Genetic variation in the promoter region of beta-defensin 1 (DEFB 1) is associated with high caries experience in children born with cleft lip and palate.

OBJECTIVE: Caries is a common disease in humans and has a multifactorial etiology. It has been suggested that children born with cleft lip and/or palate (CL/P) have a higher susceptibility to caries, but data from several independent cohorts does not support this assumption. Previous work from our group suggested DEFB 1 is associated with higher caries experience. Since it is suspected that children born with CL/P have the same risk factors predisposing them to caries as other children of the same ages, the aim was to test if DEFB 1 was associated with caries experience in children born with CL/P. MATERIALS AND METHODS: Sixty-nine children born with CL/P (aged 2-12 years) were included. Twenty-seven males and seven females had cleft lip and palate (CLP), six males and seven females had cleft lip (CL) and 13 males and nine females had cleft palate (CP). Caries was evaluated with the DMFT/dmft index by a calibrated evaluator. Two single nucleotide polymorphisms in DEFB 1 were selected (rs11362 and rs1800972) based on being associated with higher caries experience in previous work. Genotyping were carried out by real-time PCR using the Taqman assay method. The statistical analysis was performed between 'low-to-moderate caries experience group' and the 'high caries experience group'. Odds ratio calculations between caries experience and variant alleles and chi-square of Fisher exact tests at a level of significance of 0.05 were used. RESULTS: There was no significant difference for caries experience between cleft types (p = 0.551). An association was found for the marker rs11362 and genotype distribution (p = 0.047). When analyzed in a recessive model, the genotype GG in this polymorphism increased the risk for caries susceptibility by more than 3-times (p = 0.031; OR = 3.16; 95% CI = 0.97-10.62). CONCLUSION: The genetic variant rs11362 in DEFB 1 influences caries susceptibility in CL/P children. The results support the hypothesis that expression of DEFB 1 in saliva may serve as a biomarker for future caries risk.

Analysis of the crown fractures and factors affecting pulp survival due to dental trauma.

OBJECTIVES: The aim of the present study was to investigate pulp survival following crown fracture with and without pulp exposure as well as with and without associated subluxation and in relation to stage of root development and type of enamel-dentine fracture. MATERIALS AND METHODS: This study consisted of 83 patients with 116 crown fractured incisors without pulp exposure and 35 patients with 44 complicated crown fractures. The effect of variables on the maintenance of tooth vitality were explored using the Linear Regression analysis , which assumes the effects of different factors on the pulp vitality such as (age, stage of the root development, contaminant subluxation, fracture depth, emergency treatment). RESULTS: The general distribution was 59 (71%) boys and 24 (29%) girls with uncomplicated crown fractures aged 7-17 years, mean 10.7 years ±2.83SD and 24 (68.5%) boys and 11 (31%) girls with complicated crown fracture. From 78 uncomplicated crown fractures without subluxation PN (pulp necrosis) was evaluated in 4 (4.88%) cases but from 20 uncomplicated crown fractures with subluxation PN was 14 (56.52%) cases. Univariate analysis showed that stage of root development p<0.05, subluxation p<0.001, fracture depth p<0.001 were significantly related to the pulp survival. CONCLUSIONS: The primary factors related to pulp healing events after crown fracture appears to be compromised pulp circulation due to concomitant subluxation as well as the stage of root development and fracture depth. For incisors with complicated crown fractures there were two more factors related to pulpal healing-time interval from injury until initial treatment and appropriate emergency treatment.

Growth factors/cytokines/defensins and apoptosis in periodontal pathologies.

UNLABELLED: In the recent past there has been an increased emphasis on morphogenetic tissue research of periodontal tissues. The aim of this study was to find qualitative and quantitative correlations in distribution and appearance of growth factors/cytokines/defensins and apoptosis in periodontal pathologies. MATERIAL AND METHODS: Tissue was obtained from 5 controls and 6 chronical periodontitis patients 30-50 years of age referred to Latvian Institute of Stomatology. Histological investigations were performed at the Institute of Anatomy and Anthropology of Riga Stradins University. RESULTS: Epithelial cells abundantly expressed IL10 in patients. The expression of b-defensins was very variable in both sulcular and gingival epithelium. TUNEL positive cells were observed in patients and control specimens with dominance in control group. Gingival epithelium showed moderate expression of bFGF whereas few to moderate cells were positive for bFGF in sulcular epithelium. Fibroblast growth factor receptor (FGF-1R) was abundant in gingival epithelium and in connective tissue cells, but almost not detectable in sulcular epithelium. Insulin-like growth factor receptor was not expressed in gingival epithelium and was weakly seen in basal layer of sulcular epithelium. Basic nerve growth factor expresion in both types of epithelium was numerous to abundant. Staining for the NGFR in the gingival epithelium was variable, with prevalence to be moderate whereas sulcular epithelium was free from any factor immunoreactivity. CONCLUSION: 1. Finding of apoptotic cells are variable and seems to correlate with the expression of defensins in oral epithelium in patients with periodontitis. 2. FGFR was expressed more than the bFGF, but in case with NGFR and bNGF situation was opposite. Although IGFRI was found in sulcular epithelium with no expression in gingival one suggesting about stimulation in regeneration/adaptation in periodontitis affected tissue. 3. The expression of growth factors and their receptors in sulcular epithelium was lower than into the gingival epithelium and seems to be specific for periodontitis.

Psychosocial factors correlated with children's dental anxiety.

Authors developed an idea of seven blocks with different psychosocial factors that could correlate with children's dental anxiety and explain its variance. Aim of the study was to evaluate correlation between psychosocial factors and children's dental anxiety. Totally, 240 randomly selected children (mean age M=7.96, SD=2.61, range 4 to 12) and their parents took part in the study. Parents evaluated their own (MDAS) and their children's anxiety (CFSS-DS). Psychosocial factors were evaluated by a large questionnaire, developed for this study. Dental status was fixed and child's behavior in dental setting was evaluated with Frankl's scale. Pearson's correlation of CDA with all variables and stepwise linear regression with the correlating variables within the seven psychosocial factor blocks was performed. Dental experience and attitude factors (crying at dentist and dental treatment with difficulties) as well as Children's personality and behavior factors (general anxiety and children's behavior at dentist) gave the most effect on CDA, totally explaining 56% and 54% of variance, respectively. Children's medical experience and attitude factors (anxiety and caution towards doctors) as well as Parental/information factors (parental dental anxiety, promising prizes before treatment) explained 34% and 31% of CDA variance, respectively. Socio-economic factors (number of children and mother's age) explained 15%, but oral care habits and attitude (brushing as obligation) - 14% of CDA variance. Family distress factors had no correlation with CDA and were excluded of further analysis. Children's dental anxiety variance is at best explained by Child's dental experience and attitude factors and Child's personality and behavior factors.

Prevention of occlusal caries using a ozone, sealant and fluoride varnish in children.

OBJECTIVES: To compare ozone with fissure sealants and fluoride varnish in the prevention of occlusal caries in permanent premolars of children in 12 months period. METHODS: A clinical trial was conducted on four groups of 10 years old schoolchildren: a group 1 - control group (n=50); a group 2 (n=21) in which fluoride varnish was applied and re-applied up to 12 months; a group 3 (n=17) in which sealant was applied and reapplied up to 12 months; and a group 4 (n=19) in which ozone was applied and re-applied up to 12 months. Percent caries reduction was studied in these initially healthy molars with complete occlusal eruption: 173 (control), 103 (varnish), 78 (sealants) and 103 (ozone) premolars met inclusion criteria. All patients were examined using DMFT index and Greene - Vermillion index at a baseline and in 6 months with a follow up period of 12 months. Each tooth was considered as the unit of the analysis. Data were analyzed using t-test and the chi-square tests. RESULTS: The prevalence of caries was: in group 1 - 3.5% (n=6), in group 2 and group 3 - 0% (n=0), in group 4 - 2.9%, (n=3). The changes in occlusal caries incidence between all groups were not statistically significant. CONCLUSIONS: The placement of fissure sealant, application of fluoride varnish, and application of ozone - are recommended to use in prevention of occlusal pit and fissure caries in permanent premolars in children. Furthermore, they are not significantly different from one another in their effectiveness.

IRF6 AP-2a binding site promoter polymorphism is associated with oral clefts in Latvia.

OBJECTIVE: To evaluate the association between AXIN2, CDH1 and IRF6 with oral clefts in a cohort from Latvia. MATERIAL AND METHODS: 283 unrelated individuals, 93 born with isolated oral clefts and 190 individuals born without any structural abnormalities were evaluated. Cleft type and dental anomalies outside the cleft area were determined by clinical examination. Four SNPs were selected for this study: rs2240308 and rs11867417 in AXIN2; rs9929218 in CDH1; and rs642961 in IRF6. Genotypes were determined by polymerase chain reaction using the Taqman assay method from a genomic DNA sample extracted from whole blood. Allele and genotype frequencies were compared between individuals born with or without oral clefts using the PLINK program. RESULTS: Tooth agenesis was the most frequent dental anomaly found among individuals born with oral clefts (N=10; frequency 10.8%). The allele A in the IRF6 marker rs642961 was associated with all combined types of oral clefts (OR=1.74; CI 95% 1.07-2.82) and with cases with cleft lip with or without cleft palate (OR=1.88, CI 95% 1.15-3.01; p=0.007). CONCLUSIONS: The IRF6 AP-2a binding site promoter polymorphism is associated with isolated oral clefts in Latvia.

Caries and its risk factors in young children in five different countries.

The state of oral health plays an essential role in human comprehensive health. Nevertheless, although considerable improvement in oral health caries has been noted in both developed and newly developing countries, caries is still widespread among children. Although it can be monitored, caries cannot be properly eliminated. MATERIALS AND METHODS. This investigation, performed in cooperation with Jena Hospital in Germany, was conducted in five countries from 2002-2008. The cities Riga (Latvia), Ouro Preto (Brazil), Erfurt (Germany), Volgograd (Russia) and Minsk (Belorus) were engaged in this investigation. Children at the age of 26-34 months were surveyed. Consistent with the research design, the mothers filled out questionnaires about the children's health, and an examination of the children's oral health was performed. The statistics program SPSS 15.0 was used to analyze the obtained data, and the correlations between changing findings were expressed by the Spearmen rank correlation coefficient (r). RESULTS. In this study, 472 children were observed: 179 from Riga, 152 from Erfurt, 62 from Ouru Preto, 116 from Minsk and 84 from Volgograd. A direct correlation existed between the country and plaque (r=0.16) and caries (dmft) (r=-0.11). The direct correlation between dmft and Streptococcus mutans (r=-0.36) was characteristic of children from Erfurt. The lowest dmft index (0.62) was present in children from Erfurt, and the highest (1.57) in children from Ouro Preto. CONCLUSIONS. The frequency and prevalence of caries in young children in Riga is high; it was the lowest in Erfurt and the highest - in Brazil. Plaque and dt were one of the indices with a direct relationship in Riga, Brazil and Minsk. Poor oral hygiene, irregular tooth brushing and the consumption of cariogenic foods and drinks are the most important caries risk factors among children at the age of 2-3 years. The mother's knowledge and attitude affect the child's oral health.