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Our aim was to investigate the epidemiology of dental trauma (DT) injuries in primary teeth, a health hazard issue that is often neglected by the public health care system. The records of 298 children who attended the Unit of Dental Care for Special Needs Patients and Pediatric Dentistry, University of Bologna, Bologna, Italy and had suffered a DT between January 2011 and December 2021 were examined to assess age, gender, cause and place of the DT, type of lesion and teeth involved. The chi-squared test was used to compare categorical variables. A total of 265 children (89%) suffered a single trauma, and 33 (11%) suffered from repeated DT. A total of 511 teeth (mean 1.7 ± 0.5) experienced dental trauma. Most of the trauma occurred in the 2–3 years range (153 DT, 30%). The most affected teeth were the upper central incisors (n = 388; 76%). The DT involved periodontal tissue in 316 teeth (62%) and hard dental tissue in 262 cases (51%). DT in primary teeth is commonly caused by accidental falls at home, occurs most frequently to toddlers’ upper central incisors, and usually affects tooth-supporting structures. Clinicians should be aware of the most frequent DT and be updated concerning treatment guidelines.

Objectives: Parents are aware of the importance of anterior tooth esthetics in their children. Children also pay attention to their appearance more than ever. Today, charcoal has been added to toothpastes. Charcoal can help whiten teeth through abrasion. This study aimed to investigate the degree of bleaching and abrasion of charcoal toothpaste on primary teeth. Materials and Method: This in-vitro study was performed on 30 extracted primary teeth. Initially, the samples were polished, cut, and mounted in blocks of putty. The samples were placed in a coffee solution and then the tooth color was measured by a spectrophotometer and the initial surface profile was measured by a profilometer. The samples were brushed back and forth by the brushing machine with 20 gr Bancer, Beverly, and Colgate toothpastes (mixed with 40 ml of distilled water) for 2000 times (equivalent to 3 times a day for 1.5 months). A color determination was performed again and a second surface profile was measured. The data were analyzed by one-way ANOVA, ANCOVA and paired t-test. Results: The results of this study showed that all three Beverly, Bencer and Colgate whitening toothpastes increased the surface profile and made significant statistical changes in the roughness of dental specimens (P=0.01, P=0.005, P=0.001). The statistical study of the data did not show a significant difference between the groups in terms of abrasion and whitening properties (P=0.78, P= 0.99). Conclusion: Three whitening toothpastes whiten primary teeth and increase their surface roughness. These three toothpastes are not statistically different in terms of abrasion and whitening properties.

Objectives Effects of treatment under general anesthesia versus several sessions of at‐office treatment on the transition of caries prevalence from primary to permanent dentitions have not been assessed. Moreover, other gaps exist in the literature. Material and Methods This 4‐group non‐randomized clinical trial was performed on 280 children 8–10 years old in 4 groups, including both negative and positive controls: children with a history of caries in primary teeth who were (1) treated routinely in office (n = 60) versus (2) under general anesthesia versus (n = 110) (3) similar children undergoing no treatment versus (positive control, n = 60) (4) children without a history of primary teeth caries (negative caries, n = 50). A clinical assessment was performed to assess dmft (caries and restoration statuses of primary teeth), OHI‐S (oral hygiene), and ICDAS indexes (caries and restoration statuses of permanent molars). Data were analyzed (α = 0.05). Results There were significant, positive correlations among dmft, caries component of ICDAS, and OHI‐S (p‐values = 0.000). The dmft scores were significantly different across 4 groups (Kruskal–Wallis p = 0.000), with children treated under general anesthesia followed by in‐office treatment and no‐treatment positive control group having the highest dmft scores (all Bonferroni‐adjusted p‐values ≤ 0.013). The ICDAS‐caries of the general anesthesia group was significantly greater than the negative control, but also significantly smaller than both positive control and in‐office treatment group (all Bonferroni‐adjusted p‐values ≤ 0.009). Groups were different in terms of OHI‐S (Kruskal–Wallis p = 0.000); hygiene was the worst in positive‐control and in‐office groups, followed by the anesthesia group and the negative control. Conclusions Although children who underwent treatment with general anesthesia had the worst dmft scores, treatment under general anesthesia considerably reduced caries of their permanent first molars (as indicated by ICDAS scores) and oral hygiene (as indicated by OHI‐S) compared to children who were treated routinely in the office. Primary tooth caries might be a decisive predictor of permanent molar caries formation.

The objective was to determine whether trauma in primary dentition causes alterations in the development of permanent dentition. Searches were made in May 2020 using PubMed, MEDLINE, MEDES, Scopus, Lilacs, and Embase. Papers in English, German, and Spanish, without restrictions in the year of publication, were included. The quality of the studies was analyzed using the NOS Scale. The search retrieved 537 references, and seven studies were included for a qualitative analysis. The results showed that trauma to a deciduous tooth can damage the bud of the permanent tooth. Enamel discoloration and/or hypoplasia were the most common sequelae in the permanent teeth after trauma to the primary predecessor. The type and severity of sequelae in the permanent tooth are associated with the development phase of the bud. Children with trauma of their primary teeth should receive checkups until the eruption of the permanent teeth for the early diagnosis and treatment of possible sequelae. Intrusion of the primary tooth was the trauma that caused the most damage and enamel alterations the most frequent sequelae.

Background Dental plaque causes many common oral diseases (e.g., caries, gingivitis, and periodontitis). Therefore, plaque detection and control are extremely important for children’s oral health. The objectives of this study were to design a deep learning-based artificial intelligence (AI) model to detect plaque on primary teeth and to evaluate the diagnostic accuracy of the model. Methods A conventional neural network (CNN) framework was adopted, and 886 intraoral photos of primary teeth were used for training. To validate clinical feasibility, 98 intraoral photos of primary teeth were assessed by the AI model. Additionally, tooth photos were acquired using a digital camera. One experienced pediatric dentist examined the photos and marked the regions containing plaque. Then, a plaque-disclosing agent was applied, and the areas with plaque were identified. After 1 week, the dentist drew the plaque area on the 98 photos taken by the digital camera again to evaluate the consistency of manual diagnosis. Additionally, 102 intraoral photos of primary teeth were marked to denote the plaque areas obtained by the AI model and the dentist to evaluate the diagnostic capacity of each approach based on lower-resolution photos. The mean intersection-over-union (MIoU) metric was employed to indicate detection accuracy. Results The MIoU for detecting plaque on the tested tooth photos was 0.726 ± 0.165. The dentist’s MIoU was 0.695 ± 0.269 when first diagnosing the 98 photos taken by the digital camera and 0.689 ± 0.253 after 1 week. Compared to the dentist, the AI model demonstrated a higher MIoU (0.736 ± 0.174), and the results did not change after 1 week. When the dentist and the AI model assessed the 102 intraoral photos, the MIoU was 0.652 ± 0.195 for the dentist and 0.724 ± 0.159 for the model. The results of a paired t-test found no significant difference between the AI model and human specialist ( P  > .05) in diagnosing dental plaque on primary teeth. Conclusions The AI model showed clinically acceptable performance in detecting dental plaque on primary teeth compared with an experienced pediatric dentist. This finding illustrates the potential of such AI technology to help improve pediatric oral health.

NOABSTRACTTo evaluate the microroughness of primary and permanent teeth in the initial carious lesion (white spot) area before and after orthophosphoric and hydrochloric acid application.The in vitro study included physiologically exfoliated primary molars and permanent third molars extracted for orthodontic reasons. The teeth were divided into eight groups according to the presence of initial caries lesions, type of dentition, the acid used, and the time of its application. The surface microroughness in the area of the carious lesion, both before and after etching, was assessed using a profilometer, and the results were compared. Carious lesions were etched either with 37% orthophosphoric acid for 30 seconds or with 15% hydrochloric acid for 120 seconds.Higher microroughness values were found in the area of the initial carious lesion compared to the area with intact enamel for both dentitions. The microroughness of the enamel surface in the carious lesion area increased after applying orthophosphoric and hydrochloric acids in both primary and permanent teeth. The highest microroughness was recorded after conditioning with 15% hydrochloric acid. Microroughness data from carious primary and permanent teeth showed increased microporosity after etching with 37% orthophosphoric acid.Etching (with hydrochloric and orthophosphoric acid) of initial carious lesions of primary and permanent teeth significantly increases their microroughness.

Purpose This umbrella review systematically appraised published systematic reviews on Minimal Intervention Dentistry interventions carried out to manage dentine carious primary teeth to determine how best to translate the available evidence into practice, and to provide recommendations for what requires further research. Method An experienced information specialist searched MEDLINE, Embase, Cochrane Database of Systematic Reviews, Epistemonikos, Joanna Briggs Institute Database of Systematic Reviews and Implementation Reports, and the NIHR Journals Library. In addition, the PROSPERO database was searched to identify forthcoming systematic reviews. Searches were built around the following four concepts: primary teeth AND caries/carious lesion AND Minimal Intervention Dentistry AND systematic review/meta-analysis. Searches were restricted to English language, systematic reviews with/without meta-analyses published between January 2000 and August 2020. Two reviewers independently screened all titles and abstracts. Interventions included involved no dentine carious tissue removal (fissure sealants, resin infiltration, topical application of 38% Silver Diamine Fluoride, and Hall Technique), non-restorative caries control, and selective removal of carious tissue involving both stepwise excavation and atraumatic restorative treatment. Systematic reviews were selected, data extracted, and risk of bias assessed using ROBIS by two independent reviewers. Studies overlap was calculated using corrected covered area. Results Eighteen systematic reviews were included in total; 8 assessed the caries arresting effects of 38% Silver Demine Fluoride (SDF), 1 on the Hall Technique (HT), 1 on selective removal of carious tissue, and eight investigated interventions using atraumatic restorative treatment (ART). Included systematic reviews were published between 2006 and 2020, covering a defined time frame of included randomised controlled trials ranging from 1969 to 2018. Systematic reviews assessed the sealing efficacy of fissure sealants and resin infiltration in carious primary teeth were excluded due to pooled data reporting on caries arrest in both enamel and outer third of dentine with the majority of these carious lesions being limited to enamel. Therefore, fissure sealants and resin infiltration are not recommended for the management of dentinal caries lesions in primary teeth. Topical application of 38% SDF showed a significant caries arrest effect in primary teeth ( p  < 0.05), and its success rate in arresting dental caries increased when it was applied twice (range between 53 and 91%) rather than once a year (range between 31 and 79%). Data on HT were limited and revealed that preformed metal crowns placed using the HT were likely to reduce discomfort at time of treatment, the risk of major failure (pulp treatment or extraction needed) and pain compared to conventional restorations. Selective removal of carious tissue particularly in deep carious lesions has significantly reduced the risk of pulp exposure (77% and 69% risk reduction with one-step selective caries removal and stepwise excavation, respectively). ART showed higher success rate when placed in single surface compared to multi-surface cavities (86% and 48.7–88%, respectively, over 3 years follow-up). Conclusion Minimal Intervention Dentistry techniques, namely 38% SDF, HT, selective removal of carious tissue, and ART for single surface cavity, appear to be effective in arresting the progress of dentinal caries in primary teeth when compared to no treatment, or conventional restorations. There is clear need to increase the emphasis on considering these techniques for managing carious primary teeth as a mainstream option rather than a compromise option in circumstances where the conventional approach is not possible due to cooperation or cost.

The aim of the study was to outline a simple, cost-effective technique for obturation of primary tooth root canals. A total of 75 primary teeth were treated in 52 subjects by the technique discussed, i.e. injecting plastic flowable material into the root canals after desired preparation, using disposable needle and syringe. All the patients were followed up for 3 years and 6 months, with no clinical or radiologic evidence of pathology or need for untimely extraction. In conclusion, the technique described is simple, economical, can be used with almost all filling materials used for the purpose, and is easy to master with minimal chances of failure.