To evaluate the frequency and distribution of dental anomalies (DA) in a paediatric population. Panoramic digital radiographs of children between 6 and 12 years old performed at a reference centre for radiographic exams were accessed. Two calibrated examiners evaluated the radiographs. The association between variables and outcomes was assessed using non-parametric tests. The significance level was set at 5%. Five hundred and twelve individuals were included and 61.3% presented at least one DA. The mean age of patients with DA (9.35±1.60) was significantly higher compared to patients with no anomalies (7.90±1.58). Patients with supernumerary tooth, however, were significantly younger. The most frequent DA were permanent tooth radicular dilacerations (38.1%), permanent tooth agenesis (29.3%), supernumerary tooth (6.4%) and impacted tooth (6.4%). Anterior teeth and female patients were more affected by radicular dilacerations. Dental agenesis was more frequent in the third molars followed by the upper lateral incisor. DA are quite frequent in the paediatric population and the most common DA observed herein could only be identified through imaging exams. The most appropriate timing to perform an investigation for the detection of dental anomalies appears to be between 9 and 10 years old.

A psychological behaviour management programme with information and communications technology was developed that includes symbolic modelling, tell-show-do, positive reinforcement and distraction, and provides real-time treatment information. We hypothesised that the programme would help patients feel less stressed and show less uncooperative behaviours and subjective pain. Forty-eight paediatric patients were recruited from May 2016 to January 2017, and randomly divided into a control group and an experimental group. In the control, patients watched cartoon animations during the first and second treatments. The experimental group watched cartoon animations during the first treatment, and they used the programme during the second treatment. To measure stress, uncooperative behaviour and subjective pain, we recorded the heart rate, Procedure Behaviour Checklist (PBCL) and Wong and Baker's Faces Pain Rating Scale (FPRS). The experimental group resulted in a significantly lower mean heart rate, uncooperative behaviour and subjective pain in the second treatment than did the control group (p<0.001). The differences in heart rate and uncooperative behaviour between the treatments were also significantly greater in the experimental group than in the control group (p<0.001). The programme was effective in relieving fear and anxiety as well as learning cooperative behaviour.

The European Journal of Paediatric Dentistry (EJPD) has reached the extraordinary Impact Factor of 1.5 (Journal Citation Reports 2020 Release), passing in few years from 0.421 in 2015, when Luigi Paglia became Editor in Chief, taking over the Journal after Giuliano Falcolini. EJPD is the official journal of the Italian Society of Paediatric Dentistry (SIOI), but its scientific value and diffusion made it an authoritative reference source not only in Europe, but also worldwide. This is the result of the great work and commitment of the Editorial Board, composed by national and international experts, with the collaboration of the Managing Director Giuseppe Marzo and of the editorial staff. The prominent position that EJPD has gained in the international ranking of dental journals, where the top tier is dominated by those that mainly focus on adult patients, rewards its constant pursue of excellence of the scientific approach, giving at the same time great importance to articles dealing with everyday practice. This is the reason why the papers published in the EJPD are so rich in images. Communication through images is paramount for the current generation and generations to come. Digital diagnostic instruments and advanced treatments, 3D technologies, the current concepts of aerosol and no aerosol technique, together with the progress in the field of new dental materials, like bioactive cements for paediatric restorations or new biocompatible technopolymers (milled or 3D printed) for dentofacial orthopaedics and orthodontics are areas of great interest. We believe that our Journal should pay special attention to papers that take into account the overall health and wellness of the child using safe and efficient preventive, therapeutic or comfort techniques (laser, ozone, relative analgesia, caries diagnosis with transillumination, etc), also considering the importance of environmental conditions and promoting the collaboration with other specialists, with a focus on special need patients. EJPD also aims at guiding young paediatric dentists-graduating from postgraduate schools and residency programmes in paediatric dentistry-with a more comprehensive approach to the practical aspects of the profession, while striving to become the global scientific reference point of maternal and child oral care, defending them from the attractive flatteries of the predatory journals.

To identify factors associated with negative child behaviour in the dental setting. A cross-sectional study was conducted with a sample of 324 mother-child pairs (children aged 3 to 12 years) seen at a university clinic in Canoas, southern Brazil. Mother's anxiety was measured using the Beck Anxiety Inventory. Oral examinations were performed to determine caries experience (dmft/DMFT index) in the mothers and children. Child behaviour was evaluated at six moments of the dental visit using the Frankl scale. Statistical analysis involved Poisson regression with robust variance. The prevalence of negative child behaviour was 9.3%, with a greater frequency among younger children, those with no previous use of dental services and those whose mothers exhibited a moderate to severe level of anxiety. The multivariable analysis demonstrated that the probability of negative behaviour was 2.4-fold greater among children who had not previous dental services attendance (PR = 2.37, 95% CI:1.13-4.95; p=0.022) and 3.1-fold greater among those whose mothers had a moderate to severe level of anxiety (PR = 3.08, 95% CI:1.64-5.75; p<0.001). Mother's anxiety, younger age and no previous history of visiting a dentist are associated with negative behaviour during a dental appointment and therefore merit special attention.

The aims of this study were: To evaluate oral health conditions, oral health behaviours and eating habits in Wilson's disease (WD) patients; to assess the possible relationship between oral health status and long-term pharmacological therapies undertaken. Sixty WD patients were selected and their data were compared to those of an age-matched control group of 62 subjects. Clinical examinations were carried out and a questionnaire on oral health behaviours and eating habits was submitted to both groups. WD patients were interviewed on long-term pharmacological therapies undertaken. Statistical analysis was performed. The mean DMFT value was 3.75±4.65 in the WD group and 2.81±4.65 in the control group. The difference in the mean DMFT value between the two groups was not statistically significant. Modified Dental Enamel Defects (DDE) Index showed significantly higher values in WD group than in control group. No statistical differences in Visible Plaque Index (VPI), Gingival Bleeding Index (GBI) and malocclusions were observed between groups. In relation to the questionnaire, the differences between groups were statistically significant for: dental visits in a year; brushing teeth after a snack; drinking soft beverages; using mouthwash. For WD patients no statistical correlation between oral health status and long-term pharmacological therapies undertaken was observed. WD patients did not show worse oral health conditions than the control group, despite worse oral health behaviours and eating habits. Nerveless, WD patients showed higher presence of dental enamel defects. Finally, for WD group oral health status was not correlated to the long-term pharmacological therapies.

The aim of the present report was to highlight historical and bibliometric aspects of fluoride in dentistry. Study design: In the first part of the manuscript, history of fluoride has been reported. In the second part, some bibliometric considerations have been explained. The historical research evaluated the first documents about fluoride in dentistry. The bibliometric research considered Scopus-indexed documents from 1945 to 2019. Historical search showed the consistent presence of documents since 1803, even if modern research started in the 1930s. Descriptive statistics of documents about fluoride showed a constantly increasing interest on the topic, starting from 1965 to nowadays. The topic of fluoride has a long history in dental practice, and future interesting research is needed in order to combine this well-known inorganic, monatomic anion with new emerging technologies.

As the effects of infraocclusion on mandibular growth could have a significant impact on the treatment planning made by the orthodontist, the aim of this study is to evaluate the correlation between infraocclusion and mandibular growth. Study design: A total of 42 healthy Caucasian patients with no history of dental trauma or orthodontic treatment were selected for this study from the same paediatric dentistry department. These patients were divided in two groups based on the presence or absence of infraocclusion: Group A, 22 patients (12 males and 10 females) suffering from infraocclusion of at least one inferior deciduous molar, and Group B, 20 patients (9 males and 11 females) who did not suffer from infraocclusion but had to be treated for dental overcrowding. Each patient was examined through an orthopantomography scan and lateral cephalogram. All measurements were made before the start of the treatment, and they were analysed in order to show cephalometric correlation between the skeletal class, the vertical dimension and cranio-maxillo-mandibular divergence. According to Student's t-test, the only measurements which had a statistically significant difference between Group A and Group B were the SNB angle (p-value <0.01), the ANB angle (p-value <0.05) and the PC-GO-GN angle (p-value <0.05). From the data collected in this study, it is possible to conclude that patients suffering from infraocclusion of the mandibular deciduous molars show mandibular post-rotation and an increased total Gonial angle, compared to patients who do not suffer from infraocclusion. Despite the absence of a longer-term evaluation of these patients, thanks to this data it is possible to state that early diagnosis of infraocclusion is fundamental in order to apply a well-planned and thought-out orthodontic treatment.

Single-session apexification treatment with MTA is an alternative to the root-canal treatment of immature teeth. Since its results are far from ideal, research with MTA-derivative biomaterials continues; however, the number of studies is limited as of yet. This study aimed to compare the fragilities of in vitro-simulated immature teeth in single-session apexification with MTA and newly-developed calcium-silicate-based MTA derivatives. Two hundred seventy human permanent upper incisors were randomly divided into study (n = 180), positive control (Ca (OH)2) (n = 45), and negative control (NC-intact) (n = 45) groups. The study groups used ProRoot MTA (MTA-PR), MM-MTA, NeoMTA-Plus, and Biodentine (BD). Two-week, two-month, and one-year follow-ups data were recorded. A fracture resistance (FR) test was performed at the end of each period. The results of the biomaterials at the different follow-up timepoints were statistically analysed and compared. The two-week FR medians were significantly lower in MM-MTA, NEO, MTA-PR, and Ca (OH)2 groups (p<0.001, p<0.001, p=0.003, and p<0.001. respectively), compared to NC. The two-month FR medians were significantly lower in BD, MM-MTA, NEO, MTA-PR, and Ca (OH)2, (p=0.005, p<0.001, p<0.001, p<0.001, and p<0.001, respectively) compared to NC. The one-year FR medians were significantly lower in the BD, MM-MTA, NEO, MTA-PR, and Ca (OH)2 groups (p=0.002, p<0.001, p<0.001, p<0.001, and p<0.001, respectively) compared to NC. For all groups, FR at the one-year mark was significantly lower compared to the two-week and two-month marks (p<0.001, p<0.001). All groups were compared with each other regarding fracture resistance at two weeks, two months, and one year. Also, for each group follow-up data on fracture resistance were compared. Since FR was significantly higher at the two-week and the two-month mark compared to the one-year mark for each material, filling the root canal completely with biomaterials used in our study leads to tooth denaturation over time, with effects like Ca (OH)2.

This research aims to assess the oral hygiene habits of women in the perinatal period. The study also aims to ascertain the degree of awareness of mothers, or future mothers, about the importance of oral hygiene for themselves and their child. Study design: aepidemiological, observational, cross-sectional survey among a group of young women of childbearing age. The group was composed of mothers recruited from kindergartens and pregnant women who went to counseling centers or participated in childbirth courses throughout Italy. The sample included 500 women from Central and Northern Italy and 263 from Southern Italy for a total of 763 subjects. Most of them were Italian (87.9%) and just over 50% of them had at least one child (52.7%); 40% were above 35 years old, and 52% were between 25 and 35 years of age. Young women often underestimate the importance of oral hygiene even before pregnancy, and the impact of oral hygiene lasts throughout gestation and continues after childbirth.

Macrodontia is a rare dental anomaly, and isolated macrodontia is even more infrequent. The aim of this article is to report on a young male patient with macrodontia of the mandibular premolars. We herein present a case report of a young male patient receiving pharmacological growth hormone therapy for 10 years, who was diagnosed with macrodontia of the mandibular premolars. The patient underwent surgical treatment at the School of Dentistry of the University of Buenos Aires and was followed-up for more than 3 years. Macrodontia is a rare condition. Early diagnosis and treatment of this anomaly favors adequate formation of the dental arches. In the light of this case report, a review of paediatric patients who received growth hormone therapy during the tooth formation stage would seem relevant.