Simulation of three intraoral radiographic techniques in pediatric dental patients: subjective comfort assessment using the VAS and Wong-Baker FACES Pain Raiting Scale

Perception of Pain With Bitewing, DIAGNOcam, and Teeth Separation Amongst Children

BACKGROUND

This study evaluated the pain and discomfort associated with 3 diagnostic techniques for proximal carious lesions in children aged 5 to 8 years: bitewing (BW) radiographs, DIAGNOcam, and temporary teeth separation.

METHODS

The study included 60 healthy children between the ages of 5 and 8 years who had no prior history of dry mouth or mouth breathing, were definitely positive or positive based on Frankl Behavioral Rating Scale, had at least one pair of matched bilateral primary molars and/or permanent first molars in close contact with the adjacent tooth, and were free of restorations and frank cavitation. Each patient evaluated all 3 techniques. The pain and discomfort ratings were obtained by the Wong-Baker FACES Pain Rating Scale immediately after taking 2 standardised BW radiographs or undergoing use of DIAGNOcam and 2 days after temporary teeth separation with elastic separators by a single trained and experienced paediatric dentist.

RESULTS

The DIAGNOcam procedure resulted in much higher pain and discomfort (3.69 ± 3.10) than the other 2 diagnostic techniques. Within-participant pain and discomfort scored significantly higher with DIAGNOcam compared to BW radiographs (P < .001) and temporary teeth separation (P = .002).

CONCLUSIONS

The DIAGNOcam diagnostic technique caused much more pain and discomfort than BW radiographs and temporary teeth separation using orthodontic elastic separators. The report is part of a randomised clinical trial that was registered at www.

CLINICALTRIALS

gov under the identifier NCT03685058.

Assessment of Perception of Pain with E-Speed Film, CCD Sensor and Photostimulable Phosphor Plates for Intraoral Radiographs in Children using Three Pain Rating Scales

BACKGROUND

Dental radiography is an integral part of intraoral evaluation. Children are often uncomfortable during the placement of film or sensor due to the impingement of the soft tissues. Thus, the perception of pain with three intraoral radiographic methods in children was evaluated using three subjective pain rating scales.

AIM

To evaluate the discomfort with three different techniques, that is, intraoral periapical (IOPA) radiograph, charge-coupled device (CCD), and photostimulable phosphor (PSP) luminescence (PSPL), using the Wong-Baker Faces Pain Rating Scale (WBFPRS), numerical rating scale, and visual analog scale (VAS).

MATERIALS AND METHODS

A sample of 35 children aged 6-12 years were divided into two groups: group 1 (6-8 years) and group 2 (9-12 years). For each child, simulations of the three radiological methods (IOPA, CCD, and PSPL) were performed. The meaning of each facial expression on the WBFPRS, VAS, and the numbers on the numerical rating scale was explained to each child before the procedure.

STATISTICAL ANALYSIS USED

A one-way analysis of variance (ANOVA) test and paired-samples t-test are used.

RESULTS

The results revealed that the CCD sensors elicited higher pain scores than those obtained with IOPA and PSPL, whereas the IOPA film showed the least pain score. Higher score values were obtained in group 1 than in group 2, indicating that children aged 6-8 years felt higher discomfort than the 9- to 12-year age group for the same procedure. This difference was statistically significant (P < 0.001).

CONCLUSION

It was concluded that conventional IOPA films were tolerated better by children when compared to PSP plates and CCD sensors.

Clinical Performance of Diagnostic Methods in Third Molar Teeth with Early Occlusal Caries

The aim of this study was to compare the diagnostic performance of clinical visual examination (ICDAS II), digital periapical radiography (PR), near infrared light transillumination (NIR-LT), and laser fluorescence (LF) to microcomputed tomography (Micro-CT) which is the reference standard for the detection of non-cavitated occlusal enamel and dentin caries in third molar teeth. Potential participants were consecutively recruited. In this prospective study, 101 third molars of 101 patients were examined; the molars had non-cavitated occlusal caries which required extraction. ICDAS II, PR, NIR-LT and LF examinations were carried out by two blinded examiners. Reference standard was determined by micro-CT imaging seven days after extraction. Accuracy rate, sensitivity, specificity, predictive values and areas under receiver operating characteristic (ROC) curves (Az) were statistically analyzed. Nonparametric variables were subjected to the Kruskal−Wallis Test. Significance level was set as p < 0.05. NIR-LT had the highest sensitivity (99.67−99.67%) and accuracy (78.22−77.23%) for the determination of occlusal enamel caries according to examiners 1 and 2, respectively. LF method had the highest sensitivity (70.83−54.17%) and accuracy (66.34−59.41%) for determining occlusal dentin caries according to examiners 1 and 2, respectively. The ROC curve (Az) value ranged between 0.524 and 0.726 for the different methods tested. Most effective methods for the diagnosis of occlusal enamel and dentin caries were determined to be NIR-LT and LF pen methods, respectively. The present prospective clinical study showed that NIR-LT and LF-Pen were a reliable modality for the detection of occlusal enamel and dentin caries without ionizing radiation.

Study Regarding the Optimal Dimension of Intraoral Bitewing Radiographs in Patients with Primary Dentition

The aim of this study was to determine the optimum dimensions of a radiographic plate to allow correct visualization of dental tissues and correct fit in the oral cavity of children with deciduous dentition. A quasi-experimental clinical study was carried out in children of both sexes aged between 3 and 5 years. The study variables were the complete visualization of the dental structures, the surveillance of ischemia on soft tissues, stimulation of the gag reflex, and acceptance of the radiographic plate by the pediatric patient through a validated visual analogue scale that measures anxiety. The data obtained were subjected to a descriptive and comparative statistical analysis carried out for both study phases. A total of 80 children participated in the study. The optimal dimensions obtained for the radiographic plate were 19.5 mm in height and 27.3 mm in width. Visualization of the dental tissues during both phases was not statistically significant (p = 0.412). However, there were statistically significant differences regarding the presence of ischemia, gag reflex, and child rejection (p < 0.001). A smaller radiographic plate allows correct visualization of the coronal dental tissues without causing rejection, ischemia, or gag reflex in patients in the deciduous dentition.

Optical Coherence Tomography for Patients with Developmental Disabilities: A Preliminary Study

Dental radiographs are essential for diagnosis and treatment planning, but are sometimes difficult to acquire for patients with developmental disabilities (PDD). Optical Coherence Tomography (OCT) is a non-ionizing imaging modality that has the potential application as an alternative to dental radiographs for PDD. This study aimed to determine the feasibility of intraoral OCT imaging for PDD. Ten participants were recruited in the Dental Education in the Care of Persons with Disabilities (DECOD) Clinic to explore the utility of dental OCT. The prototype system (Yoshida Dental) creates in-depth and three-dimensional images of teeth. The participants indicated their degree of pain during imaging on the Wong-Baker FACES Pain Rating Scale, and the degree of discomfort after imaging on a visual analog scale. OCT can be used for patients with developmental disabilities with minimal levels of pain and discomfort, without ionizing radiation.

The music video therapy in postoperative analgesia in preschool children after cardiothoracic surgery

OBJECTIVES

To observe the effect of music video (MV) therapy on early postoperative pain in preschool children after cardiothoracic surgery.

METHODS

116 preschool children undergoing cardiothoracic surgery were randomly divided into the MV and control groups from June 2019 to March 2020. The related vital signs parameters, the Wong-Baker FACES pain rating scale, the FLACC scale, the number of postoperative PCA press and the cumulants of sufentanil use were recorded and analyzed.

RESULTS

There were no statistically significant differences in general characteristics and preintervention data between the two groups. However, there were significantly lower in the heart rate, mean arterial pressure, respiratory rate, the number of postoperative PCA press, and the dosage of sufentanil in the MV group than those in the control group after the intervention. The Wong-Baker FACES and FLACC scales in the MV group were significantly lower than those in the control group at the time point of immediately after the first intervention, 1 day, and 2 days after the intervention. The two pain scores showed a downward trend over time, and the corresponding scores in the MV group were better than those in the control group.

CONCLUSION

MV therapy can be an effective nonpharmaceutical intervention in the clinical to relieve children's postoperative pain after cardiothoracic surgery.