bluuebunny/crossref_metadata_2025 huggingface dataset:
Sedative Effects of Oral Midazolam, Intravenous Midazolam and Oral Diazepam
Authors: Tyagi P , Dixit U , Tyagi S , Jain A
Published: April 2015

To evaluate and compare the behavioral changes and effect of sedative techniques in pediatric dental patients using Oral Midazolam, Intravenous Midazolam and Oral Diazepam as sedative agents. Materials and Methods: Triple blind randomized control trial with 40 patients aged between 2-10 years, exhibiting definitely negative behavior was considered. Patients were randomly assigned to one of the four treatment groups. Group I received midazolam 0.5mg/kg orally, Group II received 0.5mg/kg diazepam orally, Group III received 0.06mg/kg midazolam intravenously and Group IV received oral placebo. Behavioral changes (sleep, crying, movement, and overall behavior) and effect of sedative techniques on pediatric patients were assessed. Results: All the patients in group 3 were significantly better in post administrative behavior viz. sleep, crying and movement. Over all behavior scores for group 3 patients were significantly better than other three groups (p<0.001). Positive behavior of patients in group 2 and 3 did not show significant difference but positive behavior in group 3 was significantly (p<0.05) more than group 2. Placebo group showed the highest negative behavior. Conclusion: Sedative effects of oral midazolam and oral diazepam were comparable, where as intravenous midazolam produced more sedation. Anxiolysis was found to be more in both the midazolam groups than the diazepam group. Most number of positive changes were observed in midazolam groups as compared to diazepam group.
Evaluation of Facial Anthropometric Parameters in 11-17 Year Old Boys
Authors: Jahanbin A , Mahdavishahri N , Baghayeripour M , Esmaily H , Eslami N
Published: April 2015

Background and Objective: Anthropometry is the study of qualitative specifications based on linear and angular measurements of human body. The aim of the present study was to determine anthropometric parameters of 11-17 year old boys of northeast Iran. Method: This cross-sectional analytical study was conducted on 583 boys of Fars ethnicity living in Mashhad with Class I skeletal and dental relationships. Digital photographs in natural head position were transferred to a computer and the desired anthropometric landmarks were traced on each image. Anthropometric parameters including the width of the forehead, the width of the face, the width of the cranial base, intergonial width, intercanthal width, binocular width, nasal width, mouth width, facial and nasal height and depth of superior, middle and inferior one-third of the face were measured by “Smile Analyzer” software. ANOVA, Tukey test, and linear regression were used for statistical analysis. Results: Most of the parameters studied increased gradually with age. A growth spurt was evident at the ages of 15-16 years old for binocular width, nasal width, nasal height and depths of middle and inferior one-third of the face. Facial height was among some parameters which were found to increase slightly after 16. Unlike the other parameters, intercanthal width showed an irregular pattern of changes and statistical analysis did not show any significant differences among different age groups (P-value = 0.362). Conclusion: Aging of the face occurs in spurts and at different periods of life. During the studied time span, significant growth in most anthropometric parameters except intercanthal width was obvious.
Idiopathic Ulcers as an Oral Manifestation in Pediatric Patients with AIDS: Multidisciplinary Management
Authors: Martinez-Sandoval B , Ceballos-Hernández H , Téllez-Rodríguez J , Xochihua-Díaz L , Durán-Ibarra G , Pozos-Guillen AJ
Published: April 2015

HIV infection is a major global health problem affecting developing and developed countries alike. HIV infection is associated with multiple oral lesions, some of which are of value in diagnosing the disease. The aim of this report is to describe the clinical manifestations and their multidisciplinary management, in a 6- year-old girl with AIDS. The findings of this case report indicate that, it is essential to be familiar with the early oral manifestations of AIDS in order to understand the patient's dental health needs, apply preventive methods, control caries, and understand the value of oral lesions as diagnostic markers of disease progression in children with HIV infection. A multidisciplinary management is fundamental.
Oral Health Status in Children with Renal Disorders
Authors: Subramaniam P , Gupta M , Mehta A
Published: April 2015

Advances in pediatric nephrology have resulted in increased survival rates of children with renal disorders. Renal disease is characterized by multiple organ involvement, including soft and hard tissues of the oral cavity. Data regarding the oral health status of Indian children with renal disorders is scarce. Thus, the aim of this study was to assess the oral health status of children with renal disorders in Jaipur city, India. Thirty six children in the age-group of 4-14 years, diagnosed with renal disorders were selected. Data pertaining to demographics, medication history, body mass index and blood investigations were obtained from the hospital records. The World Health Organization (WHO) criteria were used to diagnose dental caries. Enamel defects were recorded according to Developmental Defects of Enamel index. Oral hygiene status, salivary pH and buffering capacity were also assessed. The mean blood hemoglobin value was 9.75gm/dl, blood urea nitrogen 43.06 gm/dl and serum creatinine 1.5 mg/dl. Enamel defects were seen in 58.3% of children. Their mean deft and DMFT scores were 1.5 and 0.5, respectively. The mean Oral Hygiene Index-Simplified (OHI-S) score was 1.56. Gingival overgrowth was not present. Mean salivary pH was 6.92 and buffering capacity of stimulated saliva was 9.86. It is necessary for pediatric dentists to follow preventive oral health regimens that are tailored to these patients.
Congenital Rubella Syndrome: Dental Manifestations and Management in a 5 year Old Child
Authors: Bhatia Sarabjot , Goyal Ashima , Dubey Mohit , Kapur Aditi , Ritwik Priyanshi
Published: April 2015

Congenital Rubella Syndrome is a rare disorder comprised of a constellation of physical abnormalities that develop in infants as a result of maternal infection and subsequent fetal infection with rubella virus. The congenital lesions involve vital organs such as heart, eye, ear, brain and endocrine system and less frequently, teeth. The severity of systemic involvement depends on the stage of gestation at which maternal rubella infection occurs. With the implementation of immunization programs worldwide, its incidence has been dramatically reduced during the past half century. This article provides an insight into the prolonged effect of the virus on ameloblasts by highlighting the presence of hypoplastic enamel in primary teeth and erupting permanent teeth in a female child diagnosed with congenital rubella syndrome.
Salivary Cortisol, Alpha-Amylase and Heart Rate Variation in Response to Dental Treatment in Children
Authors: Furlan NF , Gaviäo MBD , Barbosa TS , Nicolau J , Castelo PM
Published: April 2015

Anxiety and stress are usually related to the dental treatment situation. The objective was to investigate salivary cortisol and alpha-amylase levels (salivary biomarkers) and heart rate in children undergoing a minor dental procedure (dental prophylaxis). Study design. In total, 31 children (range 84-95 months) of both genders without caries or history of dental treatment/pain/trauma were selected. Three saliva samples were gathered: one prior to dental prophylaxis, one immediately after, and one ten minutes later. Weight and height were assessed, and heart rate was evaluated prior to and during the procedure. Data were analyzed by correlation tests and t-test/Wilcoxon (α = 0.05). Results. Higher cortisol and amylase levels were observed before prophylaxis compared to afterward. Cortisol and amylase levels did not show a significant correlation, nor did salivary biomarkers and body mass index. However, heart rate and amylase levels showed a significant positive correlation. Conclusions. In the studied sample, certain anticipation of the dental treatment was observed because higher cortisol and amylase levels were observed before, rather than after, the event; moreover, a significant correlation between amylase levels and heart rate was observed. Thus, salivary biomarkers may be a valuable tool for evaluating anxiety-producing events, such as dental treatment, in children.
Dentistry and Childhood Poverty in the United States
Authors: Waldman HB , Cannella D , Perlman SP
Published: April 2015

The proportion and numbers of children living in low income families and without health insurance continues to increase. The magnitude of these problems is considered at localized levels in terms of the impact on the use of dental services.
Impact of Maternal Xylitol Consumption on Mutans Streptococci, Plaque and Caries Levels in Children
Authors: Alamoudi N M , Hanno A G , Sabbagh H J , Masoud M I , Almushayt A S , El Derwi D A
Published: April 2015

Aim:The present study was designed to determine whether maternal xylitol consumption through regular chewing of xylitol gums can affect the salivary mutans streptococci (MS), dental caries, and dental plaque levels of their children. Method: Study sample included 60 mother and child pairs with high salivary mutans streptococcus (MS) levels. Samples were randomly divided into experimental group (30 pairs) and control group (30 pairs). Mothers in the experimental group received xylitol chewing gum treatment three times/ day for three months, whereas the controls received fluoride varnish. Both groups received oral hygiene instructions, dietary counseling and restorative treatment. All children were examined after 6, 12 and 18 months from the initiation of the study to assess caries, plaque and salivary mutans streptococcus (MS) levels. Results showed that at 18 month the percent of children with high streptococcus levels in the control significantly increased when compared to the increase in the experimental group. Throughout the study, dmft scores of experimental children showed marginal non significant increase compared to controls that showed higher scores. Plaque scores revealed statistically non significant decrease among both groups. Conclusions: maternal xylitol consumption provided better preventive outcomes on salivary (MS) levels compared to fluoride varnish treatments.
Timing of Permanent Teeth Eruption in Turkish Children
Authors: Bayrak S , Sen Tunc E , Tuloglu N , Acikgoz A
Published: April 2015

Objective: To identify the mean time of permanent teeth eruption in children aged 5-15 years in Samsun, Turkey. Study Design: A total of 1,491 children aged 5-15 years (Female: 773; Male: 718) were included in this study. Teeth were recorded as either “not erupted” or “erupted,” which was defined as having at least one cusp visible in the oral cavity. Differences between eruption times for males and females and for maxillary and mandibular teeth were analysed using independent t-tests. Results: Eruption tended to be earlier in females than in males, but this difference was significant only for maxillary and mandibular canines and mandibular first premolars (p<0.05). For both females and males, the first teeth to erupt were the central incisors and first molars, and the last to erupt were the second premolars, molars and canines. Mandibular incisors and canines erupted significantly earlier than their maxillary counterparts in both females and males (p<0.05). Conclusion: In comparison with other studies, eruption times of permanent first molars, central and lateral incisors were delayed by several months, whereas eruption times of other teeth were accelerated by several months. The findings regarding eruption times should be considered when planning dental treatment.
Measurement and Assessment of Pain In Children - A Review
Authors: Jain Amit , Yeluri Ramakrishna , Munshi A K
Published: April 2015

Pain is a common experience during childhood. Despite the magnitude of effects that pain can have on a child, it is often inadequately assessed and treated. Numerous myths, insufficient knowledge among caregivers, and inadequate application of knowledge contribute to the lack of effective management. The pediatric pain experience involves the interaction of physiologic, psychologic, behavioral, developmental, and situational factors. Pain is an inherently subjective multifactorial experience and should be assessed and treated as such. Pediatric Dentists are responsible for eliminating or assuaging pain and suffering in children when possible. To accomplish this, we need to expand our knowledge, use appropriate assessment tools and techniques, anticipate painful experiences and intervene accordingly. As an assessment of pain which constitutes the foundation for all pain treatment, developing valid measures is both a clinical and research challenge. Clinicians and researchers should select measures with full knowledge of their psychometric strengths and weakness, as well as in keeping with their explicit conceptual model of pain. The purpose of this paper is to address potential sources of pain measurement, and responses to pain control and distractions based on the pediatric developmental stages.
Clinical Measurement of Maximal Mouth Opening in Children: A Pioneer Method
Authors: Kumar A , Dutta S , Singh J , Mehta R , Hooda A , Namdev R
Published: April 2015

Objectives: To determine the maximal mouth opening (MMO) in children aged 3 to 5 years from Indian population and to examine the possible influence of age, gender, height and body weight on MMO. Study Design: Assessment of MMO is accomplished with a modified Vernier Caliper by measuring the distance between the incisal edge of upper and lower incisor during maximal mouth opening upto the painless limit. Participants of the study were healthy children selected among regular students from local schools. Age, gender, height and body weight of each child were also recorded at the same time. Results: The results of the present study revealed that MMO in Indian children were 41.61 mm, 44.9 mm and 46.81 mm for boys and 40.09 mm, 44.22 mm and 46.2 mm for girls at age of 3,4 and 5 years respectively. Further significant associations were noted in between age, height, body weight and MMO. However, no gender difference was observed. Conclusion: A definite relationships exist between MMO, age, height and body weight in Indian children with primary dentition.
A Novel Music based Tooth Brushing System for Blind Children
Authors: Shetty V , Hegde AM , Varghese E , Shetty V
Published: April 2015

Objectives: To assess the Oral Health Status (OHS) of visually impaired children in South India, to devise and implement a specially designed Oral Health Education (OHE) program for them and to assess its efficacy in improving their OHS. Study design: OHS of 98 institutionalized visually impaired children aged 6 to 14 years were evaluated at the start of the study (Pre-OHE level) using the Modified Gingival Index (MGI), the Turesky-Gilmore-Glickman modification of the Quigley Hein Plaque Index (MQHPI) and Streptococcus mutans colony count. Oral Health Education was imparted with the help of specially designed models and tooth-brushing taught with specially formulated music aided instructions in a song format. These parameters were re-evaluated after a period of reinforced (two weeks and one month) and non-reinforced (two months) tooth-brushing. Results: Mean values of MGI and MQHPI showed a statistically very highly significant drop from the Pre-OHE level to the end of both the periods of reinforcement and non-reinforcement. There was a significant decrease in the S.mutans counts from the Pre-OHE levels to the period of non-reinforcement (p < 0.0005). Conclusion: The OHE program specially formulated for the visually impaired children was effective in improving their OHS significantly.
Biofilm Associated Microorganisms on Removable Oral Orthodontic Appliances in Children in the Mixed Dentition
Authors: Pathak A K , Sharma D S
Published: April 2015

Objective: Biofilms on removable orthodontic appliances act as reservoir of microorganisms, capable of modifying the environmental condition of oral cavity and are difficult to be removed with routine hygiene measures. The present investigation includes enumeration, identification and numerical analysis of different types of cultivable bacteria associated with the biofilms on removable orthodontic appliances. Study design: Removable appliances of 25 healthy children among the ages of 10 to 14 years were taken to measure the prevalence of biofilms and type of microorganisms. For isolation of microorganism from biofilms different types of selective and non-selective medium based on standard methods were used. The data were further analysed by using Kolmogorov-Smirnov test, one-sample t-test and Spearman rank correlation coefficient. The percentage frequencies of isolates were also calculated. Results : The survey revealed the presence of both multi-species and mono species biofilms on appliances, with Non-Streptococci, anaerobic bacteria, Streptococcus spp., members of the family Enterobacteriaceae and Lactobacillus spp. as a dominant microbial flora of biofilms. Bacilllus sp. and Candida sp. were isolated from one sample each. Significant positive and negative correlations were established among the species isolated from biofilms. Conclusion Higher prevalence of the members of the family Enterobacteriaceae were reported during this study, advocating an extra hygienic measure is essential for this age group while wearing acrylic orthodontic appliances in oral cavity.
Cyclic Neutropenia Presenting as Recurrent Oral Ulcers and Periodontitis
Authors: Chen Y , Fang L , Yang X
Published: April 2015

Background: Cyclic neutropenia (CN) is a rare congenital disease that can present with recurrent oral ulcers and periodontitis. CN can easily be misdiagnosed as major recurrent aphthous stomatitis (MaRAS) or aggressive periodontitis (AP) in dental clinics. We describe the case of an 8-year-old boy with CN, and compare the oral manifestations of CN with those of MaRAS and AP. Case report: An 8-year-old boy presented with a history of recurrent oral ulcers, periodontal destruction, pharyngitis and otitis media since the age of 3 months. Repeated, routine blood tests showed 1-week-long neutropenic periods that occurred at intervals of 2 weeks. A bone marrow cytology test during a neutropenic period demonstrated a decrease in granulocyte count. During a 2-year follow-up, his symptoms were well controlled by regular administration of granulocyte colony-stimulating factor and periodontal maintenance. Conclusion: Several clinical features help to differentiate CN from MaRAS and AP. Early recognition of the systemic cause of oral symptoms is important.
Maternal Education, Dental Visits and Age of Pacifier Withdrawal: Pediatric Dentist Role in Malocclusion Prevention
Authors: Pérez-Suárez V , Carrillo-Diaz M , Crego A , Romero M
Published: April 2015

Objective: Although discouraged, pacifier usage is widespread and often practiced beyond two years of age. The current study explored the effects of maternal education and dental visits on the age of pacifier withdrawal. Study design: The dental histories of 213 children (53.1% male) attending a primary school in Madrid were obtained along with maternal education level and age at pacifier withdrawal. Data were analyzed by using independent samples t-test, one-way ANOVA two-way ANOVA and a complementary non-parametric approach was also used. Results: There was a significant effect of maternal education on the age of pacifier withdrawal; the higher the maternal education, the younger the age of withdrawal. The frequency of dental visits influenced the relationship between maternal education and the age of pacifier withdrawal . Dental visits considerably shortened pacifier use among children with low- and medium- educated mothers. Conclusions: Pediatric dentists play a critical role in the correction of unhealthy oral habits such as prolonged pacifier use. The educational component of peediatric dentistry could reverse the lack of knowledge or misinformation among high-risk groups (e.g. low maternal education). As a consequence, we recommend that children start dental visits at an early age and maintain visits with a high frequency.
Relationship between Severe Early Childhood Caries and Body Mass Index
Authors: Bhoomika W , Y Ramakrishna , Munshi AK
Published: April 2015

Aim: This study was undertaken to evaluate the relationship between Severe Early Childhood Caries (S-ECC) and Body Mass Index (BMI) in the absence of any underlying medical condition for the school going (3 to 6 years old) children of Mathura city, India. Method: One hundred caries free children (50 boys and 50 girls) and one hundred children (50 boys and 50 girls) affected with S-ECC in the age range of 3-6 years without any contributing medical history were included in the study. Measurements of the weight (kg) and height (m) were done using a standard balanced beam scale and stadiometer. The BMI (kg/m2) was determined and the body weight status was evaluated using CDC based classification for each child. Independent t-test was used to evaluate whether the weight, height and BMI of S-ECC children is significantly different from caries free children. Result: Although the weight of the S-ECC children is more when compared to the normal children, the difference is not statistically significant. However, the mean BMI of S-ECC children is more when compared to the caries free children which was found to be statistically significant at p<0.05. The body weight status of the Normal and S-ECC affected children based on the CDC classification revealed that 48% have been classified in underweight category and 43% in normal weight category and very few children are found to be at risk of overweight and overweight. Conclusions: A positive correlation between the BMI and S-ECC was observed in this study. 51% of caries free children and 45% of S-ECC children were classified in underweight category based on CDC classification.
Determining Treatibility of Primary Teeth with Pulpal Exposure
Authors: Doğan S , Durutürk L , Orhan AI , Batmaz I
Published: April 2015

Objectives: To determine rates of pulpal exposure during caries removal with an excavator or a bur, to assess success rates of vital pulp therapies in both cases, to analyze pulpal bleeding as an indicator of primary teeth treatability. Study Design: Of the 352 primary mandibular molars with deep carious lesions, 141 with pulp exposed during the removal of caries were grouped according to type of instrument causing pulpal exposure and existence of bleeding at the exposure site. Teeth suitable for direct pulp capping or formocresol pulpotomy were treated and followed up for two years. Results: The difference between the rates of pulpal exposure with an excavator (52.5%) or a bur (47.5%) was insignificant. The treatment success rate of teeth with pulp exposed by an excavator (15.8%) was significantly lower than teeth with pulp exposed by a bur (48.8%), regardless of whether bleeding existed at the exposure site or not; however, when bleeding existed, this difference was insignificant (15.8% and 40.6%, respectively). Conclusions: Pulpal exposure possibility during caries removal caused by an excavator and a bur was similar, the treatment success rate was lower when the exposure was caused by an excavator, the existence of pulpal bleeding resulted in mistakes in diagnoses.
Evaluation of Microbial Profile in Dental Unit Waterlines and Assessment of Antimicrobial Efficacy of Two Treating Agents
Authors: Mungara J , Dilna NC , Joseph E , Reddy N
Published: April 2015

The quality of water in a dental unit used for cooling and flushing the high and low speed handpiece, air/water syringes and the scalers is of considerable importance. The present study was carried out to enumerate and identify the microorganisms present in water samples collected from dental unit waterlines of different dental specialty clinics and to find out the efficacy of two treating agents in disinfecting dental unit waterlines. Study design: Sample included 70 dental unit waterlines from different speciality dental clinics which were checked for microbial contamination. From these dental units 40 units were randomly selected and divided into two groups of 20 each. Group A, treatment was done in 20 dental units with 0.2% Chlorhexidine gluconate solution and Group B, treatment was done in 20 dental units with 10% Povidone iodine solution and the reduction in the microbial levels were assessed. Five dental units were randomly selected and checked the microbial contamination using mineral water, sterile distilled water, fresh tap water as a water source in the dental unit reservoir bottles. Also from the test group, five from each group were checked for the duration of efficacy of treating agent for one week by analyzing the water samples collected on 3 ,5 and 7 day intervals. Results: Most of the identified microorganisms are Gram negative and pseudomonas predominating up to 98.59% of the total isolates. Usage of disinfectants 0.2% Chlorhexidine and 10% Povidone Iodine were found to be very effective in reducing the microbial contamination and 10% Povidone iodine was found to be more efficient (97.13%) and active for a period of 3 days and gradually loosing its efficacy by 7th day. No significant difference were found in microbial contamination of water samples collected from different water outlets such as handpiece outlets, air water syringe outlets, scaler lines. Conclusion: To continue maintaining the sterility of the Dental unit waterlines and to complete the infection control measures adopted in the dental clinics, suitable disinfectants like 0.2% Chlorhexidine on daily basis or 10% Povidone iodine on every 3rd day basis intermittently maintain the sterility of dental unit waterlines it is essential to have a good water source and an effective disinfectant.
A Double Blind Randomized Trial of Ketofol Versus Propofol for Endodontic Treatment of Anxious Pediatric Patients
Authors: Mittal N , Goyal A , Gauba K , Kapur A , Jain K
Published: April 2015

Objective: To find out the safe and efficient sedative agent for primary molar pulpectomy in uncooperative pediatric patients. Study Design: This double blind randomized trial enrolled 40 anxious and healthy 2-6 year olds. All subjects received IV propofol (1-1.5mg/kg) or ketofol (1-1.5 mg/kg propofol with 0.25mg/kg ketamine) as per group assignment after oral midazolam premedication (0.5 mg/kg). Sedation maintenance was done with propofol infusion at 25-75?g/kg/min titrated to a predefined Worse level as per Houpt's sedation rating scale. Additional bolus/es was/were administered in the dosage similar to induction dose in case of inadequate sedation. Primary outcomes were intraoperative and postoperative adverse events. Secondary outcomes were vital signs, success of procedure, operator satisfaction, sedation quality, treatment time, recovery time and total propofol dose. Results: Significantly greater incidence of respiratory depression was reported for ketofol group (11/20; 55%) when compared to propofol group (3/20; 15%) (p = 0.008). Desaturation was the most common adverse respiratory event with significantly greater incidence in ketofol group (9/20; 45%) when compared to propofol only group (3/20; 15%) (p = 0.033). No significant differences regarding secondary outcomes were reported in two groups. Conclusion: Both the regimen exhibited similar sedation profile while propofol alone emerged as a safer option.
Molar Luxations Caused by Holding Water Taps. Report of Five Cases
Authors: Horie N , Hino S , Fukai S , Kaneko T , Shimoyama T
Published: April 2015

Luxation of a primary molar occurs rarely. Here, we describe five cases of primary molar luxation caused by holding a water tap pipe in the mouth during bathing. The patients were aged 16 to 19 months and the mandibular first primary molar was affected in all five cases. The second primary molar had not erupted. It is assumed that the flange of the pipe got stuck in the interdental space between the mandibular primary canine and first primary molar and the affected first molar was pushed out by force with the flange acting as a lever.
Pattern of Parental Acceptance of Management Techniques Used in Pediatric Dentistry
Authors: Peretz B , Kharouba J , Blumer S
Published: April 2015

Aim: To evaluate parents' acceptance of management techniques in Israeli pediatric dental clinics. Study Design: Ninety parents who accompanied their children to three pediatric dental clinics provided information on selected parameters including their attitudes about management techniques. Results: 68.9% of the parents preferred to stay in the treatment room. The most accepted technique was positive reinforcement (81.1%) followed by tell-show-do (TSD) (76.7%, with younger parents more accepting than older, p = 0.049). The least accepted techniques were restraint (1.1%) and voice control (7.8%, especially by parents with the highest dental anxiety, p = 0.002). Sedation was unacceptable by 15.6% of the parents: those with the lowest dental anxiety agreed to sedation significantly more than those with greater dental anxiety (p = 0.031). Conclusions: Parents preferred more positive approaches and management techniques that involve demonstrations geared for the child's level of understanding. Restraint and voice control were more strongly rejected than sedation.
Knowledge and Practice of Eating Disorders among a Group of Adolescent Dental Patients
Authors: Hicks TM , Lee JY , Nguyen T , La Via M , Roberts MW
Published: April 2015

Objectives: The objectives are to ascertain how much is known about the eating disorders of bulimia and anorexia nervosa in a group of female adolescents, to determine if they had practiced behaviors consistent with these eating disorders, and to determine if there was a disconnect with actual and perceived healthy weight status. Study Design: 126 research subjects completed a survey instrument. Embedded in the eighteen question survey were the five “SCOFF” questions, to determine if an eating disorder may exist. The BMI percentile was obtained for all participants. Results: 18.3% of the research sample may have an eating disorder as predicted by the SCOFF questions. Of those with a suspected eating disorder, only 38% could correctly identify the best description of bulimia nervosa and 50% for anorexia nervosa. The BMI percentiles were higher in the group suspected of having an eating disorder. Conclusions: Young adolescent females are at risk for eating disorders. Educational interventions should be directed at this young age group. If the at-risk individuals knew more about the consequences of these disorders, they may be less likely to practice the behaviors.
Presence of Oral Bacterial Species in Primary Endodontic Infections of Primary Teeth
Authors: Topcuoglu N , Bozdoğan E , Aktoren O , Kulekci G
Published: April 2015

Objective: Knowledge of the microbial composition of deciduous endodontic infections is limited. This study aimed to evaluate the presence of the 10 oral bacterial species in samples from primary tooth root canals by using microarray technology and to determine the association of these organisms with clinical conditions. Study Design: The samples were collected from 30 root canals of primary teeth with primer infection. The bacterial composition of the samples was semi-quantitatively defined using a microarray system (Parocheck®). Results: All the tested species were detected in the samples. Fusobacterium nucleatum was the most frequently isolated bacterium (96.7%), followed by Prevotella intermedia (86.7%), Parvimonas micra (83.3%), Treponema denticola (76.7%) and Tannerella forsythia (66.7%). These bacteria were also present in high levels. All pairs of bacterial species were positively associated (RR≯1), except P.intermedia and P.micra. On average, five species (range:3-8) were detected per amplified sample. Root canals of teeth with ≯5 different species were statistically associated with periapical radiolucency (P=0.049). Conclusions: Primary teeth with endodontic infections show a highly diverse variety of bacteria, in which the most prevalent specie are present in high proportions. The well-directed use of the improved microarray technology will provide additional valuable information for causative factors associated with endodontic diseases, helping to develop more successful antibacterial or anti-inflammatory treatment strategies.
Severe Congenital Hypoglossia: A Case Report
Authors: Noyola-Frías M , Santos-Díaz M , Chávez-Herrera C , Santos-Calderón L , Garrocho-Rangel A , Pozos-Guillén A
Published: April 2015

Hypoglossia is referred to a small volume and/or size of the tongue. It is a rare congenital condition caused by failed embryogenesis of the lateral lingual swellings and tuberculum impar during the fourth to eighth weeks of gestation. The anomaly has often occurred in association with limb abnormalities and various syndromes, and it affects facial and mandibular growth. The present report describes a case of severe congenital hypoglossia in a female infant, her systemic and dentofacial features, and the initial management.
Effect of Corticosteroids on Orthodontic Tooth Movement in a Rabbit Model
Authors: Abtahi M , Shafaee H , Saghravania N , Peel S , Giddon D , Sohrabi K
Published: April 2015

Introduction: While there are a growing number of studies on the effects of medications on orthodontic tooth movement (OTM), only few studies have investigated the role of corticosteroids, despite their widespread use. The aim of the current study was to evaluate the effects of triamcinolone acetonide injection on OTM in a rabbit model. Study design: Sixteen one-month old rabbits were randomly divided into two groups: Eight rabbits had triamcinolone acetonide (1mg/kg/day) administered IM daily for 21 days (test group) while the remaining eight rabbits received no drug (control group). The rabbits in both groups had a tube bonded to the upper central incisors and a stainless steel helical spring was inserted in tube slot to apply 50 cN distal force. After 3 weeks, the rabbits were sacrificed and the distance between mesial corners of incisors was measured. The incisors are associated tissue was processed for histology and the apical and cervical area of the roots evaluated. An observer who was blind to the study groups evaluated the specimens. Results: All appliance-treated incisors in test and control groups showed evidence of tooth movement. The distance between the incisors was significantly greater in the triamcinolone acetonide treated group compared to the control group (P<0.001). Histological examination revealed an increased number of resorption lacunae and decreased number of cuboidal osteoblastic cells around the apical and cervical area of the Incisor roots in the test compared to the control group (P<0.01). Conclusion: Treatment with triamcinolone acetonide is associated with increased tooth movement in rabbits via increased resorptive activity in the alveolar bone.
Bacterial Penetration along Different Root Canal Fillings in the Presence or Absence of Smear Layer in Primary Teeth
Authors: Sisodia R , Ravi KS , Shashikiran ND , Singla S , Kulkarni V
Published: April 2015

Aims: To study the effect of the smear layer on the penetration of bacteria along different root canal fillings and to compare the sealing ability of new endodontic material Apexit plus as compared to Zinc Oxide Eugenol (ZOE) in primary teeth. Study design: A total of 60 human root segments were instrumented for endodontic treatment. Half of the sample size was irrigated with normal saline and in other half, 3% NaOCl, 3% H2O2 and 17% EDTA was used alternatively as irrigant during instrumentation. The roots were rinsed thoroughly with distilled water and sterilized by autoclaving for 20 min at 121 ± 2 °C. Roots with and without smear layer were obturated with Apexit plus, Zinc oxide eugenol. Following storage in humid conditions at 37°C for 2 days, the specimens were mounted into a bacterial leakage test model for 180 days. Results: At 180 days, there is statistically significant difference with a P value of < 0.05 among all groups except ZOE -smear and -nonsmear. In the presence of smear layer, Apexit plus demonstrated more leakage. No leakage was observed in ZOE groups. ZOE demonstrated better sealing ability than Apexit plus. Conclusions: Removal of smear layer helps in better resistance to bacterial penetration along Apexit plus root canal fillings but no effect is seen along ZOE root canal fillings.
Assessment of Salivary Total Antioxidant Levels and Oral Health Status in Children with Cerebral Palsy
Authors: Subramaniam P , Mohan Das L , Girish Babu KL
Published: April 2015

Oxidative stress plays a pivotal role in the pathogenesis of neurological disorders. Saliva may constitute a first line of defence, against free radical-modified oxidative stress. The objective of the present study was to evaluate Total Antioxidant Capacity(TAC), levels of Nitric Oxide(NO), and Sialic Acid (SA) in saliva of cerebral palsied children. Study design: Thirty four non-institutionalized children in the age group of 7-12 years having cerebral palsy formed the study group. The control group consisted of thirty three normal, healthy children. The W.H.O. criteria was used for diagnosis and recording of dental caries. Oral hygiene status was assessed using the Simplified Oral Hygiene Index OHI-S. Estimation of Total Antioxidant Capacity, levels of Nitric Oxide and Sialic Acid in saliva was done. Data obtained was subjected to statistical analysis. Results: Children with CP had higher deft scores than that of normal children. Oral hygiene of children with CP was significantly poorer than that of normal children. Total Antioxidant Capacity of saliva was significantly higher in normal children than cerebral palsied children. Levels of Sialic Acid in saliva were significantly higher in cerebral palsy children. Conclusions: In children with CP, TAC of saliva showed an inverse relation with dental caries.
Relationship between Disk Position and Degenerative Bone Changes in Temporomandibular Joints of Young Subjects with TMD. An MRI Study
Authors: Moncada G , Cortés D , Millas P , Marholz C
Published: April 2015

This study determines the frequency and relationship between disk position and degenerative bone changes in temporomandibular joints in children and adolescent patients with internal derangement. Study design: TMJ, MRI of 88 patients were analyzed (average age: 14.7 years-old, range age: 10-18 years-old), female n=65 (73.9%) and male n=23 (26.1%). Images obtained were used to determine the frequency of disk position, joint effusion (JE) and degenerative bone changes (OA). Images were assessed by a calibrated radiologist (Kappa=0.82). Results: No significant association was found between disk displacement with reduction and degenerative bone changes (Chi2=9.894; OR= 0.375; p=0.0017), nor disk without displacement (Chi2=9.448; OR= 0.223; p=0.0021). A significant association was found between disk displacement without reduction and degenerative bone changes (Chi2=30.951; OR=6.304; p=0.0001). Conclusions: There is a significant association between disk displacement without reduction and degenerative bone changes (p=0.0001) in children and adolescent patients with TMD.
Changing Demographics and Providing Dental Services for Hispanic Children
Authors: Waldman H B , Perlman SP
Published: April 2015

General population demographics in the United States are undergoing dramatic changes. Long term customary populations which provided the bulwark for many successful dental practices are being replaced by the many minority populations, in particular the Hispanic population. Despite these significant general population developments, the demographic profile of the dental profession has experienced (and apparently – based on dental student populations – will continue to experience) limited changes. The economic strength of the profession may well be predicated upon its responses to these developments.
Direct Pulp Capping of Carious Primary Molars. A Specialty Practice Based Study
Authors: Kotsanos N , Arapostathis KN , Arhakis A , Menexes G
Published: April 2015

Objective: Recommendations against direct pulp capping (DPC) for carious primary teeth are based on old, low level evidence. This study investigates the medium to long term clinical and radiographic outcomes of such treatment. Study design: Each of 62 3-9 year old children with any deep, primary molar cavity was included if a pulp exposure occurred during caries excavation. Exclusion criteria were irreversible pulp damage / uncontrolled hemorrhage. Using rubber-dam, fast setting calcium hydroxide (CH) and tooth restoration were placed. Patients were followed up for signs/symptoms. Survival analysis, the Kaplan-Meier method and the Mantel-Cox test were used for statistically analyzing the data. Results: Seven patients (11.3%) dropped out. Controlled hemorrhage occurred in 25 exposures. Fourteen exposures were large and 46 were pin point. Out of 60 primary molars with DPC (in 55 patients), 7 failed by clinical and/or radiographic criteria. The remaining 53/60 (88.3%) teeth survived for 21.0 (±9.0) months. The 4 year cumulative survival rate by Kaplan-Meier analysis was 80%. All restorations remained in place with 3 needing replacement without affecting pulp survival. Conclusion: The CH success rate of carious primary molar DPC justifies further research based on careful initial diagnosis of pulp inflammation reversibility.
Effect of Bifidobacterium bifidum Containing Yoghurt on Dental Plaque Bacteria in Children
Authors: Caglar Esber
Published: April 2015

This article has been removed due to a claim of academic plagiarism.
Serum-Containing Medium Effect on Isolation Rate of Dental Pulp Cells from Cryopreserved Intact Deciduous Teeth
Authors: Bressan Werle S , Lindemann D , Machado J , Pranke P , Casagrande L
Published: April 2015

Objectives: To isolate cells from pulp of intact cryopreserved deciduous teeth. The null hypothesis raised here is to find no difference in the establishment of cell culture after cryopreservation (1) using culture medium supplemented with different concentrations of fetal bovine serum (FBS); and (2) between teeth with different stages of physiological root resorption. Study design: Intact deciduous teeth with different root resorption stages were cryopreserved using FBS and Dimethyl Sulfoxide (DMSO) medium (9:1) in a progressive freezing process, by placing the samples in the refrigerator (4°C/60 min) and subsequently transferring them to a -80°C freezer (controlled device -1°C/min/24 hours), and finally into liquid nitrogen (-196°C/30 days). After the thawing process, the cell isolation was performed by enzymatic digestion (type I collagenase). The cells were re-suspended into the culture medium with 10% (G1) or 20% (G2) of FBS. Microscopic analysis was performed after 30 days to visualize the cell attachment. Results: The culture establishment rate was higher in G2 (75%) than G1 (12.5%) (p=0.041). There was no difference between the different stages of root resorption. Conclusions: It was possible to establish cell cultures from the pulp of intact cryopreserved deciduous teeth. The use of 20% FBS after thawing improved the culture rate.
MTA and Ferric Sulfate in Pulpotomy Outcomes of Primary Molars: A Systematic Review and Meta-Analysis
Authors: Asgary S , Shirvani A , Fazlyab M
Published: April 2015

Objective: Methods of systematic review and meta analysis were employed to compare the success rate of pulpotomy of primary molars using mineral trioxide aggregate (MTA) and ferric sulfate (FS) as two regenerative and preservative agents, respectively. Study design: After raising a PICO question (In pulpotomy of vital carious-exposed primary molars, how does MTA compare to FS in terms of clinical and radiographic outcomes?) and determining the search strategy, MeSH-matching keywords were searched in four electronic databases and retrieved papers were examined in titles, and if necessary abstracts and full texts, to be relevant. Randomized clinical trials (RCTs) evaluating pulpotomy of vital primary molars after carious/traumatic exposure conducted with either FS or MTA, with at least a 6-month recall, tooth restorability, and those considering clinical and radiographic signs/symptoms, were included. The nonrandomized allocation and absence of comparison between the treatment groups caused the exclusion of the article. The quality of the RCTs and also their risk of bias (low, moderate, high), were assessed using a modification of van Tulder list; for meta-analysis of the matching studies, the extracted data were analyzed by Mantel Hanszel analysis. Results: A total number of 620 articles were found. After exclusion of the common titles and application of the eligibility criteria, 4 RCTs [12-month follow-up: n=3, 24-month follow-up: n=4, in total: 264 teeth) comparing MTA and FS, were selected. It was showed that the 12-month outcome of both materials were similar [RR= 0.642 (CI 95%: 0.225-1.833, P=0.407)], while the two-year follow-up results revealed significant differences in treatment outcome, in favor of MTA [RR was 0.300 (CI 95%: 0.132-0.683, P=0.004)]. Conclusion: MTA demonstrated superior long-term treatment outcomes in pulpotomy of primary molars than FS. Clinical Significance: Considering the advantages of MTA compared to FS and its better clinical results, use of this bioregenerative material in primary molar pulpotomy is recommended.
Increasing Use of Dental Services by Children, but Many Are Unable to Secure Needed Care
Authors: Waldman HB , Ackerman MB , Perlman SP
Published: April 2015

National studies indicate that an increasing proportion of children are receiving needed oral health care. However, this increase is not uniform throughout all populations of youngsters. Overall national study findings regarding the use of dental services mask the fact that, a significant subset of low-income, minority, medically and developmentally compromised and socially vulnerable children continue to lack access to care and suffer significant and consequential dental and oral disease. In addition, these same children will face continued difficulties in securing needed care as they reach their early adult years.
Minimal Intervention Dentistry Procedures: a Ten Year Retrospective Study
Authors: Freitas MFL , Santos JM , Fuks A , Bezerra ACB , Azevedo TDPL
Published: April 2015

Minimal Intervention Dentistry (MID) is an effective treatment approach with increasing acceptance among dental professionals. Objective – This study aimed to evaluate the MID impact on Dentistry by analyzing procedures performed on patients treated at a Pediatric Dentistry Graduate Program clinic which implemented MID. Study design – The number of procedures including sealants, modified atraumatic restorative treatment (mART), resin crowns, direct pulp capping, pulpotomy, pulpectomy, and deciduous/ permanent extractions from 333 pediatric patients treated between the years 2001 to 2003 and 2008 to 2010 in Distrito Federal, Brazil were analyzed. Statistical analysis involved chi-square and G Williams tests. Results – 783 procedures were analyzed and demonstrated that there was a significant reduction of sealant placement in the last triennium when compared to the first one (p<0.0001). Moreover, there was a significant increase in the amount of mART (p<0.0001). This increase in mART procedures resulted in a significant reduction in procedures with pulp involvement: direct pulp capping (p=0.0014), pulpotomy (p=0.0014) and pulpectomy (p=0.0002). Conclusions – Based on the results, MID represented a positive impact on the intervention on caries lesions in patients, mainly reflected by the significant reduction in the number of direct pulp capping, pulpotomy and pulpectomy.