Structural Changes in Primary Teeth of Diabetic Children: Composition and Ultrastructure: A Systematic Review.
Bibliographic record
Abstract
Background: Type 1 diabetes mellitus (T1DM) in children is associated with distinct oral health complications, including alterations in primary tooth structure and composition. These changes may affect enamel and dentin integrity, caries risk and periodontal status. This systematic review aimed to evaluate the structural, compositional and ultrastructural changes in primary teeth of diabetic children. Methods: Following PRISMA guidelines, PubMed/MEDLINE, Science Direct, Google Scholar and Cochrane Library were searched for studies up to July 2024. Observational, case-control, cohort and cross-sectional studies assessing primary teeth of T1DM children with clinical, chemical or imaging techniques (SEM, EDX) were included. Quality was assessed using the Newcastle-Ottawa Scale. Results: Ten studies met the inclusion criteria. SEM/EDX analyses showed significant enamel abnormalities in diabetic children, including prism defects and an irregular aprismatic layer. Calcium and phosphorus content were consistently lower (Ca: 33.8% vs. 37.6% in controls, p = 0.017; P: 16.8% vs. 18.9%, p<0.001). Caries outcomes varied: some studies reported higher DMFT scores in diabetics (e.g., 1.43 vs. 0.56, p<0.05), while others found no difference or lower scores. Periodontal indices were consistently worse in diabetics, with significantly higher gingival indices (p<0.01) and plaque accumulation. Altered tooth eruption patterns (earlier by ~1.6 years) and reduced salivary buffering capacity were also observed. Conclusions: Children with T1DM exhibit clear alterations in the structure and composition of primary teeth, including enamel hypoplasia, reduced mineralization and higher susceptibility to periodontal disease. Variability in caries outcomes suggests an influence of metabolic control, oral hygiene and dietary factors. Early preventive dental care and interdisciplinary management are recommended.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.014 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.006 | 0.005 |
| Bibliometrics | 0.008 | 0.010 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".