The enhancement of the clinical management of growing patients has always been a great challenge for orthodontists and pediatric dentists. In this regard, pediatric orthodontics and dentistry aim to provide complete preventative and therapeutic care for children and teenagers.
New diagnostic and therapeutic tools are available to enhance the diagnosis and treatment plan strategies in various aspects of oral healthcare for children, including diagnosis, treatment, and consulting expertise for newborns, children and teenagers of all ages, and special care needs. These advancements aim to enhance the quality of care, improve patient experience, and promote better oral health outcomes. Also, they reflect the ongoing commitment to improving the oral health and overall well-being of children, with a focus on minimizing discomfort, anxiety, and long-term dental issues. In this regard, pediatric dentists continue to explore innovative approaches to make dental visits more child-friendly and effective. Below, we provide a brief description of the main clinical topics that underwent significant updating in recent years.
Digital Radiography and Imaging. Digital radiography has become a standard tool in pediatric dentistry. It reduces radiation exposure, provides instant images for diagnosis, and allows for better visualization of dental structures. In pediatric dentistry, digital radiography minimizes radiation risks to developing tissues while providing immediate image results for assessing dental and skeletal development, carious lesions, and traumatic injuries. Three-dimensional imaging techniques, such as cone-beam computed tomography (CBCT), offer precise views of dental and craniofacial structures, aiding in treatment planning for complex cases [1,2].
Laser Dentistry. Laser technology has gained popularity in pediatric dentistry due to its minimally invasive nature and reduced discomfort. Lasers are used for procedures like cavity preparation, soft tissue surgeries, and frenectomies [3,4]. They offer a more comfortable experience for children and can minimize anxiety associated with traditional dental drills [5].
Silver Diamine Fluoride (SDF). SDF is a minimally invasive treatment for dental caries [6]. It involves applying a liquid solution containing silver and fluoride to stop the progression of cavities. SDF can be especially beneficial for young children who may have difficulty sitting through traditional restorative procedures [7].
Teledentistry. The integration of telehealth in pediatric dentistry allows for remote consultations, follow-ups, and monitoring of oral health [8]. This approach is particularly valuable for underserved populations and in situations where in-person visits may be challenging [9].
Behavioral Management Techniques. Pediatric dentists have refined their behavioral management techniques to create a positive and less stressful experience for children. This includes techniques like tell–show–do, distraction, and desensitization, as well as the use of child-friendly language and communication [10,11].
Pulpotomy Techniques. Advances in materials and techniques have improved the success rates of pulpotomies in primary teeth, preserving the tooth’s function and structure [12]. This is particularly important in pediatric dentistry, where the focus is on maintaining primary teeth until they naturally exfoliate [13,14].
Sedation and Anesthesia. Pediatric dentists now have a wider range of sedation and anesthesia options to ensure patient comfort and safety during procedures [15]. This includes conscious sedation, deep sedation, and general anesthesia, tailored to the specific needs of each child [16].
Interceptive Orthodontics. Early orthodontic interventions, known as interceptive orthodontics, have gained prominence in pediatric dentistry. Identifying and addressing orthodontic issues in primary dentition can help prevent more severe problems later in life. In this regard, the usage of new materials and devices such as eruption guides or elastodontic devices is becoming more widespread among clinicians for the management of early signs of malocclusion [17,18].
Preventive Care and Education. Pediatric dentists increasingly emphasize preventive care and education. This includes promoting proper oral hygiene practices, dietary guidance, and the use of sealants and fluoride treatments to reduce the risk of cavities [19,20,21,22].
Customized Pediatric Dental Materials and CAD-CAM fabrication. Advancements in dental materials have led to the development of age-specific and pediatric-friendly restorative materials that mimic the natural tooth’s appearance and function. These materials provide better aesthetic outcomes and durability. In pediatric dentistry, this technology enables the fabrication of pediatric-specific restorations that fit accurately and aesthetically, reducing chair time and ensuring optimal clinical outcomes. It can also be used to produce customized orthodontic or functional appliances and, compared to the conventional analogical systems, CAD-CAM devices are digitally designed and produced after careful planning supported by a three-dimensional evaluation of the patients’ characteristics [23,24].
Despite the increasing interest in pediatric dentistry updates, there is still the necessity of future research investigating the effectiveness of new clinical protocols for children. In this regard, the readers of this Special Issue entitled “New Clinical Evidence in Pediatric Orthodontics and Pediatric Dentistry” will be presented with new insights into this new cutting-edge topic in pediatric dentistry.
Conflicts of Interest
The author declares no conflict of interest.
Funding Statement
This research received no external funding.
Footnotes
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References
- 1.Lo Giudice A., Ronsivalle V., Gastaldi G., Leonardi R. Assessment of the accuracy of imaging software for 3D rendering of the upper airway, usable in orthodontic and craniofacial clinical settings. Prog. Orthod. 2022;23:22. doi: 10.1186/s40510-022-00413-8. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Mota de Almeida F.J., Knutsson K., Flygare L. The effect of cone beam ct (cbct) on therapeutic decision-making in endodontics. Dentomaxillofac. Radiol. 2014;43:20130137. doi: 10.1259/dmfr.20130137. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Martens L.C. Laser physics and a review of laser applications in dentistry for children. Eur. Arch. Paediatr. Dent. 2011;12:61–67. doi: 10.1007/BF03262781. [DOI] [PubMed] [Google Scholar]
- 4.Olivi G., Genovese M.D. Laser restorative dentistry in children and adolescents. Eur. Arch. Paediatr. Dent. 2011;12:68–78. doi: 10.1007/BF03262782. [DOI] [PubMed] [Google Scholar]
- 5.Smaïl-Faugeron V., Glenny A.M., Courson F., Durieux P., Muller-Bolla M., Fron Chabouis H. Pulp treatment for extensive decay in primary teeth. Cochrane Database Syst. Rev. 2018;5:CD003220. doi: 10.1002/14651858.CD003220.pub3. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 6.Crystal Y.O., Niederman R. Evidence-based dentistry update on silver diamine fluoride. Dent. Clin. N. Am. 2019;63:45–68. doi: 10.1016/j.cden.2018.08.011. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 7.Surendranath P., Krishnappa S., Srinath S. Silver diamine fluoride in preventing caries: A review of current trends. Int. J. Clin. Pediatr. Dent. 2022;15:S247–S251. doi: 10.5005/jp-journals-10005-2167. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 8.Sharma H., Suprabha B.S., Rao A. Teledentistry and its applications in paediatric dentistry: A literature review. Pediatr. Dent. J. 2021;31:203–215. doi: 10.1016/j.pdj.2021.08.003. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 9.El Tantawi M., Lam W.Y.H., Giraudeau N., Virtanen J.I., Matanhire C., Chifamba T., Sabbah W., Gomaa N., Al-Maweri S.A., Uribe S.E., et al. Teledentistry from research to practice: A tale of nineteen countries. Front. Oral Health. 2023;4:1188557. doi: 10.3389/froh.2023.1188557. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 10.Roberts J.F., Curzon M.E., Koch G., Martens L.C. Review: Behaviour management techniques in paediatric dentistry. Eur. Arch. Paediatr. Dent. 2010;11:166–174. doi: 10.1007/BF03262738. [DOI] [PubMed] [Google Scholar]
- 11.Delli K., Reichart P.A., Bornstein M.M., Livas C. Management of children with autism spectrum disorder in the dental setting: Concerns, behavioural approaches and recommendations. Med. Oral Patol. Oral Cir. Bucal. 2013;18:e862–e868. doi: 10.4317/medoral.19084. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 12.El Meligy O., Alamoudi N.M., Allazzam S.M., El-Housseiny A.A.M. Biodentine(tm) versus formocresol pulpotomy technique in primary molars: A 12-month randomized controlled clinical trial. BMC Oral Health. 2019;19:3. doi: 10.1186/s12903-018-0702-4. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 13.Baliga S. Emerging trends in pediatric dentistry. J. Indian Soc. Pedod. Prev. Dent. 2018;36:107. doi: 10.4103/JISPPD.JISPPD_171_18. [DOI] [PubMed] [Google Scholar]
- 14.Aidasani B., Solanki M., Khetarpal S., Ravi Pratap S. Antibiotics: Their use and misuse in paediatric dentistry. A systematic review. Eur. J. Paediatr. Dent. 2019;20:133–138. doi: 10.23804/ejpd.2019.20.02.10. [DOI] [PubMed] [Google Scholar]
- 15.Vallogini G., Festa P., Matarazzo G., Gentile T., Garret-Bernardin A., Zanette G., Galeotti A. Conscious sedation in dentistry for the management of pediatric patients with autism: A narrative review of the literature. Children. 2022;9:460. doi: 10.3390/children9040460. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 16.Coté C.J., Wilson S. Guidelines for monitoring and management of pediatric patients before, during, and after sedation for diagnostic and therapeutic procedures. Pediatrics. 2019;143:e20191000. doi: 10.1542/peds.2019-1000. [DOI] [PubMed] [Google Scholar]
- 17.Lo Giudice A., Ronsivalle V., Santonocito S., Lucchese A., Venezia P., Marzo G., Leonardi R., Quinzi V. Digital analysis of the occlusal changes and palatal morphology using elastodontic devices. A prospective clinical study including class ii subjects in mixed dentition. Eur. J. Paediatr. Dent. 2022;23:275–280. doi: 10.23804/ejpd.2022.23.04.04. [DOI] [PubMed] [Google Scholar]
- 18.Perillo L., Isola G., Esercizio D., Iovane M., Triolo G., Matarese G. Differences in craniofacial characteristics in southern italian children from naples: A retrospective study by cephalometric analysis. Eur. J. Paediatr. Dent. 2013;14:195–198. [PubMed] [Google Scholar]
- 19.Graif C., Meurer J., Fontana M. An ecological model to frame the delivery of pediatric preventive care. Pediatrics. 2021;148:s13–s20. doi: 10.1542/peds.2021-050693D. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 20.Isola G., Perillo L., Migliorati M., Matarese M., Dalessandri D., Grassia V., Alibrandi A., Matarese G. The impact of temporomandibular joint arthritis on functional disability and global health in patients with juvenile idiopathic arthritis. Eur. J. Orthod. 2019;41:117–124. doi: 10.1093/ejo/cjy034. [DOI] [PubMed] [Google Scholar]
- 21.Jaber M.A. Dental caries experience, oral health status and treatment needs of dental patients with autism. J. Appl. Oral Sci. 2011;19:212–217. doi: 10.1590/S1678-77572011000300006. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 22.Dhanotra K.G., Bhatia R. Digitainers-digital space maintainers: A review. Int. J. Clin. Pediatr. Dent. 2021;14:S69–S75. doi: 10.5005/jp-journals-10005-2040. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 23.Ronsivalle V., Venezia P., Bennici O., D’Antò V., Leonardi R., Giudice A.L. Accuracy of digital workflow for placing orthodontic miniscrews using generic and licensed open systems. A 3D imaging analysis of non-native.Stl files for guided protocols. BMC Oral Health. 2023;23:494. doi: 10.1186/s12903-023-03113-9. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 24.Venezia P., Ronsivalle V., Rustico L., Barbato E., Leonardi R., Lo Giudice A. Accuracy of orthodontic models prototyped for clear aligners therapy: A 3D imaging analysis comparing different market segments 3D printing protocols. J. Dent. 2022;124:104212. doi: 10.1016/j.jdent.2022.104212. [DOI] [PubMed] [Google Scholar]