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Purpose/objectives: To survey potential applicants applying to advanced education in pediatric dental programs and evaluate their preparedness upon graduating from an accredited dental school. Methods: Attendees of a virtual externship of a University program were recruited to participate in a web‐based survey. The survey collected demographic data, current levels of confidence with various pediatric clinical procedures, predicted confidence with those procedures, and number of procedures completed. Chi‐Square and analysis of variance statistics were performed on resulting data to determine statistical significance. Results: Fifty‐three participants completed the survey in its entirety (n = 53). Most respondents reported adequate didactic training, mean score of 3.6 (range 0–5) and a moderate to high impact of coronavirus disease 2019 on their overall training with a mean score of 4.9 (range 0–10). Current dental students reported that they are "not confident at all" (<2.0) for 15/24 (63%) of the procedures. Graduates reported "somewhat confident" (<3.0) for 13/24 (54%) of the categories. Both students and graduates report the lowest levels of confidence for managing dental trauma, invasive treatment of young patients (<4 years of age), and patients with special healthcare needs. Dental students self‐reported the expectation to feel more confident throughout their matriculation; however, their clinical experience was still reported to be limited. Students did not report reaching the level of "confident" for 75% of the procedures. Conclusion: Dental students and recent dental graduates alike perceive themselves to be under prepared for practice and do not feel confident in performing pediatric dental procedures. This study can provide dental schools, program directors, recent graduates, and dental students with an understanding of areas where they are under prepared and could offer areas where curricula and clinical experiences could be updated or modified. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate the microleakage of atraumatic glass ionomer restorations with and without silver diammine fluoride (SDF) application. Restorations with SDF are termed silver-modified atraumatic restorations (SMART). Methods: Sixty carious extracted permanent teeth were randomly allocated to two SMART groups and two control groups (n equals 15 per group) for a total of four groups. After selective caries removal, test specimens were treated with 38 percent SDF and polyacrylic acid conditioner was applied and rinsed; teeth were restored with Fuji IX GP® glass ionomer (n equals 15) or with SMART Advantage™ glass ionomer (SAGI; n equals 15). For control groups, specimens were restored with their respective GI material after selective caries removal, both without SDF. Restored teeth were placed in Dulbecco's Phosphate-Buffered Saline solution at 37 degrees Celsius for 24 hours. Teeth were thermocycled between five and 55 degrees Celsius for 1,000 cycles, stained with two percent basic fuchsin, sectioned, and visually inspected for microleakage utilizing stereomicroscopy on a four-point scale. Data were statistically analyzed using Kruskal-Wallis one-way analysis of variance on ranks using Dunn's method (P<0.05). Results: Microleakage between the two SMART restoration groups was insignificant. SAGI alone demonstrated significantly more microleakage than all other groups. There was no statistical significance between the Fuji IX GP® control group and the two SMART restoration groups. Conclusions: This in vitro study indicated that silver diammine fluoride placed before glass ionomer restoration does not increase microleakage. Polyacrylic acid may be used after SDF placement without increasing microleakage. [ABSTRACT FROM AUTHOR]

Purpose: To present evidence-based recommendations on nonpharmacological behavior guidance for the pediatric dental patient. Methods: The work group assessed eight systematic reviews for effectiveness of nonpharmacological behavior guidance techniques in children undergoing preventive care or a dental treatment visit. The key outcomes assessed included cooperative behavior, anxiety, and procedural pain. To formulate the recommendations, the work group used the GRADE framework to obtain consensus on domains such as priority of the problem, certainty of the evidence, balance between desirable and undesirable consequences, patients’ values and preferences, acceptability, and feasibility. Results: Overall, the use of basic nonpharmacological behavior guidance techniques resulted in trivial-to-small effect on improvement in behavior or reduction in anxiety. However, for children and adolescents undergoing preventive care, mobile applications and modeling showed large effects in reduction of anxiety. For those undergoing dental treatment, strategies such as modeling, positive reinforcement, biofeedback relaxation, breathing relaxation, animal-assisted therapy, combined tell-show-do, audiovisual distraction, and cognitive behavior therapy showed large reduction in anxiety. For children and adolescents with special health care needs, audiovisual distraction and sensory-adapted dental environment showed large reduction of anxiety. Conclusions: All the formulated recommendations were conditional and were mostly based on very low certainty of evidence. Conditional recommendations imply that different choices or combinations of behavior guidance techniques may be most appropriate for different patients. Clinicians should use techniques consistent with the parent/patient values and preferences. These recommendations are based on the best available evidence to-date and are intended to aid clinical decision making. [ABSTRACT FROM AUTHOR]

Purpose: To design, fabricate, and evaluate in vitro 3D printed space maintainers (SMs) and compare their retentive capabilities to traditional stainless-steel (SS) space maintainers. Methods: E-Guard was selected as the printing material based on flexural strength and elastic modulus. SMs with a claw design were printed, cemented to testing blocks, and vertically loaded to determine failure strength and flexure (n equals 10). The intaglio surfaces of SM bands, printed with plain, crosshatched, or horizontal ridges, were cemented to extracted primary teeth. The force needed to dislodge the bands was compared to cemented traditional SS bands (n equals 14). Results: Flexural strength (mean±standard deviation [SD]) of E-Guide, E-Dent, and E-Guard materials was 65±12, 90±13, 134±25 MPa, respectively. Elastic modulus (mean±SD) was 1.54±0.40, 2.49±0.14, 2.65±0.89 GPa, respectively. When subjected to vertical loading, the mean failure load of 3D printed SMs (E-Guard) was 124 N and the mean deflection at fracture was 1.73 mm. Retention strengths (mean±SD) of 3D printed bands were 32±13, 43±13, 43±16 N for the plain printed, crosshatched, and horizontal ridges designs, respectively. The retention strength of traditional SS bands was 126±27 N. Conclusions: E-Guard had superior mechanical properties among tested printing resins. Strength and deflection under the vertical load of claw-design 3D printed space maintainers may be adequate as a viable alternative to traditional SMs. Retention of 3D printed SMs was significantly lower than for traditional SS bands. Textured intaglio surfaces did not significantly improve the retention of 3D printed bands. [ABSTRACT FROM AUTHOR]

Purpose: To assess the effectiveness of nonpharmacological behavior guidance interventions used for children and youth with special health care needs (CYSHCN) during preventive and dental treatment visits. Methods: Databases: Ovid MEDLINE, PsyclNFO (EBSCOhost), Embase, and Cochrane Library, were searched from 1946 to February 2022, for randomized clinical trials (RCTs) comparing effectiveness of basic and advanced nonpharmacological techniques rendered during a preventive visit (exam, fluoride application, radiographs, and prophylaxis) or a treatment visit (simple surgical treatment, sealants, restorative care with or with local anesthesia) with control or other interventions. The primary outcome measures for the studied interventions were reduction in anxiety, fear, pain, and improvement in cooperative behavior. Eight authors determined the included Randomized Controlled Trials (RCTs), performed data extraction, and assessed the risk of bias (ROB). Standardized Mean Difference calculation and assignment of quality of evidence by Grading of Recommendations Assessment, Development and Evaluation approach were done. Results: Eleven articles qualified for analysis from 219 screened articles. Included studies evaluate the effectiveness of in office strategies such as modeling, audio-visual distraction, sensory adapted dental environment, and picture exchange communication system. The certainty of evidence ranged from Very low to Low and the magnitude of effect varied from trivial to large change in the desired outcomes. Conclusions: Most basic non-pharmacological behavior guidance techniques showed some trivial to small reduction in self-reported anxiety and/ or improvement in behavior, with audiovisual distraction, Sensory Adopted Dental Environment, and Picture Exchange Communication System showing large reduction in anxiety based on some rating scales. [ABSTRACT FROM AUTHOR]

Purpose: To assess the effectiveness of nonpharmocological behavior guidance interventions used for children undergoing dental treatment visits. Methods: Databases: Ovid MEDLINE, PsycINFO (EBSCOhost), Embase, and Cochrane Library, were searched from 1946 to February 2022, for randomized clinical trials (RCTs) comparing effectiveness of basic and advanced nonpharmocological techniques rendered during a dental . treatment visit including sealants, restorative core, dental local anesthesia, and simple surgical procedures. The primary outcome measures were reduction in anxiety, fear, pain, and improvement in cooperative behavior. Eight authors determined the included RCTs, performed data extraction, and assessed the risk of bios (ROB). Standardized Mean Difference calculation and assignment of quality of evidence by Grading of Recommendations Assessment, Development and Evaluation approach were done. Results: Forty articles qualified for analysis from 219 screened articles. Included studies evaluated the effectiveness of pre-visit preparation and in office strategies rendered pre-/post- or during treatment such as positive imagery, direct observation/modeling, desensitization, tell-show-do and its modifications, voice control, positive reinforcement, memory restructuring, bio-feedback and breathing relaxation, animal assisted therapy, combined therapies, and cognitive behavior therapy. The certainty of evidence ranged from Very low to high and the magnitude of effect varied from trivial to large change in the desired outcomes. Conclusions: Most of the basic non-pharmacological behavior guidance techniques showed trivial to small reduction in self-reported anxiety and/or improvement in behavior, with modeling, positive reinforcement, biofeedback relaxation, breathing relaxation, animal assisted therapy, combined tell-show-do and audiovisual distraction, and cognitive behavior therapy showing large effects in reduction of anxiety based on some scales. [ABSTRACT FROM AUTHOR]

Purpose: To assess the effectiveness of nonpharmacological behavior guidance interventions used for a child undergoing preventive dental visits. Methods: Databases: Ovid MEDLINE, PsyclNFO (EBSCOhost), Embase, and Cochrane Library, were searched from 1946 to February 2022, for randomized clinical trials (RCTs) comparing effectiveness of basic and advanced nonpharmacological techniques rendered during a preventive visit including examination, prophylaxis, fluoride application and radiographs. Workgroup (WG) identified moderate-to-high quality systematic reviews (SRs) published on hypnosis, audiovisual distraction, and parental presence/absence; and decided to exclude these interventions from current SR to avoid duplication. The primary outcome measures for the studied interventions included reduction in anxiety, fear, pain, and improvement in cooperative behavior. Eight authors determined the included RCTs, performed data extraction, and assessed the risk of bias. Standardized Mean Difference calculation and assignment of quality of evidence by Grading of Recommendations Assessment, Development and Evaluation approach were done. Results: Fifteen articles qualified for analysis from 219 screened articles. WG found studies evaluating effectiveness of pre-visit preparation and in-office strategies rendered pre- or during treatment such as positive imagery, communication, modeling, tell-show-do, magic tricks, mobile applications, positive reinforcement, and sensory adapted dental environment. The certainty of evidence ranged from Very low to Moderate and the magnitude of effect varied from trivial to a large change in the desired outcomes. Conclusions: Most basic nonpharmacological behavior guidance techniques showed trivial to small reduction in self-reported anxiety and/or improvement in behavior, with mobile application and modeling showing large effects in reduction of anxiety based on some rating scales. [ABSTRACT FROM AUTHOR]

Purpose: Esthetic prefabricated pediatric crowns require more tooth reduction than stainless steel crowns due to their passive fit. The purpose of this study was to determine tooth reduction in primary molar preparations for various pediatric prefabricated crowns. Methods: Fifty primary maxillary and fifty mandibular typodont molars were scanned with an optical scanner. The teeth were mounted in a typodont, and 10 experienced pediatric clinicians prepared them for five types of pediatric prefabricated crowns: (1) stainless steel (SS); (2) zirconia EZCrowns™ (EZ); (3) NuSmile® ZR (NS); (4) Zirconia Kinder Krowns® (KD); and (5) an experimental composite crown (PS). The prepared teeth were rescanned, and the pre- and postpreparation scans were precisely aligned. Mean and maximum reduction depths were calculated for occlusal and mesiobuccal surfaces. Differences in reduction among crown types were compared using one-way analysis of variance followed by the Student-Newman-Keuls post hoc test (a equals 0.05). Results: Reduction depths were not significantly different among the esthetic crowns but were significantly higher than SS crowns. Maximum reduction exceeded two mm in some of the KD and NS crown preparations, with KD consistently showing the highest reduction. Conclusions: Preparations for esthetic prefabricated molar crowns were more extensive than SS crowns, especially at occlusal and mesiobuccal surfaces. Clinicians should carefully follow manufacturer preparation guidelines to avoid encroaching the mesiobucccal pulp horn. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate whether reduced curing performance due to compromised light tip placement can be mitigated by bulk-fill composite and/or high-intensity curing light. Methods: Plastic discs with 2.5-mm deep cavities were filled with a conventional (Mosaic™) or bulk-fill (Tetric® PowerFill) composite and cured with a BluePhase® PowerCure curing light at normal and high-power settings, with light tip placement at distance and/or 45 degree angle. Curing time and irradiance were three, five, or 10 seconds at 1,200, 2,000, or 3,000 mW/cm2 (10 samples). After 24 hours, Vickers hardness on top and bottom surfaces was measured and analyzed using analysis of variance and pairwise comparisons (α<0.05). Results: All top surfaces had higher hardness than bottom surfaces. Cure (bottom-to-top hardness ratio) was significantly affected by material, distance/angle, and curing regimen (P<0.001), and generally decreased when tip distance and angle increased. Bottom-to-top hardness ratios of bulk-fill composite (0.42 to 0.66) were significantly higher than those of conventional composite (0.20 to 0.31). High-power curing significantly increased bulk-fill's curing performance as it was specifically formulated for this curing light. Conclusions: Increased light tip distance and angle compromised composite curing. Bulk-fill composite cured better at the bottom of the restoration than conventional composite regardless of light tip distance/angle. High-power light curing improved curing performance only in bulk-fill composite. Nevertheless, due to low bottom-to-top ratios (0.20 to 0.66) across all samples, even under ideal light tip placement, both composites should be cured in increments of less than 2.5 mm.

Per- and polyfluoroalkyl substances (PFAS) are refractory anthropogenic chemicals and current treatment processes at municipal water resource recovery facilities (WRRFs) cannot efficiently degrade them, hence, these chemicals cycle through the environment. Certain PFAS can be concentrated in biosolids from WRRFs and are commonly land applied for beneficial reuse. Given recent advances in measurement of PFAS, documentation of the range of concentrations in pre-stabilized sludge and stabilized biosolids is critical to evaluating treatment best practices and assessing potential human health and ecological risks. In this study, pre-stabilized sludge and post-stabilized biosolids samples were collected from 12 major WRRFs across the United States. PFAS were analyzed using Environmental Protection Agency (EPA) Method SW846-3500C/537.1, and Draft EPA Method 1633, by one commercial laboratory and two university research laboratories, respectively. Results comparison among laboratories demonstrated statistical differences in PFAS concentrations among split samples. For example, 5:3 FTCA (fluorotelomer carboxylic acid) concentrations in post-stabilized sludge at Lab 1 were measured at 21 ng/g (dry), while they were detected at 151 ng/g (dry) in Lab 3. Further, higher PFAS concentrations were observed in post-stabilized biosolids compared to pre-stabilized sludges, regardless of the laboratory or analysis method, even when solids destruction through solids stabilization was considered. Further research is required to refine methods for analyses of PFAS in sludge and biosolids samples from WRRFs prior to being used for development of regulatory actions as well as understanding how various treatment protocols could impact concentrations of PFAS in land-applied biosolids., (© 2024 The Author(s). Journal of Environmental Quality published by Wiley Periodicals LLC on behalf of American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America.)

Purpose: The purpose of this study was to investigate the microleakage of atraumatic glass ionomer restorations with and without silver diammine fluoride (SDF) application. Restorations with SDF are termed silver-modified atraumatic restorations (SMART). Methods: Sixty carious extracted permanent teeth were randomly allocated to two SMART groups and two control groups (n equals 15 per group) for a total of four groups. After selective caries removal, test specimens were treated with 38 percent SDF and polyacrylic acid conditioner was applied and rinsed; teeth were restored with Fuji IX GP® glass ionomer (n equals 15) or with SMART Advantage™ glass ionomer (SAGI; n equals 15). For control groups, specimens were restored with their respective GI material after selective caries removal, both without SDF. Restored teeth were placed in Dulbecco's Phosphate-Buffered Saline solution at 37 degrees Celsius for 24 hours. Teeth were thermocycled between five and 55 degrees Celsius for 1,000 cycles, stained with two percent basic fuchsin, sectioned, and visually inspected for microleakage utilizing stereomicroscopy on a four-point scale. Data were statistically analyzed using Kruskal-Wallis one-way analysis of variance on ranks using Dunn's method (P<0.05). Results: Microleakage between the two SMART restoration groups was insignificant. SAGI alone demonstrated significantly more microleakage than all other groups. There was no statistical significance between the Fuji IX GP® control group and the two SMART restoration groups. Conclusions: This in vitro study indicated that silver diammine fluoride placed before glass ionomer restoration does not increase microleakage. Polyacrylic acid may be used after SDF placement without increasing microleakage.