Rickets is a medical condition caused by vitamin D deficiency, typically caused by inadequate dietary intake, limited sun exposure, or, less commonly, genetic disorders. While skeletal abnormalities are the hallmark of rickets in children, oral manifestations, such as recurrent dental abscesses occurring in the absence of carious lesions, can also be observed. This report describes the case of a child presenting with oral features suggestive of hereditary rickets, despite the lack of skeletal abnormalities and without a confirmed genetic aetiology. Histological and microstructural analyses of dental tissues played a key role in guiding the diagnosis, ultimately leading to referral to a paediatrician and confirmation of vitamin D deficiency. A 4-year-old male presented to the Emergency Dental Department of a paediatric clinic with a history of spontaneous dental abscesses. Three affected primary teeth, extracted for clinical reasons, were comprehensively analysed using micro-computed tomography, scanning electron microscopy, energy-dispersive X-ray spectroscopy, and optical microscopy. Investigations revealed an enlarged pulp chamber, pulpal calcifications, extensive interglobular dentine, and porous, hypomineralised enamel. Additionally, an irregular and poorly defined dentino-enamel junction was observed, along with abrupt spatial variations in mineral composition. The findings are consistent with defective biomineralisation. Subsequent biochemical testing confirmed vitamin D deficiency in the absence of a detectable genetic cause. The patient was supplemented with vitamin D and calcium, resulting in clinical improvement. Vitamin D deficiency profoundly impairs the development and mineralisation of dental hard tissues, including both enamel and dentine. These alterations compromise the structural integrity of teeth and may increase the risk of spontaneous dental abscesses. Early identification of such oral manifestations is critical for prompt diagnosis and appropriate management.

When planning dental treatment, particularly in orthodontics, the timing and order of tooth eruption (TE) are crucial considerations. It has been noted that fluctuations in body weight have garnered increasing scientific interest due to their potential impact on TE. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. An online database search was conducted using the keywords "dental eruption" AND "weight". A total of 14 relevant papers were scrutinised. Various population and age range were employed in different studies to evaluate surface roughness, color change, and surface fracturing. Numerous studies have investigated the impact of BMI on dental eruption, with findings suggesting a positive correlation between being overweight or obese and early tooth eruption. Understanding these relationships is crucial for identifying at-risk populations and developing effective public health interventions aimed at promoting optimal oral health outcomes worldwide. Further research is needed to comprehensively unravel the underlying mechanisms and implications of these associations.

This study explored the association between overprotective parenting and children's behaviour during dental treatment, toothbrushing behaviour and children's dental caries experience in the Netherlands. Overprotective parenting is significantly associated with more disruptive behaviour of children during dental treatment and more difficult toothbrushing behaviour.

To analyse the role of prevention, early diagnosis, and treatment timing in orthodontics, with a focus on preventive orthodontic treatment in the growing patient. A narrative literature review was performed, combined with clinical evidence. Diagnostic criteria in deciduous and mixed dentition, evaluation of occlusal indicators, oral habits, and radiographic and photographic records were analysed. Literature sources included PubMed, Scopus, and EJPD publications on prevention, early orthodontics, interceptive treatment, and treatment timing. Early identification of malocclusion patterns such as cross-bites, increased overjet, and skeletal Class III discrepancies is essential for targeted interventions. Evidence demonstrates benefits in reducing traumatic risk, improving psychosocial outcomes, and simplifying future orthodontic treatment. Up to 15% of malocclusions can be completely corrected and nearly 50% improved with interceptive measures in mixed dentition. The correct timing of intervention represents a pivotal clinical variable: decisions must be based on growth status, risk evaluation, and evidence of effectiveness and predictability. Prevention, early diagnosis, and treatment timing are key factors in paediatric orthodontics. Timely preventive orthodontic treatment can correct skeletal and dental discrepancies, reduce trauma risk, and improve quality of life. Clinical decisions must be evidence-based and personalised, avoiding unnecessary overtreatment. Therapeutic methods must be effective and efficient in achieving the treatment goals and, above all, must not interfere with the health of growing patients.

This study examined maternity ward indicators associated with exclusive breastfeeding prevalence (EBFP) for six months, including diagnosis and treatment of ankyloglossia and indicators associated with the evaluation of the latter. An online survey assessed mothers' breastfeeding experiences during the COVID-19 pandemic. The study enlisted 2,540 mothers in Portugal who had given birth at least once between 1 January 2020 and 31 December 2022. An online survey was circulated via social media during August 2023 with closed questions regarding mothers' breastfeeding experiences and questions on the evaluation, diagnosis, and treatment of ankyloglossia. Poisson regressions were performed. Positive measures in the maternity ward, such as breastfeeding support, skin-on-skin contact, along with early initiation of breastfeeding within the first hour after birth, contribute to EBFP for up to six months and evaluation of the lingual frenulum. These findings underscore the importance of consistent breastfeeding support and highlight an increased emphasis on ankyloglossia assessment during the COVID-19 pandemic.

The aim of this research is examining the effectiveness of Virtual Reality (VR) in the reduction of dental anxiety in children with novel methods. The three arm parallel-group randomised clinical study was conducted in children aged 6-10 years. Pulpotomy procedure was performed on randomised 90 selected children (n=30 in each group; AG: group applied active distraction using VR glasses, PG: group applied passive distraction, i.e., watching cartoons on a screen mounted onto a dental unit, CG: control group). Before and after the procedure, children were administered Facial Pain Scale (FIS), Children's Fear Rating Scale (CFSS-DS) and Frankl Behaviour Rating Scale (FBRS). The pulse rate was measured to check the anxiety levels of all treated children at five different time points. Statistical significance was determined as p<0.05. VR has been found to positively contribute to the performance of children in adapting to dental treatment. The VR application aims to create positive attitude in children by providing them a safe atmosphere and becoming a useful tool in the dental profession.

The present systematic review and meta-analysis (Prospero registration number: CRD42023472016) aims to assess the prevalence of developmental defects of enamel (DDEs), qualitatively and/or quantitatively, in childhood cancer survivors (CCS) and evaluate, when possible, these data in comparison with those found in healthy children. Three electronic databases (PubMed, Embase, Scopus) were searched from January 2003 to January 2024 for studies reporting on DDEs in children with a mean age not exceeding 16 years at the time of the study who underwent antineoplastic therapy. The ROBINS-I and the Joanna Briggs Institute (JBI) tools were used to assess the risk of bias. Included studies with comparable outcomes underwent random effects models meta-analysis using Stata®18. CCS showed a higher prevalence of DDEs, both qualitative and quantitative, compared to healthy children. The meta- analysis showed higher odds of developing qualitative defects over quantitative defects in CCS. Conclusions regarding the association between the type of therapy administered, age of therapy initiation, and prevalence of DDEs could not be drawn due to insufficient data. A lack of a standardized method of detecting enamel defects posed a challenge in the qualitative and quantitative analysis.

Infraocclusion refers to a tooth located below the occlusal surface compared to adjacent teeth long after it should have reached occlusion. Ankylosis is frequently associated with the infraocclusion of primary molars, but it is challenging to distinguish between the two conditions. Surgical luxation and orthodontic traction have been applied for the treatment of ankylosed, infraoccluded permanent teeth, but reports on primary molars are scarce. A 5-year-old boy presented with a severely infraoccluded primary mandibular second molar with deep caries. A partial pulpotomy was performed to treat the affected tooth when the pulp was exposed after caries removal. A combination of surgical luxation and orthodontic tractionwas performed for the affected tooth, and after 5 months, the tooth successfully erupted to the occlusal level. During the follow-up period of two years, no complications were observed. This report identified that surgical luxation, in conjunction with orthodontic traction, is effective and feasible for severely infraoccluded primary teeth. Additionally, partial pulpotomy may be an alternative for vital pulp therapy on primary teeth.

Dental caries is a common oral disease in children with special needs such as those with autism spectrum disorders (ASDs). The aim is to assess whether the type and survival of three caries management, conventional resin restorations (CR), ART technique (ART) and SDF application without caries removal (SDF), in primary teeth carried out at the Pediatric Dentistry Department of San Paolo Hospital (University of Milan) differed between children with ASDs and unaffected peers. Data from a convenience sample of children with and without ASDs, who have received dental care for caries in primary teeth from January 2019 to June 2022, were analysed. Medical history, age, sex, teeth treated, and type of treatment were collected from dental charts. Data on success and minor and major failures of each treatment were also collected. Two survival analysis were performed, one considering both major and minor failures, a second considering only major failures. Cox Proportional Hazards multivariate logistic models were run to assess factors associated with failures. The statistical significance was set at 5% (p< 0.05). In children with autism, the different techniques for approaching caries lesions seem to have the same probability of success. Therefore, the choice of treatment should be patient-oriented rather than lesion-oriented. In unaffected children, the gold standard always seems to be traditional restorative treatment.

Orofacial trauma (OFT) occurs frequently in children and requires thorough evaluation not only by paediatric dentists but also by all specialists involved in emergency services, particularly in cases involving children under 3 years of age, given their inability to directly participate in clinical-anamnestic evaluations. Addressing early childhood orofacial trauma resulting from maltreatment, this study explores the key role played by various healthcare professionals, including paediatric dentists, general dentists, maxillofacial surgeons, dental hygienists, and paediatricians, in the optimal management of these cases. In the event of trauma due to suspected or confirmed mistreatment, it is essential that all healthcare workers involved have precise knowledge of the appropriate course of action from both a clinical and legal point of view, guaranteeing maximum protection for the young patient. This is particularly significant as cases of mistreatment with apparently minor consequences can degenerate into situations of irreparable severity. The latest guidelines from the International Association of Dental Traumatology (IADT) in 2020 continue to emphasise the potential correlation between OFT and cases of abuse or violence. Recent recommendations in the literature highlight the importance of facilitating mandatory reporting of incidents to relevant authorities and improving information sharing between dental healthcare professionals and child welfare services. A new flow diagram, called Paediatric Orofacial Trauma Alert (P.O.T.A.), has been proposed at the University of Verona. This tool is specifically designed to assist specialists dealing with early childhood orofacial trauma cases by assisting them in identifying potential cases of maltreatment. In this innovative approach, the collaborative efforts of general dentists, paediatric dentists, maxillofacial surgeons, dental hygienists and paediatricians play a vital role in cases of abuse. In addition to restoring the oral health of young patients, these professionals can activate a vast network of contacts, ensuring not only optimal oral health care but also providing comprehensive support to victims. The objective is to safeguard not only the physical but also the psychological well-being of these vulnerable subjects.