Ghrelin hormone might have a potential role in amelogenesis.

AIMS: Amelogenesis imperfecta and generalised enamel hypoplasia are developmental dental anomalies that affect dental enamel. While amelogenesis imperfecta results from various gene mutations, the exact underlying mechanisms of the etiopathogenesis of both remain unclear. This study aims to evaluate Ghrelin hormone levels in children with generalised enamel hypoplasia to establish whether Ghrelin might have a potential role in enamel hypoplasia's etiology. The second purpose is to determine the correlations among the blood levels of Ghrelin, growth hormone (GH), insulin-like growth factor-1 (IGF-1), bone alkaline phosphatase (BALP) and osteocalcin (OC) that are vital in dental development. MATERIAL AND METHODS: Study was designed with two study groups, AI (hypoplastic amelogenesis imperfecta) (n = 15; mean-age 10.36 ± 1.90) and GEH (idiopathic generalised enamel hypoplasia) (n = 15; mean-age 10.42 ± 1.84), and a healthy control (n = 15; mean-age 10.39 ± 1.91) group. After fasting for 10-12 hours, simultaneous blood samples were collected; then, after centrifugation, serum and plasma were stored at -80°C until the day of analysis. Total Ghrelin levels of plasma and serum levels of GH, IGF-1, BALP and OC were measured using commercial ELISA kits. RESULTS: Ghrelin levels of AI and GEH groups were significantly lower (P < .01) than the control group. CONCLUSION: This is the first study to reveal the decreased levels of Ghrelin in plasma of children with generalised enamel hypoplasia, suggesting a potential role for Ghrelin in amelogenesis. In order to determine its function in enamel formation, further studies should be carried out. The result of the present study suggests that paediatricians refer children with abnormal Ghrelin levels to a paediatric dentist to contribute to appropriate prophylactic and therapeutic interventions. Generalised enamel hypoplasia may also indicate possible abnormalities in Ghrelin levels for paediatricians. Therefore, paediatricians' knowledge about the clinical appearance of generalised enamel hypoplasia should be increased.

Evaluation of maxillary sinus expansion in children due to maxillary first molar extraction.

PURPOSE: This study is aimed at understanding the effects of maxillary first molar extraction on the expansion of maxillary sinus in children. SUBJECTS AND METHODS: 119 patients (aged 11-17 years) who had only one extracted maxillary first molar were included in the study. The superoinferior differences of the sinus floor position were measured in both dentate and edentulous sites on panoramic radiographs. The expansion of the maxillary sinus after maxillary first molar extraction was investigated in relation to fixed anatomic structures. The interorbital line (IL) and two zygomatic process lines (IZ) were used as a reference. The vertical distances between the IL and the inferior border of the maxillary sinus (IS) in edentulous (ISX) and in dentate sites (IST) were measured. The data was analyzed statistically. RESULTS: The amount of maxillary sinus expansion in ISX was statistically significant in comparison to IST (p<0.001). The most prominent sinus expansions were found in subjects with extractions over six months prior to analysis (p<0.001). A negative correlation was detected between the amount of maxillary sinus expansion and IST (r = -0.438, p<0.001). There was a positive correlation between the amount of maxillary sinus expansion and IZT (r = 23.8, p<0.009). CONCLUSION: This study showed that the extraction of one maxillary first molar resulted in a negligible amount of sinus expansion in children. The results could be attributed to there being only one tooth extraction and a transferring of functional forces to the area of the neighboring teeth.

Importance of knowledge of the management of traumatic dental injuries in emergency departments.

BACKGROUND: Hospital emergency departments (EDs) are confronted with managing dental emergencies of both traumatic and non-traumatic origin. However, the literature suggests inadequate knowledge of the management of traumatic dental injuries (TDIs) among medical professionals. The aim of this study was to investigate the knowledge and attitudes regarding management of TDIs among Istanbul ED physicians. METHODS: Surveys were distributed to emergency departments (ED) directors and their physicians. The survey contained questions about their characteristics and tested their knowledge of managing dental trauma. RESULTS: A total of 126 surveys (13 ED directors and 113 physicians) were returned and included in the analysis. ED physician's knowledge of the appropriate management of crown fractures and avulsion was generally good (p=0.221), but poor for luxation injuries (p=0.0001). Physicians were more likely to have a better knowledge about permanent teeth than about primary teeth (p=0.027). CONCLUSION: Education, monitoring, improved availability of resources, and disciplinary measures in cases of poor compliance are necessary to improve TDI management in hospitals, especially among physicians.

The prevelance of mesiodens in a group of non-syndromic Turkish children: a radiographic study.

PURPOSE: The aim of the present study is to determine the prevelance and clinical status of mesiodens in a group of non-syndromic Turkish children, with an analysis of the associated clinical-eruptive complications. MATERIALS AND METHODS: This study sample consists of 58142 pediatric patients'. Standard equipment and films were used in the suspected patients. The examination of all radiographs was performed under standard conditions by two pediatric dentists with over 10 years experience. Age, gender, number of mesiodens, morphology and clinical status were recorded in forms. RESULTS: A total of 83 mesiodentes were diagnosed in 59 children with ages ranging from 6-14 years. The prevelance of mesiodens was estimated as 0.1%. Males were more frequently affected than females in the ratio of 2.3:1. Of the 83 mesiodentes, 48.2% were conical, 31.3% were tuberculate and 20.5% were incisor like, 22.9% were inverted, and 68.7% were fully impacted. The number of mesiodens was one in 36 cases (61.0%), two in 22 cases (37.3%) and three in one case (1.7%). The mean age at the time of diagnosis of the mesiodens was 9.5 years. The main complication associated with the mesiodens was displacement or rotation of the permanent teeth (73.3%). CONCLUSION: This study presents 0.1% prevelance of mesiodens in a group of Turkish children sample. The majority of the mesiodentes were unilateral located in the premaxillary region, were conical shaped, and remained unerupted. The mean age at the time of diagnosis of the mesiodens in this study was 9.5 years, with this period being later than the eruption time of the maxillary central incisor.

Familial gigantiform cementoma with Ehlers - Danlos syndrome: A report of 2 cases.

Ehlers-Danlos syndrome is an autosomal dominant hereditary disorder of connective tissue, while familial gigantiform cementoma is a condition that usually manifests as multiple radiopaque cementum-like masses throughout the jaws. This case report discusses the oral management and prosthetic rehabilitation of two patients presenting familial gigantiform cementoma with Ehlers-Danlos Syndrome.

The prevalence of dental anomalies in a turkish population.

PURPOSE: The aim of the present study was to investigate the prevalence of dental anomalies in a Turkish population according to the gender and age. MATERIALS AND METHODS: A retrospective study was performed using panoramic radiographs of 2025 patients (885 males and 1140 females) ranging in age from 9 to 35 (mean age 25.61±10.04) years attending Department of Oral Radiology, University of Istanbul, Faculty of Dentistry. These patients were examined to determine the presence of developmental dental anomalies involving hypodontia, hyperdontia, microdontia, taurodontism and other root anomalies. The incidence of these anomalies were assessed according to the gender and age. RESULTS: Among the 2025 subjects, a total of 96 individuals (42 males and 54 females) showed at least one of the selected dental anomalies (4.74%). Tooth agenesis was the most common dental abnormality (1.77%) followed by taurodontism (1.18%), hyperdontia (0.79%), microdontia (0.54%) and root anomalies (0.44%), respectively. CONCLUSION: Tooth agenesis is the most common developmental dental anomaly in the studied Turkish population followed by taurodontism.

Knowledge of sports participants about dental emergency procedures and the use of mouthguards.

AIM: The aim of this study was to evaluate the knowledge of sports participants regarding emergency management of dental trauma and the awareness about mouthguards. METHODS: A specific questionnaire regarding knowledge, experiences and behaviours after dental trauma and the use of mouthguard was distributed to 359 sports participants up to 18 years of age. The sports involved were basketball, swimming, volleyball, soccer, tennis, badminton, handball, athleticism, golf, gymnastics, water polo and karate. The questions were focused on personal experience, awareness of first aid and dental emergency procedures and knowledge about mouthguards. RESULTS: The results showed that 10.9% had experienced a kind of dental trauma, and 12.5% would look for a dentist for treatment in emergency. 34.5% would re-implant the avulsed tooth, 33.4% would maintain the avulsed tooth in handkerchief and 25.3% would maintain it in saline solution. 41.1% were aware of the possibility of oral injuries during sports practice, and 55.4% knew about mouthguards, but only 11.2% of the participants reported to use them. There was a statistically significant difference between the experienced participants (>5 years) and less-experienced group (<5 years) in knowledge about dental emergency procedures and mouthguards. Reasons given for not wearing mouthguards include 'lack of aesthetic' was significantly high in experienced participants. The less-experienced participants significantly stated that they had never heard about mouthguards before. CONCLUSION: Our results showed a lack of knowledge of sports participants about management and prevention of traumatic dental injuries. Educational programs should be organized to give information about emergency treatment and promote the use of mouthguards to sport participants.

Predominant causes and types of orofacial injury in children seen in the emergency department.

BACKGROUND: The aim of this study is to determine the type and cause of traumatic orofacial injuries in children up to 18 years of age. METHODS: This retrospective study involved data collected from 12055 patients that came to Istanbul University, Medical Faculty, Department of Emergency in 2011. The patients' data were evaluated with regard to age, gender, etiologic factor of the trauma, type and localization of the injury, and time interval between injury and treatment. RESULTS: A total of 1296 children in 12055 patients with orofacial trauma were evaluated. Trauma incidence was higher in boys (65%). The major etiologic factor of injury was falls (56%) and primary localization was in the frontal region (41%). The most frequent types of injury were laceration (30.1%) and hematoma (18.6%). 4% of the injuries were found in the orodental region including lips, teeth, tongue and oral mucosa of the mouth. 38% of the patients came to the emergency department within 30-60 minutes after the injury and 68% were sent home with symptomatic treatment. CONCLUSION: Considering the high percentage of orofacial traumas, effective education is necessary regarding the appropriate diagnostic approach, emergency management and prevention of traumatic dental injuries.

Reasons for early loss of primary molars.

PURPOSE: The aims of this study were to investigate the principal reasons for untimely loss of primary molars and to evaluate the risk factors of early primary molar loss in children aged four to nine years. MATERIALS AND METHODS: 1150 untimely lost primary molars were analyzed from 546 patients. The early loss of primary molars was analyzed in relation to age, sex, dmf (t), DMF (T) scores, toothbrushing frequency, history of treatment and maternal education. The data were converted to SPSS format. Pearson Chi-square test was used for statistical analysis. RESULTS: Among the investigated subjects, 15.2% of children reported regular toothbrushing. Only 23.1% of subjects had a history of treatment before the tooth extraction and 33% of mothers had a low education level. Untimely loss of primary molars due to pain, caries and sepsis were 30.2%, 31% and 38.8%, respectively. The frequency of 'only one primary molar loss' was significantly higher in group 1 (p < 0.05), however the frequency of 'more than one primary molar loss' for group 2 was more than group 1 (p < 0.05). Irregular toothbrushing for the children in group 2 was found significantly high than in group 1 (p < 0.05). Irregular toothbrushing was associated with number of early primary molar loss in group 2 (p < 0.05). The level of maternal education was associated with dmf (t) scores (p < 0.05). The caries incidence was associated with number of early primary molar loss in both groups (p < 0.05). The mean number of treated teeth before extraction for group 2 was significantly higher than for group 1 (p < 0.05). CONCLUSION: Results of this study suggested that irregular toothbrushing, high dmf (t) scores and untreatment of carious primary molars were significant risk factors in early loss of primary molars. Every effort must be taken into account in restoring rather than extracting carious teeth.

Clinical performance of sealants with and without a bonding agent.

OBJECTIVES: The objective of this study was to assess the effect of a one-bottle bonding agent on sealant success after 3, 6, 12, and 24 months. METHOD AND MATERIALS: The sample group consisted of 30 schoolchildren (8 to 10 years of age) who had all their permanent first molars sound and unsealed. Occlusal sealants were placed on first molars according to a split-mouth design. Sealant scoring occurred at 3, 6, 12, and 24 months and was performed by two clinicians blinded to the treatment group. Fisher's exact test was used to analyze the data. RESULTS: The clinically acceptable marginal integrity rates for sealants with a bonding agent after 3, 6, 12, and 24 months were 93%, 93%, 83%, and 79%, respectively. For sealants without a bonding agent, the clinically acceptable marginal integrity rates after 3, 6, 12, and 24 months were 90%, 88%, 81%, and 77%. The rates for no color change in sealants with a bonding agent after 3, 6, 12, and 24 months were 96%, 93%, 81%, and 75%, respectively. For sealants without a bonding agent, the no color change rates after 3, 6, 12, and 24 months were 93%, 93%, 79%, and 72%. After 24 months, 73% of the sample group were available for recall. The retention rates for sealants with and without a bonding agent after 24 months were 79% and 75%, respectively. The results of the statistical analysis showed that there were no differences among the sealants with and without bonding agents evaluated in relation to marginal integrity, marginal discoloration, and anatomic form. CONCLUSION: The success of a sealant is related to whether the sealant is applied under optimal conditions. The results of this study show that at the 2-year mark, the placement of a bonding agent under sealants did not significantly affect the clinical success of sealants.

Evaluation of oral and systemic manifestations in an amelogenesis imperfecta population.

OBJECTIVES: The aim of this investigation was to describe the dental and craniofacial characteristics of patients with amelogenesis imperfecta (AI). METHODS: The study group included 43 patients(33 female and 10 male) with a mean age of 11.4+/-2.6 years. A panoramic and a cephalometric radiograph were obtained from each of these patients. Clinically AI cases were divided into four main groups according to Witkop. All patients were evaluated for chronological, bone and dental age. The patients who had severe retarded bone age were evaluated for plasma growth hormone(GH) concentrations. RESULTS: Dental and bone ages were retarded with respect to chronological age in five patients. Dental maturity and tooth eruption were not age- appropriate in some of our patients. In type III AI patients a delay in skeletal age was observed. Severe late eruption was seen in 3 patients, severe delay in dental maturity was noted in patients with type IV AI. Dental age was clinically lower in GH-deficient subjects, and skeletal age was consistently more retarded than dental age when compared to chronological age. Anterior open bite was present in both primary and permanent dentitions of 50% of the patients with type I AI, 30.8% of the patients with type II AI, and 60% of type III AI. CONCLUSION: It is concluded that the primary structure for the classification of AI be based on the mode of inheritance, with the clinical and radiographic appearances (and any other features such as systemic findings) being the secondary discriminators.

In vitro effects of bleaching agents on FM3A cell line.

OBJECTIVE: There are concerns about the possible pathologic effects of relatively long-term exposure of oral tissues to bleaching agents. The purpose of the present study was to investigate the cytotoxic effects of various bleaching agents on mouse mammary carcinoma FM3A cell line. METHOD AND MATERIALS: FM3A cell line obtained from European Collection of Animal Cell Cultures was used in cell culture assay. Exponentially growing cells were seeded in 1 x 105 cells/mL in 5 mL of RPMI 1640 medium supplemented with 10% fetal calf serum and antibiotics in each well of a six-well plate. PowerGel was applied onto the cell culture medium and incubated for 24 hours at 37 degrees C in a 5% carbon dioxide atmosphere after light curing. Opalescence PF gel was left on cell culture medium for 24 hours at the same conditions. After 24-hour incubation, the cells were collected by trypsinization and counted with a hemocytometer. For cell viability, trypane blue exclusion assay was used. The cytotoxicity of PowerGel and Opalescence PF were determined by evaluation of cell growth and viability in comparison to untreated controls (cell growth = 100%). The data were submitted to statistical analysis (One-way analysis of variance, Dunnett's t test). RESULTS: Cell growth after 24 hours was significantly reduced (P = .000) in comparison to the control group. The cell growth in the Opalescence PF gel group also was reduced (P < .05). It was found that both gels affected cell viability. CONCLUSION: PowerGel and Opalescence PF showed a cytotoxic effect on cell growth in FM3A cell line.

Freeman-Sheldon syndrome: a case report.

Freeman-Sheldon syndrome, also called "whistling-face syndrome," is a very rare genetic condition, occurring both sporadically and by transmission through autosomal dominant or recessive mode, which affects primarily the face and skeleton. Characteristics include microstomia of the mouth, which gives the person a whistling appearance, a flat face, club feet, contracted joint muscles of the fingers and hands, and underdeveloped nose cartilage. This article describes a case of Freeman-Sheldon syndrome in a 10-year-old male. The most apparent deformities are associated with orofacial and skeletal development.

Clinical and immunological findings of two siblings in a family with generalized aggressive periodontitis.

PURPOSE: The clinical and immunological data from 2 siblings with generalized aggressive periodontitis in a family are presented. METHODS: Peripheral blood lymphocyte subpopulations were analyzed by dual color flow cytometry by using monoclonal antibodies for the lymphocyte receptors CD2, CD3, CD4, CD5, CD8, CD16, CD19, CD11b, CD11c, and HLA-DR. RESULTS: Both patients showed a higher increase in CD11b/CD18 expression. CONCLUSIONS: The evaluation of CD11b and CD11c receptors may be important in explaining leukocyte abnormalities in the pathogenesis of the disease. One of the patients showed decreased counts of natural killer cells while the other was normal. In both patients, the authors observed a slight elevation in Ts lymphocytes.

Periodontal health, salivary status, and metabolic control in children with type 1 diabetes mellitus.

BACKGROUND: The aim of this study was to determine whether detectable periodontal destruction and alterations in the salivary status were present with duration of diabetes in children with type 1 insulin-dependent diabetes mellitus (type 1 DM) as compared to healthy controls. METHODS: Sixteen newly diagnosed children with DM (group 1), 16 children with type 1 DM of long duration (group 2), and 16 healthy children (group 3) participated in the study. Periodontal health was assessed by plaque index, gingival index, bleeding on probing, and periodontal probing depths. The flow rate, pH, buffering capacity, and peroxidase activities of stimulated saliva were determined. The data were analyzed by Kruskall-Wallis, Student t test, and Pearson's correlation analysis. RESULTS: The mean values for fasting blood glucose levels for the diabetic groups were significantly higher than for the controls. The mean values for salivary buffering capacities and salivary pH from the diabetic groups were significantly lower than for the controls. The plaque index values for the diabetic groups were significantly higher than for the controls. The mean gingival index value for group 1 was significantly lower than for group 2. The mean periodontal probing depths for group 1 were similar to those of the non-DM controls, but the mean periodontal probing depths for group 2 were significantly greater than for both the non-DM controls and group 1. Group 1 had significantly greater bleeding on probing scores than did the other groups (P < 0.05). CONCLUSION: The glycemic status of the diabetic subjects affects the periodontal probing depths, salivary pH, buffering capacity, and peroxidase activity.

Congenital analgia syndrome.

Hereditary sensory and autonomic neuropathy is a rare syndrome which is seen in early childhood. Five different types have been described. Absence of pain and self-mutilation are characteristic findings of this syndrome. This report describes one female and two male children with the syndrome. The most severe oral consequence of their disorder was damage to the oral tissues and tongue. The primary aim in management was to monitor the eruption of the permanent teeth.

Inverted impaction of primary incisors: a case report.

Dental and radiological findings of a 5-year-old female patient show inverted impaction of the maxillary primary incisors. Family and personal histories of the patient were unremarkable. There were no abnormalities in general growth and development nor was there any history of trauma.