, regardless of airway patency. DSI was associated with significantly better behavior during the dental procedure (P = 0.002) and less behavioral pain (P < 0.001) among all participants, regardless of airway patency.
UNASSIGNED: Irrespective of airway patency, DSI outperformed RDI in terms of behavior, pain, and procedure duration; however, DSI was characterized by noise, pressure on soft tissues, and an increased tendency to induce gag reflexes.

Introduction Putting in stainless steel crowns as a post-endodontic restoration and space maintainers as a post-extraction appliance to maintain the space for the eruption of underlying teeth in case of early loss in children are some of the most commonly practised procedures that pediatric dentists undertake in their day-to-day lives. Maintaining good oral hygiene for better gingival health is important. If it is not taken care of, gradual destruction of supporting soft and hard tissues of the teeth occurs. There were numerous studies conducted over the past few years, but no split-mouth study compares the crowns and bands. Hence, this study compares the gingival health between stainless steel crowns and band and loop space maintainers. Materials and methods This split-mouth randomised controlled trial included 31 children aged between four and nine years who had stainless steel crowns on one side and a band and loop space maintainer on the other side of the mandibular arch. The split-mouth study was carried out to minimise the outcome bias as oral hygiene practices differ from one individual to another. Presence/absence of bleeding on probing (BOP) and the Gingival Index (GI) using the Loe and Silness GI were assessed at baseline and at six months. Data was entered in an Excel sheet (Microsoft Corporation, Redmond, Washington, United States) and analysed in IBM SPSS Statistics for Windows, Version 23, (Released 2015; IBM Corp., Armonk, New York, United States). The significance level was fixed as 5% (α = 0.05). The Shapiro-Wilk test was used to assess the normality of parameters of gingival health. The parameters are described in terms of mean, standard deviation, frequency and percentages. Intragroup analysis was done using Friedman tests across the timelines. Intergroup analysis using Mann-Whitney U tests was done between the groups at different timelines.  Results At the beginning of the study, 46 children (22 girls and 24 boys) were enrolled considering the dropout. However, 15 children did not attend the follow-up review, resulting in a loss to follow-up. Consequently, only 31 children, each with a band and loop space maintainer and a stainless steel crown, were included for the final interpretation of the results in this study. At one month, both BOP and GI were significantly different (p<0.05) between the stainless steel crown and stainless steel band where the crown showed better gingival health and absence of bleeding than the band and loop. At three months and six months, gingival health improved in both groups, but there was no significant difference between the groups. The Friedman test revealed that both the stainless steel crown and stainless steel band groups had a significant difference at six months from baseline. Mann-Whitney tests were done to analyse the difference in parameters at baseline and at six months between both groups. There was no significant difference in the baseline in the parameters between the groups. Conclusion Within the limitations of the study, this study concludes that the gingival health based on BOP and GI shows a significant difference across the timeline within the groups, namely, stainless steel crown and stainless steel band, but no significant difference between the groups at various timelines.

Pediatric dentistry plays a critical role in ensuring the oral health and well-being of children and adolescents. The quest for effective dental materials that are safe, biocompatible, and capable of promoting natural remineralization has led to the emergence of biosilicate cements as a promising advancement in this field. Biosilicate cements are bioactive materials composed of amorphous silica, calcium oxide, phosphorus pentoxide, and other trace elements. The bioactivity of biosilicate cements allows them to interact with living tissues, promoting remineralization and stimulating the formation of hydroxyapatite, a vital component of teeth and bones. Their ability to release essential ions, such as calcium, phosphate, and fluoride, supports the natural healing processes, aiding in the preservation of pulp vitality and reducing the risk of secondary caries. Biosilicate cements offer versatility in pediatric dentistry, finding application indirect pulp capping, indirect pulp capping, and small-sized restorations. Their rapid setting time proves advantageous when treating young patients with limited cooperation. Furthermore, the continuous release of fluoride contributes to caries prevention and enhances the long-term oral health of children. While the advantages of biosilicate cements in pediatric dentistry are promising, this manuscript also discusses the limitations and challenges associated with their use. Some biosilicate cements may have different handling characteristics compared to traditional materials, necessitating adaptations in clinical techniques. In addition, long-term clinical data on the performance of these materials in pediatric patients are still limited, requiring further research to establish their efficacy and longevity. This manuscript explores the potential of biosilicate cements in pediatric dentistry.