The oral microbiome-the relevant reservoir for acute pediatric appendicitis?

PURPOSE: The oral microbiome has been related to numerous extra oral diseases. Recent studies detected a high abundance of oral bacteria in inflamed appendices in pediatric patients. To elucidate the role of oral bacteria in acute pediatric appendicitis, we studied the oral and appendiceal microbiome of affected children compared to healthy controls. METHODS: Between January and June 2015, 21 children undergoing appendectomy for acute appendicitis and 28 healthy controls were prospectively enrolled in the study. All individuals underwent thorough dental examination and laboratory for inflammatory parameters. Samples of inflamed appendices and the gingival sulcus were taken for 16S rDNA sequencing. RT-qPCR of Fusobacterium nucleatum, Peptostreptococcus stomatis, and Eikenella corrodens was performed and their viability was tested under acidic conditions to mimic gastric transfer. RESULTS: In phlegmonous appendices, Bacteroidetes and Porphyromonas were discovered as dominant phylum and genus. In sulcus samples, Firmicutes and Streptococcus were detected predominantly. P. stomatis, E. corrodens, and F. nucleatum were identified in each group. Viable amounts of P. stomatis were increased in sulci of children with acute appendicitis compared to sulci of healthy controls. In inflamed appendices, viable amounts of E. corrodens and F. nucleatum were decreased compared to sulci of children with appendicitis. Postprandial viability could be demonstrated for all tested bacteria. CONCLUSION: In children with acute appendicitis, we identified several oral bacterial pathogens. Based on postprandial viability of selected species, a viable migration from the oral cavity through the stomach to the appendix seems possible. Thus, the oral cavity could be a relevant reservoir for acute appendicitis.

The Influence of Coordinative Skills on the Oral Health of Children and Adolescents in Permanent Dentition.

Removing dental plaque by using a toothbrush is the most important measure for oral hygiene. The aim of the present study was to estimate the impact of the coordination skills of children and adolescents on their oral health (plaque level, DMF/T: decayed, missing, filled teeth). Within a prospective cohort study, 996 children (10 to 18 years) were examined. The results of three coordination tests from the Motorik Modul (MoMo) were included to evaluate the coordination skills. Other parameters taken into account were age, sex, orthodontic treatment and socioeconomic status (SES). Univariate and various multivariate analyses were performed to evaluate relationships. Better results in precision coordination tests were significantly related to a better oral hygiene (backward balancing: logistic regression OR 0.86, 95%CI: 0.73−0.99, p = 0.051, proportional odds model OR 0.86, 95%CI: 0.75−0.99, p = 0.037; one-leg-stand: logistic regression OR 0.78, 95%CI: 0.63−0.96, p = 0.018, proportional odds model OR 0.77, 95%CI: 0.64−0.92, p = 0.003). Higher scores on one-leg-stand were significantly related to a lower caries prevalence (logistic regression OR 0.81, 95%CI: 0.66−0.99, p = 0.037; Poisson regression exp(ß) 0.82, 95%CI: 0.74−0.91, p < 0.001). Coordination test under a time constraint (jumping side-to-side) showed no significant relation. Oral hygiene was poorer in younger children, boys and low SES. Caries prevalence increased with low SES and increasing age. The present results suggest that oral health is influenced by coordinative skills.

[Indirect resin composites - a new material option when restoring malformed teeth]. / Indirekte Komposite. Neue Materialoptionen bei Anomalien der Zahnform.

OBJECTIVES: An abnormal development of teeth can result in malformed teeth. Indirect resin composites that can be fabricated with the computer-aided design/computer-aided manufacturing (CAD/ CAM) technique are available for the fabrication of permanent restorations. This case report presents the esthetical and functional rehabilitation of a 10-year-old female patient with oligodontia and conical canines. MATERIAL AND METHODS: Crowns fabricated from indirect resin composites were milled and polished to restore the conical canines 23, 33, and 43 (FDI). In addition, direct resin composite fillings were applied to teeth 53, 52, and 11, and a resin-bonded fixed dental prosthesis with single-retainer design fabricated from zirconia ceramic that was partially veneered with silica-based ceramic was inserted to replace tooth 22. RESULTS: The young patient and her parents were very satisfied with the functional and esthetical results of the resin composite crowns after insertion. Oral hygiene measures were demonstrated, and could be easily realized by the girl. Since only a few clinical studies are available, the clinical longevity of permanent restorations fabricated from indirect resin composite has not yet been proven. In this case report, indirect resin composites were used to achieve esthetically and functionally pleasing results treating conical teeth.

Relationship between deciduous molar hypomineralisation and parameters of bone metabolism in preschool children.

BACKGROUND: The aetiology of deciduous molar hypomineralisation (DMH) is still largely unknown. AIM: The aim of the study was to elucidate the occurrence of DMH as a function of the parameters of bone metabolism, as it is suspected that abnormalities in these parameters may affect the mineralisation of teeth. DESIGN: In a prospective cohort study, 958 children aged 1-6 years were examined. The inclusion criteria were: a blood sample to determine the parameters of bone metabolism; and documentation of enamel mineralisation using the European Academy of Paediatric Dentistry (EAPD) criteria. Multivariable methods were applied to analyse the incidence of DMH relative to the concentrations of serum calcium, phosphate, vitamin D, vitamin B12 and alkaline phosphatase, taking into account the effects of age, gender and height. RESULTS: The proportion of children diagnosed with DMH was 4.0% (38 of 958). A significant difference between DMH-affected and non-DMH-affected children was found only in the serum concentration of calcium (2.47 ± 0.08 mmol/l vs. 2.52 ± 0.10 mmol/l, respectively, P = 0.004). The risk of DMH significantly increased, by 1.63-fold (95% CI: 1.03-2.57), if the calcium level dropped by 0.1 mmol/l, regardless of age, gender or adjusted height. During the follow-up examination of 17 DMH-affected subjects, the calcium level remained consistently low 1 year later (t-test, P > 0.05). CONCLUSION: Children with DMH showed consistently subclinically lower serum calcium levels. No associations were found for other parameters.

Influence of overweight/obesity, socioeconomic status, and oral hygiene on caries in primary dentition.

AIM: The aim of the present study was to investigate possible influences of overweight (OW)/obesity on caries in primary dentition. Socioeconomic status (SES) and quality of oral hygiene were also considered. METHODS: In the present study, 1628 children between the ages of 6 months and 9 years were included. In addition to dental examinations regarding the decayed, missing, filled teeth (dmft) index in primary dentition and the evaluation of oral hygiene, the body mass index standard deviation score (BMI SDS) was determined, and SES was recorded. RESULTS: The presence of OW/obesity was associated with higher caries prevalence (P < 0.001). A lower SES and non-optimal oral hygiene were also associated with increased dmft. The Poisson regression also showed a significantly higher risk in the combination of a high SES and OW/obesity (ßlow-high  = 0.21, P = 0.01). The increase was evident in both good and poor oral hygiene. In contrast, there was no difference between the lower and middle social strata (ßlow-medium  = 0.03, P = 0.6). With increasing age, the BMI influence decreased (ßage: BMI SDS  = -0.06, P < 0.001). CONCLUSIONS: BMI, oral hygiene, and SES are important factors in caries prevalence. In the highest social class, however, increased body weight has an adverse effect regardless of oral hygiene.