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Women's presence in pediatric dentistry has dramatically increased over the past several decodes. Women now comprise almost 50 percent of AAPD membership and almost 75 percent of new members. Purpose: The purpose of this investigation was to determine differences between male and female pediatric dentists relative to practice patterns and use of behavior guidance techniques (BGTs). Methods: A web-based survey was sent to 511 pediatric dentists who had been recruited by the AAPD to participate in a series of surveys related to pediatric dentistry. Results: Fifty-nine percent of dentists responded. Fifty-two percent of the respondents were male and 48 percent were female. Female respondents were significantly younger than male respondents. Males were more likely to own a practice and hold leadership positions in dentistry while females were more likely to work as faculty, staff dentists, or part-time in private practice. No significant differences were noted between the genders relative to the use of BGTs, though females tended to involve parents more and were more likely to report the use of protective stabilization in selected situations. Both genders reported that parenthood had an effect on their behavior guidance styles. [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: The purpose of this study was to investigate and compare microleakage of prefabricated posterior NuSmiie ® ZR and EZCrowns when cemented with BioCem and Ketac Cem dental cements. Methods: Forty extracted permanent teeth (n equals 10 per group) were fitted for either NuSmiie or EZCrowns prefabricated posterior zirconia crowns and cemented with BioCem or Ketac Cem, for a total of four groups. Crowned teeth were placed in Dulbecco's Phosphate Buffered Saline solution at 37 degrees Celsius for 24 hours. Teeth were thermocycled between five degrees Celsius and 55 degrees Celsius fo r 6,000 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 one-way analysis of variance, SNK (P<.05). Resuits: All samples in this study had microleakage. NuSmiie ® ZR crowns demonstrated significantly less microleakage when cemented with BioCem and compared to Ketac Cem (P=.002). NuSmiie ® ZR cemented with BioCem had significantly less microleakage compared to EZCrowns with Ketac Cem (P=.002). Conclusions: In this in vitro investigation, BioCem cement had significantly less microleakage in zirconia prefabricated crowns compared to Ketac Cem, and NuSmiie® ZR crowns cemented with BioCem resulted in significantly less microleakage than EZCrowns cemented with Ketac Cem. [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: To investigate intrapulpal temperature rise in a primary molar during light activation of a composite restoration to determine if clinically significant pulpal temperatures (greater than 5.5 degrees Celsius) were reached.Methods: Restorative composites (EsthetX HD, Filtek Supreme Ultra, Filtek Bulk Fill) were placed into a primary molar with occlusal preparation (1.5 mm depth; remaining pulpal floor thickness one mm). The pulp was extirpated through a root access to place a thermocouple against the pulpal roof. Temperature changes were recorded during composite restoration light polymerization with three curing lights (one quartz-tungsten-halogen, two LEDs). Sample size was 10. Samples received additional irradiation to assure complete polymerization, followed by a third irradiation for calculating the exothermic heat contribution (subtracting third irradiation temperatures from first irradiation temperatures). Cured restorations were removed after each test, and the tooth was reused. Results were analyzed with Kruskal-Wallis (α =0.05).Results: Type of curing light and composite material affected the intrapulpal temperature rise, which was up to five degrees Celsius for one combination of LED-composite.Conclusions: Clinicians should be aware of the potential for clinically significant intrapulpal temperature rises when light-activating composite restorations in a primary molar with a moderately deep cavity. [ABSTRACT FROM AUTHOR]

Purpose: This study's purpose was to test the hypothesis that, after glass ionomer (Gl) sealant debonding, remaining Gl in the deepest parts of fissures and/or the inhibition of enamel demoralization after artificial caries challenge imparts the residual cariostatic property observed in clinical studies. Methods: Fuji IX Gl sealant was placed on one tooth from 14 matched pairs of noncarious extracted human permanent molars and premolars; the other tooth was the control. Sealed teeth underwent thermocycling (4,000 cycles), and the sealant was manually debonded. The amount of remaining sealant in the fissures was determined using a stereomicroscope. All teeth were placed in lactic acid gel (pH 5.0) at 37 degrees Celsius for three weeks to simulate caries formation. The extent of demineralizotion was determined using the serial micro-hardness method on the cross-sectioned specimens at 0.5 mm from the depth of the central fissure. Results: All teeth had Gl retained in the fissures at a microscopic level. Enamel deminerolization adjacent to the remaining Gl was not significantly different from the control (t test; P=.88). Conclusions: The residual cariostatic property of gloss ionomer sealant is most likely due to a physical barrier of remaining Gl in the fissures rather than a chemical effect on demineralization inhibition. [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]

[Display omitted] • IC is an innovative development for thickening, enhanced digestion, and ammonia recovery in a single-step. • IC could increase the OLR 3 times compared to conventional digesters. • Ex-situ vacuum changed the methanogens community and abundancy compared to the control. • The IC degraded protein-like matter and generated ammonia. This work evaluated the application of a novel ex-situ vacuum-enhanced anaerobic digestion technology, IntensiCarbTM (IC), which decouples hydraulic retention time (HRT) from solids retention time (SRT), and strips ammonia at neutral pH. Four bench-scale reactors were daily fed with a 50/50 (v/v) mix of primary sludge (PS) and thickened waste-activated sludge (TWAS). Three reactors were operated at SRT 20d and intensification factors (IF = SRT/HRT) of 1 (control), 2, and 3, while the fourth was operated at an IF4 at SRT 30d. The findings showed that at an OLR of 5.1 ± 0.79 kgCOD/m3/d, which was 3 times the control, the COD and volatile solids reduction were maintained at around 50 %. The methanogenic community, the most vulnerable ones to high ammonia toxicity, was dominated by Methanosarcinaceae in IC digesters versus Methanoseata in the control digester. Specific methanogenic activity (SMA) and biomethanation potential tests (BMP) on the digestates indicated 35 %-62 % higher activity, relative to the control. The enhanced performance of the IC was due to a combination of increased biomass concentration, mitigation of ammonia toxicity at high loadings, and a microbial shift. Reduced digester size and increased organic loading rates (OLR) are two main benefits of IC-AD technology. Recovery of 50 % of influent total nitrogen in clean water is another promising aspect of IC-AD technology which enables running at high OLR but comparable ammonia concentration. The water recovery and a reduced N loading in recycle streams, thus minimizing the need for side-stream treatment and mainstream nitrogen removal, are additional benefits. [ABSTRACT FROM AUTHOR]