Best Clinical Practice Guidance for clinicians dealing with children presenting with Molar-Incisor-Hypomineralisation (MIH): An EAPD Policy Document.

BACKGROUND: The European Academy of Paediatric Dentistry (EAPD) has long recognised the necessity of promoting further research and knowledge regarding the dental defect described as molar-incisor-hypomineralisation (MIH). Following the establishment by EAPD of the defect diagnostic criteria in 2003, the publication of various papers and a whole issue assigned to the defect in the European Archives of Paediatric Dentistry (2008), an Interim Seminar and Workshop on MIH was organized in Helsinki in 2009. RESULT: The outcome of this event is the present consensus paper on the prevalence, diagnosis, aetiology and treatment for children and adolescents presenting with MIH. A clear diagnostic proposal and a treatment decision-making guide are presented together with suggestions on aetiology and guidance for future research. CONCLUSION: MIH is an important clinical problem that often concerns both the general dental and specialist paediatric dentists; the present 'best clinical practice guidance' aims to further help clinicians dealing with the condition.

The subjective image quality of conventional and digital panoramic radiography among 6 to 10 year old children.

OBJECTIVES: To compare the diagnostic quality of orthopantomographs made with the conventional unit Orthophos Siemens and the direct digital unit Planmeca 2000 cc Proline among children 6-10 years old and to investigate possible diferences on image interpretation between oral radiologists and pediatric dentists. METHODS: Study material included two independent groups of panoramic images (50 in each group) made with different panoramic modalities (digital conventional). Eight observers (four pediatric dentists and four oral radiologists) evaluated all images for diagnostic quality in 12 pre-determined areas using a 4-point rating scale. RESULTS: Digital and conventional panoramic radiography performed almost similarly as far as it concerns the specific diagnostic tasks rated with the exception of the interproximal contacts of mandibular molars where digital panoramic radiography was scored significantly higher and the periapical region of anterior mandible and anterior mandibular tooth germs where conventional panoramic radiography was found to be significantly better. Both oral radiologists and pediatric dentists graded similarly digital and conventional radiographs for a variety of diagnostic tasks. CONCLUSIONS: It can be concluded that diagnostic image quality obtained with the digital orthopantomograph unit Planmeca 2000 cc Proline was generally equal to image quality obtained with the conventional orthopantomograph unit Orthophos Plus CD. Image interpretation between oral radiologists and pediatric dentists was not substantially different

[Management of the cleft patient from birth to completion of the deciduous teeth]. / E antimetopise tou paidiou me schistia apo te gennese mechri kai te symplerose tou neogilou phragmou.

Cleft lip and cleft palate are the most common defects of the craniofacial system. The treatment of children with this craniofacial malformation requires a multidisciplinary approach due to the complexity of their problems. Thus, cleft lip and palate teams have developed in many institutions, in order to provide the necessary medical and psychosocial treatment to these children. The treatment of children with cleft lip and cleft palate should begin right after birth and include their families as well. The purpose of the present paper is to present the problems of children with cleft lip and cleft palate from birth until the completion of their primary dentition. In addition, the systematic and comprehensive treatment planned by the various specialists of the team for the solution of the above problems, is presented in detail.

[Fluoride poisoning: mechanism, symptoms and treatment]. / Deleteriase apo phthorioucha. Mechanismos, symptomatoligia kai antimetopise.

The use of fluorides in doses recommended by the International Dental Association is totally safe. Fluoride toxicity occurs only when these doses are exceeded. The human organism is capable of metabolizing fluoride when administered in low doses. Toxic doses though can cause signs and symptoms which vary from simple gastric disturbances to serious health problems or even death. The least fluoride dose which can cause signs and symptoms of fluoride poisoning is called possibly toxic dose. In the present paper the amount of 5 mgF-/kg is considered as the probably toxic dose of fluoride. In the case of accidental ingestion of a fluoride overdose the dentist should be also to calculate the amount of fluoride ingested. A simple method of calculating the amount of fluoride swallowed is presented in this paper. In addition the emergency treatment for fluoride overdoses is discussed. The danger of acute fluoride poisoning has increased lately, especially for children, due to the variety, pleasant taste smell and colour of fluoride products. Dentists should be able to estimate the toxic potential of fluoride in case of accidental poisoning and advise appropriate treatment.

[Hemophilic patients. Treatment protocol in the dental office]. / O aimorrhophilikos asthenes--protokollo antimetopises sto odontiatreio.

Hemophilia is an inherited hemorrhagic disease which is due to the insufficiency of Factor VIII, or Factor IX, or Factor XI. Hemophilia patients are regarded as special patients with increased dental problems. The present paper consists of two parts. In the first part the types of hemophilia, ways of transmission, severity forms, and clinical characteristics are described. In the second part a protocol concerning the dental treatment of hemophilia patients is presented. There are four basic types of hemophilia: hemophilia A or classical hemophilia or Factor VIII deficiency, hemophilia B or Christmas disease, hemophilia C and von Willebrand's disease. Hemophilia is transmitted either as a sex-linked recessive or as an autosomal dominant trait, depending on the type of the disease. The severity of hemophilia depends on the amount of the coagulation factor present. According to this amount, there are four scales of severity. The clinical characteristics of the disease also depend on the amount of the factor present and vary, from occasional bleedings to serious and even life-threatening bleeding episodes. In the second part of the paper the special psychological and physiological problems of the hemophiliacs are discussed. In addition, there is reference to the hematologic coverage these patients need, as well as to the protection measures for the dental personnel against hepatitis and AIDS. The dental treatment plan at the office is presented in detail, including a discussion of the advantages and disadvantages of the treatment of hemophilia patients in the operating room under general anesthesia.

Control of Streptococcus mutans with topical fluoride in patients undergoing orthodontic treatment.

Subjects undergoing orthodontic treatment were asked to brush their teeth twice a day for 6 weeks with stannous fluoride gel or acidulated phosphate-fluoride gel. A reduction in salivary Streptococcus mutans levels was evident in subjects who brushed with the stannous fluoride.