搜索结果：Journal of the Indian Society of Pedodontics and Preventive Dentistry

Early childhood caries (ECC) results from a complex interplay of genetic and environmental factors. Polymorphisms of enamel formation genes may alter the susceptibility to ECC. The primary objective of this study is to analyze the association between rs12640848 of the ENAM gene, rs1376729959 of the TUFT1 gene, and rs1784418 of the MMP20 gene with ECC. This case-control study included 124 children aged 3-6 years in each group. A questionnaire was administered to collect the demographic information, socioeconomic status, oral hygiene and feeding practices, 24-h diet diary, and caries status by International Caries Detection and Assessment System II criteria. DNA was isolated from peripheral venous blood, followed by Polymerase Chain Reaction, and analysis of the genotypes under dominant and recessive models. Logistic regression was performed to understand the effect of covariates. The frequency of Allele A of rs12640848 was greater in children with caries as compared to children without caries. The AG and AA genotypes of rs12640848, with odds ratios of 2.03 (1.17-3.54) and 3.20 (1.24-8.25), respectively, were significantly more frequent in children with caries. The computed tomography (CT) genotype of rs1784418 was significantly more prevalent in cases than in controls, with an odds ratio of 1.82 (1.04-3.18). The CC genotype of rs1784418 was significantly more common in children without caries, with an odds ratio of 1.79 (1.06-3.01). AA, AG genotypes of rs12640848, and the CT genotype of rs1784418 were more prevalent in children with caries. Polymorphism rs1376729959 did not reveal an association with ECC.

Regenerative endodontic therapy (RET) is a novel technique that offers a biological alternative for managing immature permanent teeth with necrotic pulps. This cross-sectional study aimed to assess the knowledge, attitude, practice, and experience regarding RET among pediatric dentists (specialists) and postgraduate students (students) in India. The sample size was estimated as 195 participants in two groups (specialists and students). A structured, validated online "Bristol questionnaire" was used with permission. The questionnaire was sent to randomly selected members of the National Society of Pediatric Dentistry. The data were collected and analyzed using descriptive statistics, Chi-square, and Fisher's exact tests. A total of 415 responses were analyzed, of which 214 (51.6%) respondents were specialists and 201 (48.4%) were students. RET was practiced by 74% of respondents, with a significantly higher adoption rate among the participants who had completed MDS (P = 0.03). Most respondents had performed fewer than five RET cases. Triple antibiotic paste and NaOCl were commonly used as intracanal medicaments and root canal irrigants, respectively. Mineral trioxide aggregate was the preferred material for coronal sealing. Although 72.5% of respondents reported clinical success, nearly half of the respondents considered root development outcomes to be unpredictable. Pediatric dentists (specialists and students) reported to practice RET, but there were variabilities in the protocols followed for case selection and treatment. The belief in RET leading to healing with or without the maturation of the root was apparent. The need for improved educational initiatives and clinical exposure to RET within pediatric dental training in India was expressed.

Selecting an ideal obturation material is important for the success of pulpectomy in primary teeth. Definitive evidence is lacking in suggesting an ideal obturation material in the literature. The current Network Meta-Analysis (NMA) aimed to assess the effectiveness of various obturation materials in primary teeth. A systematic search was conducted across four electronic databases for selecting eligible Randomized Controlled Trials (RCTs). Two independent reviewers screened studies, extracted data, and evaluated the risk of bias (RoB) using the Cochrane RoB 2 tool. Data synthesis utilized a Bayesian random-effects model, and Odds Ratios (ORs) were calculated for the dichotomous overall success outcome. The ranking of obturation materials was performed using the SUCRA ranking method. All statistical analyses were carried out with the MetaInsight software. The certainty of evidence for all treatment comparisons was evaluated using the GRADE approach, complemented by the Confidence in Network Meta-Analysis web application. NMA assessed over 1608 patients and 19 different combinations of obturation materials from 47 studies. Only eight among 47 included articles have shown a low RoB. The quantitative analysis showed the ZOE, CH, and Iodoform-based paste (Endoflas) demonstrated one of the best effect estimates (OR ≈ 0.35; 95% confidence interval 0.11-1.17). The overall certainty of evidence was low to very low, considering the methodological pitfalls and small sample size in the included studies. The combination of ZOE, CH, and Iodoform-based paste (Endoflas) can be considered as a viable option as an obturation material in primary teeth with low certainty of evidence.

A comprehensive understanding of craniofacial growth and development is crucial for all dentists. Variability is a key principle in studying growth patterns. Cephalometrics, as a morphological diagnostic tool, quantitatively expresses this variability and plays a vital role in assessing craniofacial growth and development. This study aims to determine cephalometric principles (skeletal and dental) for the Indore population of India and to establish cephalometric values for children in the late mixed dentition stage. An observational study was performed in the outpatient department over 2 months. The lateral cephalograms of 100 children of 11-13-year age group with normal occlusion and pleasant profile were taken, and cephalometric values were established using Steiner's analysis. Data were processed utilizing SPSS (Statistical Package for Social Sciences) version 25.0, IBM, Chicago. The intergroup comparison utilized the Mann-Whitney U-test. The findings of this study indicated that the children of Indore had mandibular retrusion in relation to the cranial base (SNB - 76.2), accompanied by enhanced facial convexity and a horizontal growth pattern (mandibular plane angle - 21.3). The craniofacial features, which include both skeletal and dental characteristics, can be attributed to either genetic inheritance or the dietary patterns that are acquired from parents. These characteristics are unique to certain ethnic, racial, and subracial groupings, as well as to other community groups. With the growing number of children in Indore seeking professional treatment for malocclusion, it has become increasingly important to define the criteria for an esthetically pleasing and normative facial appearance within this population.

Maxillary canines are the most frequently impacted teeth after the third molars, with an incidence of 0.9%-2.2% where females are 2-3 times more affected. The various causes include local, systemic, and genetic factors. To prevent complications, early prediction and age-appropriate intervention are crucial for initiating timely interceptive orthodontic treatment, thereby reducing treatment duration and cost. To validate the modified Erickson's and Kuroll's method in predicting the prevalence of canine impaction in children aged 14-18 years. Children visiting the outpatient department in the department of pediatric dentistry from October 2024 to December 2024 with orthopantomograms (OPGs) available during their mixed dentition stage of age 7-13 years were screened. A total of 383 OPGs were retrieved. Based on the inclusion criteria, 90 OPGs of children were included, traced, and analyzed by a single operator using Modified Erickson and Kuroll's sectorial method. The clinical position of erupted canine was correlated with the predicted position and also the prevalence of canine impaction was evaluated. The analysis of impaction parameters (sectors and angle) showed significant findings for both sides of the maxilla. Sector location was strongly correlated compared to the angles considered (P < 0.001). Twenty-two canines were impacted in total, contributing to 12.23% prevalence with cusp tips located in Sectors II, III, and IV. Modified Erickson's and Kuroll's method for the predicted canine impaction in the present study showed a sensitivity value of 100%; hence, it can be considered as a reliable tool.

The primary teeth's unique histological properties and interactions with the oral cavity pose a challenge in treatment, unlike the permanent teeth. A repaired natural tooth maintains space better than an artificial one. These factors lead to a greater emphasis on saving the tooth by pulpectomy involving effective chemical cleaning and disinfection of canals than on meticulous mechanical canal shaping. As chemically available irrigants show cytotoxic effects, hence herbal-based irrigants are being considered viable options. The present study was undertaken to compare and assess the antimicrobial effect of 2.4% Curcuma longa extract, 25% aqueous propolis, and 2% chlorhexidine in deciduous teeth. Forty eight subjects in age range of 4-7 years were allocated equally into four groups - Group I: saline (Negative control), Group II: 2% chlorhexidine (Positive control), Group III: 2.4% Curcuma longa, and Group IV: 25% aqueous propolis based on inclusion and exclusion criteria. Isolation was achieved using a rubber dam. Pre and postirrigation samples were collected using sterile absorbent paper points and transferred to a test tube containing brain heart infusion. The pre and postirrigation samples were sent for microbial assay. Streptococcus mutans and Enterococcus faecalis were isolated using standard microbiological methods, and serial dilution method was done to determine the pre and post irrigation colony counts. The plates were duplicated and incubated at 37&#xb0;C for 24 h. The preirrigation and post irrigation colony count samples with different irrigants were counted and compared. For the saline paired t-test was used to compare the pre- and postirrigation values, and for 2% chlorhexidine, 2.4% curcuma longa, and 25% aqueous extract of propolis groups. The Wilcoxon matched signed rank test was used to compare pre- and post-irrigation bacterial counts. To compare the mean change in bacterial colony counts ANOVA test was done. S. mutans and E. faecalis were the most commonly isolated microorganisms. There was no statistical significant difference between saline, 2% chlorhexidine, 2.4% curcuma longa, and 25% aqueous extract of propolis. The micro-organisms prevalent in primary teeth with necrosis included S. mutans and E. faecalis. Antimicrobial sensitivity testing done with the serial dilution method showed that herbal irrigants such as 2.4% Curcuma longa extract and propolis were equally effective as 2% chlorhexidine.

Lateral mandibular functional shifts (LFMSH) have been found to be associated with facial asymmetry (FA), posterior crossbite, midline shift, and dissimilar molar occlusion, including uneven biting or unilateral chewing. The aim is to evaluate the prevalence of LFMSH and its known associated factors, i.e., FA, midline deviation (MD), unilateral posterior crossbite (UPXB), posterior occlusion (PO), preferred chewing side (PCHWS), premature contacts (PC), and correlation of each factor with LFMSH among children with deciduous and early mixed dentition in a North-Indian city. This cross-sectional study was conducted among the schoolchildren of North-Indian city. This study assessed 400 school children. Extra- and intra-oral static examination was done in the maximum intercuspation position (MIP). CR was attained, and functional mandibular shift (FMSH) in any direction, with special emphasis on LFMSH, was confirmed when mandible got shifted from PC to MIP. Causative factors for PC were further assessed. The correlation between LFMSH and associated variables was tested by the Chi-square test. The prevalence of LFMSH, FA, MD, UPXB, PCHWS, and PC were 11.8%, 10.3%, 13.2%, 13.8%, 32.8%, and 15.0%, respectively. Significant correlation (P < 0.001) was found between LFMSH and FA (74.5%), MD (100%), UPXB (100%), dissimilar PO (93.7%), PCHWS (100%), and correction of CR postphonetics (100%). PCs were found in deciduous canine and maxillary incisor regions. Crossbites in the permanent first molar and primary second molar were coexisting. Significant correlation of LFMSH with associated factors emphasizes early detection, understanding of the predisposing factors for their prevention and/or early interception. Long phonetics was clinically successful in observing FMSH in the field.

Palatal rugae, or palatal folds, are the unique anatomical features on the hard palate that emerge during fetal development and remain stable throughout the life. These features are valuable for human identification in forensic science, as they are less prone to damage from thermal exposure or physical trauma. This study aimed to determine if there is an association between different palatal rugae patterns and terminal planes in primary dentition. The study population consisted of 600 children aged 3-6 years, classified into three terminal planes: mesial step, distal step, and flush terminal plane. Palatal rugae were analyzed using the modified Thomas and Kotze classification system, and data were assessed using the Chi-square tests. Results showed no significant differences in the number, unification, or orientation of rugae between the terminal planes. However, a significant difference was found in the shape of the rugae, with circular and wavy patterns being more predominant in the mesial and distal step terminal planes, respectively. The most common shape of the incisive papilla was droplet-shaped across all groups. These findings suggest that while palatal rugae patterns can offer insights into occlusal relationships in primary dentition, they do not show strong association with the terminal planes of primary molar relationships. The study highlights the potential for early diagnosis and preventive interventions in pediatric dentistry based on palatal rugae patterns.

In children with untimely loss or extraction of primary teeth, space maintainers (SMs) are the dental appliances which help in preventing the unwanted migration of nearby teeth in dental arch, and thus, avoid the potential need for complex and lengthy orthodontic procedures. Several drawbacks of traditional SMs and their traditional fabrication modalities are well evident from the relevant literature. In the current modern era, digital technological innovations and advancements are progressively evolving and revolutionizing the clinical pediatric dentistry. Digital technologies including intra-oral sensors for acquiring oral tissue impression and three-dimensional (3D)-printers for fabricating SM appliances have been a boon and evolving swiftly, and its various positive aspects have been reported by the studies. However, till now, there is no published scoping review pertinent to the clinical performance of 3D-printed space maintainers (3DP-SMs) in growing children. Therefore, this present scoping review was planned and executed with the aim to appraise the existing published literature regarding 3DP-SMs appliances by extensively exploring published studies/articles from various databases ("PubMed," "Scopus," "Cochrane," "Web of science," "Lilacs," "ScienceDirect," and "Scielo") and also from the manual searching methods by following the "PRISMA - ScR checklist/guidelines" and the best research practices. Nine (n = 9) studies were finally included for review and critical appraisal. Majority of studies including clinical randomized controlled trials (RCTs), non-RCTs, and case-reports reported favorable clinical outcomes (higher survival/retention of 3DP-SMs, higher preference and acceptance (patient friendly) among children/parents, faster and easier fabrication method, higher accuracy in size, shape, better adaptability, etc. Nevertheless, some limitations have been reported. Furthermore, a scarcity of robust evidence pertaining to 3DP-SMs was observed in the current literature.

To compare and evaluate the clinical success of conventional, preformed, and three-dimensional (3D) printed band and loop (B and L) space maintainers. Forty-five participants in the age group of 5-7 years visiting the pediatric and preventive dentistry department, with grossly carious primary mandibular first molar of either side requiring extraction, were randomly divided into three groups: conventional, preformed, and 3D printed B and L space maintainer groups. Following extraction, the assigned space maintainer was fabricated and delivered. Clinical evaluation for survival and failure rates and gingival health was done at Baseline, 1, 3, 6, 9, and 12 months. Statistical analysis was performed using Chi-square or Fisher's exact tests, survival using Kaplan-Meier analysis, and ordinal data using Kruskal-Wallis and Mann-Whitney U tests. All space maintainers showed 100% survival at 1 and 3 months. At 12-months, conventional and preformed appliances demonstrated similar survival (86.7%), while the 3D printed group showed a lower rate (73.3%); however, differences were not statistically significant ( P > 0.05). Decementation was the primary cause of failure among all groups. Gingival and plaque scores increased over time in all groups. A significant difference in the gingival index was observed at 12 months ( P = 0.045), favoring the Preformed group. Plaque scores differed significantly at 9 and 12 months ( P < 0.05), with higher accumulation in the Conventional group. All three space maintainers demonstrated comparable 12-month survival; however, Preformed appliances showed relatively better gingival and plaque outcomes, with decementation identified as the predominant cause of failure across all groups.

Saliva offers a promising medium for assessing systemic health, including oxidative stress. Investigating the relationship between salivary total antioxidant capacity (TAC) and sleep disordered breathing (SDB) may be crucial for understanding and assessing the impact of SDB in children. This study aims to evaluate and compare physiological parameters of salivary pH, buffering capacity, and TAC in children with and without sleep disorders. A cross-sectional study was conducted on 56 children (aged 6-11 years) visiting the Department of Pediatric and Preventive Dentistry. Participants were divided into a study group (n = 28) with a history of sleep problems and skeletal Class II malocclusion, and a control group (n = 28) without sleep problems and with normal skeletal relations. Unstimulated saliva samples were collected in the morning. Salivary pH and buffering capacity were determined using a digital pH meter and an acid challenge assay. Salivary TAC was estimated using the modified phosphomolybdenum spectrophotometric assay. The statistical analysis was conducted using the Shapiro-Wilk test to assess normality of data and the Mann-Whitney U-test for intergroup comparisons. Effect sizes were calculated using Cohen's d. Intergroup comparison revealed that the median salivary pH, buffering capacity, and TAC did not differ significantly between the study and control group (P > 0.05 for all). Effect size calculation using Cohen's d showed negligible to small effects for pH and buffering capacity, and a moderate effect for TAC, indicating limited clinical differences. Children with sleep disorders showed a trend toward lower salivary pH, buffering capacity, and TAC values than children without sleep disorders. Saliva remains a promising, noninvasive medium for assessing the physiological changes associated with obstructive SDB in children.

Silver diamine fluoride (SDF) has gained significant attention in the past decades owing to its proven efficacy in arresting active carious lesion. LASERs in combination with topical fluorides have been shown to have a synergistic effect. This study aims to evaluate and compare the pretreatment and posttreatment effect of LASER on the color stability and surface characteristics of SDF treated carious primary molars. Thirty extracted carious primary molars were allocated into three Groups: Group 1: SDF; Group 2: Pretreatment LASER followed by SDF; and Group 3: SDF followed by posttreatment LASER. Spectrophotometric analysis, Scanning Electron Microscope (SEM), and Energy Dispersive X-ray Spectrophotometer for elemental analysis were done. One-way ANOVA was used for intergroup comparisons, Paired t-test and repeated-measures ANOVA were used for intra-group comparisons. The level of significance was set at 5%. On intergroup comparison, color change (&#x2206;E) was the highest in Group 3 (32.16 + 13.40) followed by Group 1 (29.19 + 13.42) and Group 2 (25.78 + 15.48) (P value = 0.60). Color change was the highest during intra-group comparisons of baseline and posttreatment LASER in Group 3. SEM images of Group 2 revealed smooth regular compact globular structures, whereas Group 1 and 3 revealed irregular granular structures. Application of diode LASER following SDF treatment significantly improved the remineralization properties of carious primary molars, as evidenced by increased mineral uptake. In contrast, LASER pretreatment resulted in the lowest color change, indicating reduced discoloration risk. These findings highlight the importance of LASER timing to optimize both therapeutic efficacy and esthetic outcomes in pediatric dental care.

India is the most populous country in the world now with about one-third of the population being children. Preventive dental checkup and treatment is as important as periodic General Health examination and preventive measures such as timely vaccination have been incorporated in Public health policies for new-borns and young children. Dental checkup and examination as part of public health presents a different scenario wherein most children are not presented even for the first dental checkup before any "problem" or "pain" arises. One major cause of this could be high out of pocket expenses that parents may have to bear. While multiple government schemes for General health examination and treatment exist, It is still not clear about their effectiveness at the level of an individual patient. At present, there seems to be a lack of a dedicated scheme for children's oral health. Hence, the only other avenue for parents to seek dental attention for their wards would be the health insurance sector. The aim is to highlight the benefit to cost ratio of existing health insurances for dental treatment and to explore if any insurance offers best features for pediatric dental treatment. We studied and compared various health insurances existing in the market currently and tried to find out if any dental benefits of such insurances exist on the basis of Benefit to cost ratio (BCR). After comparison, we did not find any health insurance plan that covers oral health for children effectively. With BCR offered by insurance companies which was found to be far less than recommended, it makes little sense for parents to seek dental insurance for their wards currently.

The longevity of resin-modified glass ionomer cement (RMGIC) restorations in primary teeth depends on the integrity of the dentin-restorative interface. Pre-treatment with collagen cross-linkers or silver diamine fluoride (SDF) may enhance bonding and remineralization potential. To comparatively evaluate the effect of a natural collagen cross-linker and SDF on the performance of RMGIC restorations in primary teeth based on shear bond strength (SBS), fluoride release, microleakage, and remineralization potential. Ninety-six extracted primary molars were randomly divided into four groups with 24 samples in each group: Group I (polyacrylic acid + RMGIC), Group II (Proanthocyanidin + RMGIC), Group III (SDF + RMGIC), and Group IV (Proanthocyanidin + SDF + RMGIC). SBS was measured using a universal testing machine, fluoride release by ion-selective electrode, microleakage via dye penetration, and remineralization using SEM-EDX analysis. Data were tabulated in Microsoft Excel 2010 and analyzed using SPSS version 21. One-way ANOVA was applied for intergroup comparison of quantitative variables (SBS, fluoride release, microleakage, and remineralization), and the Chi-square test was used for comparison of failure modes. Both collagen cross-linker and SDF groups showed significantly higher SBS and remineralization potential (P < 0.05) compared to the control. Group IV exhibited the highest bond strength, fluoride release, and least microleakage. Dentin pre-treatment with collagen cross-linker or SDF enhances RMGIC performance in primary teeth. SDF improves fluoride release and remineralization, while the collagen cross-linker offers superior bonding and sealing.

The sense of coherence (SOC) is a pivotal element within the salutogenic framework of health, which endeavors to elucidate the determinants that facilitate health promotion. This study examined the relationship between maternal and adolescent SOC and its impact on adolescents' oral health behaviors, explicitly brushing frequency, sugar consumption, and dental visits. A cross-sectional investigation was conducted within the department, encompassing 723 mother-adolescent dyads selected from urban and semi-urban educational institutions. Both cohorts completed the SOC-13 scale, and data about demographic variables and oral health behaviors were systematically gathered. Logistic regression and mediation analyses examined the relationships between maternal and adolescent SOC and oral health practices. The investigation revealed that elevated maternal SOC was significantly correlated with enhanced oral health behaviors among adolescents. A 10-point increase in maternal SOC was associated with a 104% increase in dental visits and a 90% increase in the frequency of brushing in adolescents. Similarly, a 10-point increase in adolescent SOC led to a 52% enhancement in daily tooth brushing and a 10% decrease in sugar intake. Maternal educational attainment and socioeconomic status were the critical determinants of oral health practices. Mediation analysis demonstrated maternal SOC partially mediated the association between adolescent SOC and oral health behaviors. Elevated SOC scores in both mothers and adolescents were associated with enhanced oral health practices among adolescents, including consistent tooth brushing and decreased intake of sugary foods. Programs that foster familial interactions that elevate maternal SOC and educational attainment may serve as effective mechanisms for encouraging healthier behavioral patterns in adolescents.

The extent and nature of the impact of special healthcare needs (SHCNs) on oral health-related quality of life (OHRQoL) of children remain inadequately synthesized. This systematic review aimed to evaluate the association between various oral health conditions and OHRQoL among children with SHCN. A comprehensive literature search was conducted across electronic databases including PubMed, LILACS, Web of Science, EMBASE, Scopus, and Google Scholar, along with manual searches. Titles, abstracts, and full texts were screened by two reviewers based on predefined criteria. Data extraction, performed by two reviewers, focused on study characteristics, types of disabilities, oral health conditions evaluated, OHRQoL tools used, and key findings. Risk of bias (RoB) was assessed using Joanna Briggs Institute checklist. Of the 27 included studies, 12 had moderate RoB, whereas the rest of the studies had low RoB. The most studied conditions were dental caries (n = 24), followed by periodontal diseases (n = 11), malocclusion (n = 7), dental trauma (n = 6), and dental erosion (n = 2). The included disabilities included cerebral palsy, autism spectrum disorder, attention deficit hyperactivity disorder, visual, hearing and mental impairment, etc., Dental caries and periodontal diseases were significantly associated with poor OHRQoL in most studies. The impact of malocclusion and dental trauma on OHRQoL was inconsistent, while dental erosion showed no significant effect. Dental caries and periodontal diseases adversely affect OHRQoL in children with SHCN. The evidence for other conditions remains limited and inconsistent. Future longitudinal studies with standardized, child-centered OHRQoL assessments are needed to strengthen the evidence base.

Dental caries remains a leading cause of early tooth loss in children, often necessitating full coronal restorations. With the rising demand for esthetic restorations, preformed zirconia and the newly introduced Bioflx crowns have emerged as alternatives to stainless steel crowns. However, their effect on the antagonistic wear of primary teeth remains underexplored. To evaluate and compare the wear of primary natural teeth when opposed by two preformed aesthetic crowns, Zirconia and Bioflex, against natural primary teeth. Eighty primary teeth and 40 crown discs (20 zirconia, 20 Bioflx) were divided into three groups ( n = 20 each): Group A (primary canines vs. zirconia discs), Group B (primary canines vs. Bioflx discs), and Group C (primary canines vs. primary molars). Wear testing was performed using a CS-4 masticatory simulator. Enamel wear was quantified via three-dimensional scanning and Boolean operations, while material wear was assessed through pre- and posttest weight measurements. Paired t -tests, one-way ANOVA ( P < 0.05), Tukey's post hoc analysis. Group A exhibited the highest enamel wear (7.69 mm 3 ), followed by Group C (6.59 mm 3 ) and Group B (4.28 mm 3 ). A statistically significant difference was observed between Groups A and B ( P = 0.019). Bioflx crowns caused significantly less antagonistic enamel wear than zirconia crowns, suggesting superior wear compatibility.

Early childhood caries (ECC) is a multifactorial disease, in which socioeconomic factors, parental knowledge, and oral health-related behaviors play critical roles in determining disease severity. The aim of the study was to evaluate the determinants of severity of ECC among preschool children diagnosed with ECC and to explore the direct and indirect pathways influencing caries severity. This descriptive cross-sectional analytical study included 770 preschool children with ECC aged 36-72 months. Sociodemographic details, parental oral health knowledge, and oral health behaviors were assessed using a structured questionnaire. The severity of caries was recorded using the decayed, missing, and filled teeth (dmft) index according to the World Health Organization criteria. Descriptive statistics, Chi-squared tests, Pearson's correlation, multiple linear regression, and multiple logistic regression were used. Structural equation modeling was employed to assess the mediation pathways. Statistical significance was set at P < 0.05. Higher dmft scores were significantly associated with increasing age, lower socioeconomic status (SES), lower maternal education, poor parental knowledge, infrequent tooth brushing, absence of dental visits, and higher sugar exposure ( P < 0.001). Multiple linear regression analysis showed that maternal education and SES were the strongest predictors of dmft scores. Logistic regression revealed that children from lower socioeconomic strata had more than threefold higher odds of severe ECC. Mediation analysis demonstrated that approximately 30% of the socioeconomic effect on caries severity was indirectly mediated by parental knowledge and oral health behaviors. ECC severity is strongly influenced by socioeconomic disadvantages, with parental knowledge and behaviors acting as important modifiable mediators.

Pit and fissure sealants are a preventive strategy against occlusal caries in children. Resin-based sealants (RSs) are considered the gold standard because of their superior retention, while glass ionomer sealants (GIS) offer fluoride release and moisture tolerance. However, their comparative long-term performance remains unclear. To systematically compare retention rates, caries-preventive efficacy, and clinical performance of resin-based and GISs in children's permanent molars. We searched PubMed, Scopus, Web of Science, and Google Scholar from database inception through September 30, 2025, for randomized controlled trials (RCTs) comparing resin based and GISs in permanent molars. The search strategy combined Medical Subject Heading and free-text terms related to sealants, permanent teeth, and pediatric populations. Risk of bias (RoB) was assessed using the Cochrane RoB 2.0 (RoB-2) tool. Certainty of evidence was not graded using GRADE. A total of 13 RCTs were included. RSs showed consistently higher retention rates than GISs, while caries-preventive efficacy was generally comparable. Considerable heterogeneity was observed (I2 = 86.6%) due to differences in populations, sealant materials, and follow-up durations. RoB was assessed using the RoB-2 tool, and publication bias was evaluated using funnel plots and Egger's test, which did not indicate small-study effects. RS outperforms GIS in retention, but both materials show comparable caries-preventive efficacy. GIS remains a viable alternative where isolation is difficult. Long-term RCTs with standardized outcome reporting are needed.