Faculty Bibliography

BACKGROUND:Recent understanding of pulp biology has shifted treatment paradigms toward preservation-based approaches. Traditional diagnostic terminology and treatment protocols require updating to align with current evidence supporting the pulp's healing capacity. AIM/OBJECTIVE:Sixteen international specialists in pediatric dentistry and endodontics convened at the 3rd IAPD Summit in Porto, Portugal (November 2024) to develop consensus-based recommendations on pulp therapies in primary and permanent teeth. METHODS:Following a structured three-phase approach, experts conducted systematic literature reviews and participated in Delphi surveys using a 7-point Likert scale. Recommendations achieving > 70% consensus were categorized as strong (based on RCTs/systematic reviews), conditional (observational studies), or consensus-based statements (expert opinion). RESULTS:Thirty-eight evidence-based recommendations were developed across four key areas: pulp inflammation and diagnosis, caries excavation, management of pulpitis in primary and permanent teeth, and traumatic dental injuries. Key findings emphasized selective caries removal over complete excavation, calcium silicate cements as preferred materials for vital pulp therapy, and conservative approaches for managing irreversible pulpitis. Decision trees were created to support clinical implementation. CONCLUSIONS:These consensus recommendations provide evidence-based guidance for managing pulpal diseases using minimally invasive, biologically driven tiered approaches that prioritize pulp preservation in both primary and permanent teeth.

PURPOSE/UNASSIGNED:The aim of this study was to investigate the feasibility of using an electronic note template to evaluate and record caries arrest from the application of 38% Silver Diamine Fluoride (SDF) at the New York University College of Dentistry Pediatric Clinic (NYUCD-PD). The study evaluated adherence to its use and explored barriers and alternatives to document this procedure among the post-doctoral residents. METHODS/UNASSIGNED:A template was designed to collect baseline characteristics of treated teeth, application methods, and caries arrest at subsequent visits. The template was implemented among 26 post-graduate students on October 31, 2023. A retrospective chart review was conducted in March 31, 2025 to evaluate utilization of the template and extracted data was analyzed using descriptive statistics. The residents' feedback was collected during two focus-group sessions and analyzed qualitatively to assess their understanding of the importance of documentation, identify barriers to utilization of the template, and explore other alternatives for documentation. RESULTS/UNASSIGNED:392 visit encounters on 250 patients were analyzed. Template utilization increased with time from graduated PGY-2 residents to current residents, but it was not universal or uniform. Qualitative analysis revealed that residents fully understand the importance of accurate record keeping, and the template's intended advantages. However, barriers for utilization like time constraints, difficulties when reporting multiple lesions in our complex patient population, and its accessibility within the system, limit their capabilities to comply. CONCLUSION/UNASSIGNED:Although a standardized electronic template can be an effective method of evaluating and documenting caries arrest in SDF-treated teeth, compliance with its use at every encounter is difficult in a hectic university clinic that treats very young children. Further investigation is required to overcome barriers for its use, and to test additional strategies that could be feasible in a dental educational setting.

BACKGROUND:Pain and anxiety can be considerable obstacles while treating paediatric dental patients. Moderate sedation is needed to treat uncooperative patients. AIM/OBJECTIVE:This study aimed to compare the effectiveness of buccal administration of dexmedetomidine-ketamine combination versus dexmedetomidine. DESIGN/METHODS:Fifty-six uncooperative children were randomly assigned into two groups: Group I received buccal dexmedetomidine (2 μg/kg) and ketamine (2 mg/kg) (DEX-KET), whereas Group II received buccal dexmedetomidine (4 μg/kg) (DEX). The effects of drugs were evaluated based on changes in vital signs, onset and duration of sedation, sedation level, analgesia, ease of treatment and procedural adverse effects. RESULTS:There were no significant differences in vital signs or sedation onset between the two groups. DEX-KET group showed shorter recovery time than DEX group (p < .0001). There were no statistically significant differences between both groups regarding sedation level at optimum sedation and during operative procedure (p = .064, p = .069 respectively). The ease of treatment was significantly better in DEX-KET group than in DEX group (p = .048). Procedural side effects and analgesic effects of the sedative drugs were comparable between both groups. CONCLUSION/CONCLUSIONS:The combination of dexmedetomidine and ketamine delivered buccally provided a better method of delivering care to uncooperative children with more rapid recovery than dexmedetomidine.

PURPOSE/UNASSIGNED:Silver Diamine Fluoride (SDF) is a minimally invasive option for caries arrest, part of a paradigm shift in the management of pediatric dental caries. The perspective of parents regarding the long-term pros and cons of this therapy should be understood in order to achieve optimal patient-centered care. METHODS/UNASSIGNED:This study used Constant comparative analysis as an analytic approach, applying the Precaution-Adoption Process Model (PAPM) as the Grounded Theory framework in the qualitative analysis of 30 parental unformatted, spontaneous comments collected at the end of a questionnaire to evaluate their satisfaction with treatment provided at a University Clinic. RESULTS/UNASSIGNED:Our analysis provided important insights about the factors that influenced the parents' decision to act and have their child receive SDF therapy, their perception of the outcomes, the necessary follow-ups after the therapy, and what impacted on their overall satisfaction with the completed procedure. Both positive and negative themes were identified. The positive themes point to SDF treatment's ease of application and addressing the immediate treatment needs on children with limited cooperation. The negative themes identified the adverse consequences of SDF treatment, specifically, the duration and appearance of the cosmetic consequences, as well as the parents' misunderstandings and incorrect expectations of the long-term sustainability of the treatment, which in many instances requires further interventions. It was also evident from the parents' comments that they needed additional educational guidance on other aspects of the treatment, such as the necessity for clinical follow-ups, information that impacted parents' overall satisfaction with the treatment their child received. CONCLUSION/UNASSIGNED:Our results highlight the need to discuss the short and long term benefits of the treatment, as well as, its short and long-term limitations. Specifically, while it is important to discuss immediate outcomes and consequences, such as the ease of treatment and the resultant staining, to ensure that parental consent for the treatment is truly well-informed, it is also important to prepare parents, when this procedure is initially proposed, of the likely need for additional oral care interventions in the future.