Management of fear and anxiety in dental treatments: a systematic review and meta-analysis of randomized controlled trials.

OBJECTIVES: This systematic review was to compare the effects of interventions for the management of fear and anxiety for dental treatments. METHODS: This research project was applied to PubMed, CENTRAL, Web of Science, Cochrane library databases. The last search was run on March 31st, 2021. A list of references of relevant articles and previous reviews were checked. Qualitative and quantitative analyses were performed. RESULTS: A total of 20 eligible randomized controlled trials were included, and 969 participations in experimental group and 892 participations in the control group were involved. Anxiety levels decreased more in intervention groups than in control groups (Z = 3.47, P = 0.0005, SMD = - 0.62, 95% CI - 0.98 to - 0.27). For adults, there was statistical difference between experimental and control groups [Z = 2.14, P = 0.03, 95% CI - 0.54 (- 1.03, - 0.04)], while there was not no such statistical difference in children and adolescents [Z = 1.62, P = 0.11, 95% CI - 0.60 (- 1.32, 0.13)]. Patients experienced a significant decrease in anxiety level using sedation drugs [Z = 2.44, P = 0.01, 95% CI - 0.61 (- 1.10, - 0.12)] and audio-visual distractions [Z = 3.1, P = 0.002, 95% CI - 0.86 (- 1.40, - 0.32)]. For the informative intervention groups, patients did not show significant difference than control groups [Z = 1.22, P = 0.22, 95% CI - 0.55 (- 1.43, 0. 33)]. There was no statistical difference in vital signs [Z = 1.39, P = 0.16, 95% CI - 0.25 (- 0.61, 0.10)] and pain levels [Z = 0.69, P = 0.49; SMD = - 0.06, 95% CI (0.27, 0.11)] between intervention and control groups. CONCLUSIONS: Interventions should be used in managing anxiety and fear for dental treatment. It might be effective for anxiety alleviating for adults, but there was a low certainty of evidence that interventions could reduce anxiety level in children and adolescents. Sedation drugs and audio-visual distractions might be useful for managing dental fear and anxiety. Pain levels and vital signs could not be improved form our study. High-quality randomized clinical trials are required for further study.

Total, bioavailable and free 25-hydroxyvitamin D are associated with the prognosis of patients with non-small cell lung cancer.

PURPOSE: To analyze the prognostic value of total, bioavailable and free 25-hydroxyvitamin D [25(OH)D] as well as vitamin D-binding protein (VDBP) in patients with non-small cell lung cancer (NSCLC). METHODS: We prospectively collected and analyzed data for 395 patients diagnosed with NSCLC between January 2016 and December 2018 in two university-affiliated hospitals. Total and free 25(OH)D and VDBP were measured directly, and bioavailable 25(OH)D was calculated using a validated formula. Their prognostic values were evaluated by Cox proportional hazards model, and hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated. RESULTS: Patients with NSCLC had significantly lower levels of total, bioavailable, and free 25(OH)D and higher VDBP levels in comparison to healthy controls (all p < 0.001). In multivariate analyses, higher levels of total, bioavailable, and free 25(OH)D were independently associated better overall survival (OS) and progression-free survival (PFS). For OS, the adjusted HRs were 0.58 (95% CI, 0.40-0.87; p for trend = 0.008), 0.45 (95% CI, 0.30-0.67; p for trend < 0.001) and 0.49 (95% CI, 0.33-0.73; p for trend < 0.001) for the highest versus the lowest tertile of total, bioavailable and free 25(OH)D, respectively. The corresponding adjusted HRs for PFS were 0.61 (95% CI, 0.43-0.86; p for trend = 0.006), 0.56 (95% CI, 0.40-0.80; p for trend = 0.001) and 0.60 (95% CI, 0.42-0.85; p for trend = 0.004), respectively. However, VDBP was not associated with either OS or PFS. CONCLUSION: The current study suggested that total, bioavailable and free 25(OH)D may be reliable prognosis indicators in NSCLC patients, though the optimal 25(OH)D form for NSCLC prognosis remains to be assessed in future studies.

The association between meat consumption and the metabolic syndrome: a cross-sectional study and meta-analysis.

The findings regarding the associations between red meat, fish and poultry consumption, and the metabolic syndrome (Mets) have been inconclusive, and evidence from Chinese populations is scarce. A cross-sectional study was performed to investigate the associations between red meat, fish and poultry consumption, and the prevalence of the Mets and its components among the residents of Suzhou Industrial Park, Suzhou, China. A total of 4424 participants were eligible for the analysis. A logistic regression model was used to estimate the OR and 95 % CI for the prevalence of the Mets and its components according to red meat, fish and poultry consumption. In addition, the data of our cross-sectional study were meta-analysed under a random effects model along with those of published observational studies to generate the summary relative risks (RR) of the associations between the highest v. lowest categories of red meat, fish and poultry consumption and the Mets and its components. In the cross-sectional study, the multivariable-adjusted OR for the highest v. lowest quartiles of consumption was 1·23 (95 % CI 1·02, 1·48) for red meat, 0·83 (95 % CI 0·72, 0·97) for fish and 0·93 (95 % CI 0·74, 1·18) for poultry. In the meta-analysis, the pooled RR for the highest v. lowest categories of consumption was 1·20 (95 % CI 1·06, 1·35) for red meat, 0·88 (95 % CI 0·81, 0·96) for fish and 0·97 (95 % CI 0·85, 1·10) for poultry. The findings of both cross-sectional studies and meta-analyses indicated that the association between fish consumption and the Mets may be partly driven by the inverse association of fish consumption with elevated TAG and reduced HDL-cholesterol and, to a lesser extent, fasting plasma glucose. No clear pattern of associations was observed between red meat or poultry consumption and the components of the Mets. The current findings add weight to the evidence that the Mets may be positively associated with red meat consumption, inversely associated with fish consumption and neutrally associated with poultry consumption.

The Geriatric Nutritional Risk Index as a Prognostic Factor in Patients with Advanced Non-Small-Cell Lung Cancer.

The Geriatric Nutritional Risk Index (GNRI) is widely applied as a prognostic factor in different cancers. We aimed to analyze the prognostic value of the GNRI in 257 patients diagnosed with advanced non-small-cell lung cancer (NSCLC). Patients with GNRI >98, 92-98, and <92 were grouped into normal, low risk and moderate/high risk groups, respectively. There were 45.1% patients at risk for malnutrition. Kaplan-Meier survival curves indicated that patients with lower GNRI scores had a poorer overall survival (OS). Two-year OS for normal, low risk and moderate/high risk groups were 57.4%, 42.3% and 15.8%, respectively. In multivariate survival analysis, GNRI (<92), body mass index (BMI, ≥24 kg/m2), combined therapy, hemoglobin and neutrophil-to-lymphocyte ratio (NLR) were independent prognostic factors of OS. Stratifying by age groups, GNRI (<92), hemoglobin and NLR were independent prognostic factors of OS in patients aged <65 years. GNRI (<92), smoking, BMI (≥24 kg/m2) and platelet-to-lymphocyte ratio were independent prognostic factors of OS in patients aged ≥65 years. In conclusion, GNRI was a significant prognostic factor in advanced NSCLC patients regardless of age. A decreased GNRI may be considered as a clinical trigger for nutritional support in advanced NSCLC patients, though additional studies are still required to confirm the best cut-point.

What can we do to prevent small children from suffering from tooth decay?

Data sources Medline, Embase, CINAHL and PubMed.Study selection Studies published in peer-reviewed journals focusing on dental caries of primary teeth and risk and/or protective factors, in healthy children aged equal to or less than six years, including randomised controlled trials (RCTs) with an intervention period of at least one year for caries, other intervention studies, and observational studies (such as cohort, case-control, ecologic and cross-sectional studies); risk and/or protective factors included: breastfeeding beyond one year of age, breastfeeding beyond two years of age, consumption of liquids that contain free sugars from an infant feeding bottle, consumption of complementary drinks that contain free sugars, consumption of complementary foods that contain free sugars, oral hygiene provided by a parent/caregiver, oral health education for caregivers, water with an optimum concentration of fluoride, consumption of fluoridated milk and salt fluoridation.Data extraction and synthesis Five reviewers independently screened the title and abstract of the identified citations and 5% of them were screened by all reviewers. Data extraction was undertaken by two reviewers. The evidence was classified into 12 groups in accordance with the 12 review questions. Eligible studies were synthesised and meta-analysis performed where appropriate. Risk of bias was tested by the Cochrane 'risk of bias' tool for RCTs and the ROBINS-I for non-randomised trials. The quality of evidence related to each of the 12 review questions was assessed by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE).Results After initial search of 13,831 studies, 137 eligible studies were included in the systematic review and grouped into 10 out of 12 review questions (no eligible study was identified for two review questions). Among those ten review questions, only two review questions had RCTs to address the answers; others were answered by observational studies and/or quasi-experimental studies. A prospective cohort study displayed no significant difference was found in severity of caries among five-year-old children inbetween those breastfed for nearly 23 months and those breastfed up to one year. Observational studies showed increased risk of early childhood caries (ECC) was associated with consumption of sugar in both bottles and complementary foods. Results of meta-analysis of three RCTs stated that children of caregivers who received oral health education had lower chance of having ECC than those who had never received oral health education (OR 0.39, 95% CI 0.19 to 0.79, P = 0.009). Another result from meta-analysis demonstrated that lower pooled mean dmft was found in children living in areas with fluoridated water than those who lived in non-fluoridated areas (-1.25, 95% CI -2.14 to -0.36, P = 0.016). Children who consumed fluoridated milk and fluoridated salt reduced the risk of ECC compared to those who did not. No publication bias was observed in the meta-analysis.Conclusions Evidence with moderate quality demonstrated that children with access to fluoridated water and fluoridated supplements could lower their risk of ECC; children with caregivers who had received oral health education had lower levels of ECC. Evidence with low quality suggested that breastfeeding up to two years old did not increase the risk of ECC; consumed sugars in bottles and complementary foods increased the risk of ECC.

Association of infant growth with emergence of permanent dentition among 12 year-aged southern Chinese school children.

BACKGROUND: There is a need to comprehensively investigate the relationship between tooth eruption and infant growth to explain the theory of tooth emergence. This study aimed to investigate the association between infant growth during the first year of life and the emergence of the permanent teeth. METHODS: A random sample of 668, 12-year-old students was recruited from a birth cohort. Erupted permanent tooth number was recorded. The association of infant growth (growth trajectories and growth rates) and permanent tooth emergence was examined through logistic regression analyses. The regression model was adjusted by potential confounders including gender, gestational age, mode of delivery, type of feeding, parental education, and health status. RESULTS: The response rate was 76.9% (n = 514). Two hundred and forty-five (47.7%) children had all 28 permanent teeth erupted. Infants who had higher birth weight z-scores and those who had grown slowly during the first three months of life were more likely to have complete permanent teeth emergence at their 12-year-old in both unadjusted (p <  0.01) and adjusted model (adjusted for gender, gestational age, mode of delivery, type of feeding, parental education, and health status, p <  0.01). However, no significant association was found between the growth trajectories and permanent tooth emergence in either unadjusted or adjusted models (p > 0.05). CONCLUSION: Birth weight and infant growth during the first three months of life might be associated with permanent tooth emergence at their 12 years of age. This association may be applied in the assessment of risk for dental caries or malocclusion.

Infant Growth and the Occurrence of Developmental Defects of Enamel in 12-Year-Olds.

BACKGROUND/AIMS: To investigate the association between birth weight and infant growth during the first year of life and the occurrence of developmental defects of enamel (DDE) in permanent dentition. METHODS: A random sample of 668 12-year-old students was recruited from a birth cohort. Permanent incisors and first molars were clinically examined for DDE using the modified FDI (DDE) index. Multivariable negative binomial regression was used to examine the association of growth trajectory (five categories) from birth to 12 months with the occurrence of DDE (any defects, demarcated opacities, diffuse opacities, and hypoplasia) in the permanent dentition. RESULTS: The response rate was 76.9% (n = 514). Four hundred and eighty-five children had complete records of growth- and health-related data. In the unadjusted model, infants who had birth weights closer to the WHO average and rapid growth were more likely to have 'demarcated opacities' (p < 0.05), and the first 3 months of life was the 'critical period' to develop 'demarcated opacities' in permanent dentition. However, after adjusting for the confounders (gender, gestational age, mode of delivery, type of feeding, parental education, and health status), significant association with the occurrence of 'demarcated opacities' (p < 0.05) remained only for the children of trajectory V (heavier birth weights and rapid growth); no 'critical period' was found to be significantly associated with DDE. CONCLUSIONS: Infants with heavy birth weight and rapid growth during the first year of life were more vulnerable to the occurrence of DDE in terms of demarcated opacities in their permanent dentition.

Is dental caries experience associated with adiposity status in preschool children?

BACKGROUND: To date, research on the relationship between dental caries experience and adiposity status is debated. AIM: To determine associations between dental caries experience and adiposity status among a community sample of preschool children in Hong Kong. DESIGN: Among a random sample of 5-year-old children, clinical assessment for dental caries was conducted using WHO criteria. Anthropometric measurements for body weight, body height, waist circumference (WC), hip circumference, and triceps skinfold thickness (TRSKF) were performed to assess general adiposity, central adiposity, and peripheral adiposity. Associations between adiposity status and caries were examined in regression analyses. RESULTS: The response rate was 83.1% (324/390). Regression analyses (adjusted for tooth brushing habits, snacking habits, and socio-demographic factors) identified that weight/height ratio z-score was associated with caries experience: prevalence of dental caries experience (dmft > 0), OR 1.41 (95% CI 1.04, 1.91), and 'very high' caries experience (dmft ≥ SiC(10) Index value), OR 1.62, (95% CI 1.05, 2.50). In addition, WC z-score was associated with 'very high' caries experience (dmft ≥ SiC(10) Index value), OR 1.72, 95% CI 1.06, 2.81. CONCLUSION: In a Hong Kong community sample of preschool children, dental caries experience was associated with general adiposity (as assessed by weight/height ratio) and central adiposity (as assessed by WC).

The prognostic value of the Naples prognostic score for patients with non-small-cell lung cancer.

The Naples prognostic score (NPS) is an effective inflammatory and nutritional scoring system widely applied as a prognostic factor in various cancers. We aimed to analyze the prognostic value of the NPS in patients diagnosed with non-small-cell lung cancer (NSCLC). We prospectively collected 395 patients diagnosed with NSCLC between January 2016 and December 2018 in two university-affiliated hospitals. Patients were divided into three groups according to their pretreatment NPS (Group 0: NPS = 0; Group 1: NPS = 1-2; Group 2: NPS = 3-4). Kaplan-Meier survival curves indicated that patients with higher NPS had a poorer overall survival (OS) and progress-free survival (PFS) (both P < 0.05). NPS was further confirmed as an independent prognostic factors of OS and PFS by multivariable survival analysis (both P < 0.05). Furthermore, stratifying by TNM stage, NPS also has significant predictive performance for OS and PFS in both early (I-IIIA) and advanced (IIIB-IV) stage NSCLC (all P < 0.05). The time-dependent receiver operating characteristic curve analysis demonstrated that NPS was more superior to other prognostic factors in predicting OS and PFS. In conclusion, NPS may serve as an effective indicator to predict OS and PFS in NSCLC patients regardless of TNM stage.

Effect of Ramie on the Production Performance of Laying Hens, and the Quality, Nutrient Composition, Antioxidation of the Eggs.

Ramie (Boehmeria nivea), which is rich in protein, fatty acid, vitamins and minerals, has become a potential alternative feed resource for poultry, and has attracted more and more attentions in nutrition research. The objective of this study is to evaluate the effect of dietary ramie at different concentrations on the production performance of the hens, and the quality, nutrient composition, and antioxidation of the eggs. A total of 432 34-week-old Lohmann commercial laying hens were divided into four groups, that were fed with corn-soybean meal-based control diet, control mixed with ramie at concentrations of 3, 6, or 9% separately for 8 weeks. Results showed that dietary ramie did not affect production performance. And egg yolk color gradually deepened as the inclusion levels of ramie increased. Ramie at tested concentration could significantly reduce the content of malondialdehyde (MDA) (p = 0.002) and 3% ramie supplementation significantly increased total antioxidative capacity (T-AOC) concentrations in egg yolk compared to the control group (p = 0.033). In addition, dietary supplementation with 6% ramie significantly reduced total cholesterol (T-CHO) content (p < 0.05) compared with controls. For egg nutrient composition, compared with the control group, the addition of 6% ramie significantly increased (p < 0.05) total omega-3 polyunsaturated fatty acids (n-3PUFA) and phenylalanine (Phe) in yolk. In conclusion, dietary inclusion of 6% ramie was most effective in improving the color, antioxidative capability, and reducing T-CHO contents of the egg yolks without any negative impacts on the production performance of the hens.

Dental anxiety and caries experience from late childhood through adolescence to early adulthood.

OBJECTIVE: To assess the association between dental anxiety and caries experience from late childhood through adolescence and into early adulthood (12, 15 and 18 years old, respectively). METHODS: A prospective cohort study was conducted among a population-representative sample of Chinese in Hong Kong. A baseline survey was conducted at age 12 and follow-up assessments were completed at ages 15 and 18. Caries experience was assessed as the number of decayed, missing and filled teeth (DMFT). Dental anxiety was assessed using the Modified Dental Anxiety Scale (MDAS). Participants' socio-economic status and oral health-related behaviours were ascertained using a self-complete questionnaire. Negative binomial regression was used to explore the association between dental anxiety and subsequent caries status, controlling for other factors. RESULTS: At baseline, 668 children participated; 279 (41.8%, comprising 57.0% females) completed all three phases of data collection. MDAS scores at age 18 were lower than at age 12. Caries experience increased as participants aged. At age 15 and 18, females had higher MDAS and DMFT scores than males. Reported frequency of snacking between meals was associated with MDAS scores at age 18. In regression analyses, dental anxiety at age 12 was not significantly associated with dental caries experience at age 15, controlling for socio-demographic and oral-health behaviour factors at age 12. Likewise, dental anxiety at age 15 was not significantly associated with dental caries experience at age 18, controlling for the same factors at age 15. CONCLUSION: Dental anxiety assessed by MDAS in late childhood and adolescence appears not to predict dental caries experience later in life in this population.

HMGB1-induced autophagy promotes extracellular matrix degradation leading to intervertebral disc degeneration.

Intervertebral disc degeneration (IDD) remains a leading cause of adult disability. High mobility group box l (HMGB1) is a nuclear DNA-binding protein and acts as a central mediator of inflammation. The purpose of this study was to investigate the effect of HMGB1 in IDD. In our study, IDD intervertebral disc tissues were collected and nucleus pulposus cells (NPCs) were primarily cultured. The HMGB1 expression and the effect of HMGB1 on NPCs and extracellular matrix and autophagy were all evaluated. Results showed that HMGB1 was markedly overexpressed in IDD (P<0.05), and upregulated expression of HMGB1 can inhibit NPC proliferation and promote NPC apoptosis (P<0.05), promote extracellular matrix degradation, and activate cell autophagy (P<0.05). Therefore, we concluded that HMGB1 was up-regulated in IDD and HMGB1-induced autophagy can promotes extracellular matrix degradation and thus lead to intervertebral disc degeneration. In brief, HMGB1 may serve as a novel diagnostic biomarker and therapeutic target for IDD.

Oral Health of Children With Attention Deficit Hyperactivity Disorder: Systematic Review and Meta-Analysis.

Objective: This systematic review investigated the oral health of children with ADHD. Method: A structured search strategy was performed on five electronic databases: SCOPUS, Web of Science, COCHRANE, PubMed, and PsychInfo. Studies were included in the review if they reported clinical oral health outcomes on a population diagnosed with ADHD under the age of 18 years old. Qualitative and quantitative analysis was performed on pooled prevalence and mean/median values for caries, trauma, periodontal problems, and tooth wear. Results: Twenty-seven effective articles were reviewed by two calibrated assessors. Meta-analysis of the results found higher mean number of decayed surfaces, plaque index, and trauma prevalence among children with ADHD. Conclusion: Children with ADHD show increased risk for caries and traumatic dental injuries, and may have poorer oral hygiene compared with children without ADHD. More awareness among clinicians would promote better caries- and trauma-preventive advice and management.

The complete mitochondrial genome of the Dongan black chicken and its phylogenetic analyses.

Dongan black chicken (Gallus gallus domesticus, DBC) is one of the famous native breed of Hunan province in China. The complete mitochondrial genome sequence plays an important role in the accurate determination of phylogenetic relationships among metazoans. It is the first time that the complete mitochondrial genome sequence of the DBC was reported. The total length of the mtDNA is 16,785 bp, It contains the typical structure, including 22 transfer RNA genes, 2 ribosomal RNA genes, 13 protein-coding genes and 1 non-coding control region (D-loop region). The overall composition of the mtDNA was estimated to be 30.27% for A, 23.78% for T, 32.46% for C, and 13.49% for G. Phylogenetic analyses using N-J computational algorithms showed that the analyzed 21 Galliformes species are divided into four major clades: Phasianidae, Numidiidae, Odontophoridae, and Megapodiidae. In addition, our work confirmed that DBC and Taoyuan chicken (TYC) have a close genetic relationship with fellow tribal members Xuefeng black-boned chicken (XBC) and Huang Lang chicken (HLC). Meanwhile, we also found that DBC and TYC have highly similar genetic relationship. This work will provide an important data set for the study of genetic mechanism of chicken in Hunan province.

Tooth eruption and obesity in 12-year-old children.

BACKGROUND/PURPOSE: There is a need to comprehensively investigate the relationship between tooth eruption and obesity. The study aimed to investigate the relationship between erupted permanent tooth number and obesity among 12-year-old children in a population-based study. MATERIALS AND METHODS: A random sample of 806 12-year-old schoolchildren in Hong Kong was recruited. Oral examinations were conducted and the eruption status of the permanent teeth was assessed. Body height, body weight, waist circumference (WC), hip circumference, and triceps skinfold thickness (TRSKF) were measured to assess the adiposity statuses [weight-height ratio (W/H) and body mass index (BMI) for general obesity; WC and waist-hip ratio (WHR) for central obesity; and TRSKF for peripheral obesity]. The relationships between erupted permanent tooth number and adiposity statuses were examined in bivariate analysis and analysis of covariance. RESULTS: The response rate was 82.9% (n = 668/806). Three hundred and forty-six (50.9%) children had 28 teeth erupted. Second molars had the highest rate of noneruption (17.5-35.8%). The mean number and standard deviation (SD) of erupted permanent tooth were 26.4 (2.4). The mean value and SD were 31.1 (6.3) for W/H, 19.8 (3.7) for BMI, 70.4 (9.4) for WC, 0.82 (0.06) for WHR, and 11.8 (4.5) for TRSKF, respectively. After accounting for sociodemographic factors, analysis of covariance identified that W/H, BMI, WC, and WHR were positively associated with the number of erupted permanent teeth (P < 0.01). CONCLUSION: Erupted permanent tooth number was positively associated with obesity (general and central) among a population-based sample of 12-year-old children in Hong Kong.

A population survey of early factors associated with permanent tooth emergence: findings from a prospective cohort study.

OBJECTIVES: Studies investigating influencing factors of permanent tooth eruption/emergence have primarily focused on anthropometric measurements while less attention has been paid to the effect of perinatal factors. We aimed to explore early factors associated with eruption status of permanent teeth among 12-year-olds through a population-representative prospective cohort. METHODS: A community sample of Hong Kong children born in 1997 was obtained by random sampling from local secondary schools. Participants' background information including birth characteristics, prenatal and early childhood exposures, family socioeconomic status and medical records was prospectively collected. Clinical examination of tooth emergence was conducted in 2010. Children were divided into complete emergence (of 28 permanent teeth) and partial emergence groups based on clinical examinations. Bivariate analyses were used to assess the association of tooth emergence status with each putative predictor. Unadjusted and adjusted logistic regression models were applied to select the best predictors for tooth emergence status at age 12. RESULTS: Complete background information and clinical data were available from 514 children (76.9% of the invited participants). Bivariate analyses showed that the average birthweight in the partial emergence group was significantly lower than the complete emergence group (mean difference 0.2 kg, P = 0.006). The finding was confirmed by logistic regression analyses. In the adjusted regression model, it was found that for every 1 kilogram increase in birthweight, the odds of having partial emergence would be lowered by 0.49 (odds ratio 0.49, P = 0.006). CONCLUSIONS: Birthweight is associated with status of permanent tooth emergence at 12 years of age, as observed from a population-representative sample of Hong Kong children.

Anthropometric measurements and dental caries in children: a systematic review of longitudinal studies.

There is growing interest in the association between anthropometric measurements and dental caries in childhood over time (life-course studies). The aim of this review was to identify and systematically review the evidence of the association between anthropometric measurements and dental caries in childhood over time. PubMed, Institute for Scientific Information (ISI) Web of Knowledge, the Cochrane Library, and 6 other databases were searched to identify effective articles. A systematic approach involving critical appraisal was conducted to examine the relation between anthropometric measurements and dental caries in preschool- and school-aged populations from longitudinal studies. An initial search identified 1338 studies, with 59 potentially effective studies (κ = 0.82) and 17 effective studies (κ = 0.88). The quality of reporting among the studies ranged from 19.5 to 30.0 according to the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) criteria. Among the effective studies, 2 studies in which caries was used to predict anthropometric measurements consistently found an inverse association and 15 studies in which anthropometric measurements were used to predict caries were inconsistent, with results appearing to be influenced by nonuniformity of assessments, setting, and procedure of measurements; age and ethnicity of participants; and confounders of dental caries. In conclusion, among >1000 studies identified, 17 informed this systematic review. The quality of reporting of these studies varied considerably. Evidence of the association between anthropometric measurements and dental caries is conflicting and remains inconclusive.

Risk factors of developmental defects of enamel--a prospective cohort study.

BACKGROUND AND OBJECTIVE: Current studies on the aetiology of developmental defects of enamel (DDE) are subject to recall bias because of the retrospective collection of information. Our objective was to investigate potential risk factors associated with the occurrence of DDE through a prospective cohort study. METHODS: Using a random community sample of Hong Kong children born in 1997, we performed a cohort study in which the subjects' background information, medical and dental records were prospectively collected. A clinical examination to identify DDE was conducted in 2010 when the subjects were 12 years old. The central incisor, lateral incisor and first molar in each quadrant were chosen as the index teeth and were examined 'wet' by two trained and calibrated examiners using the modified FDI (DDE) Index. RESULTS: With a response rate of 74.9%, the 514 examined subjects had matched data for background information. Diffuse opacites were the most common type of DDE. Of the various possible aetiological factors considered, only experience of severe diseases during the period 0-3 years was associated with the occurrence of 'any defect' (p = 0.017) and diffuse opacities (p = 0.044). The children with experience of severe diseases before 3 years of age were 7.89 times more likely to be affected by 'any defect' compared with those who did not have the experience (OR 7.89; 95% CI 1.07, 58.14; p = 0.043). However, after adjusting for confounding factors, the association no longer existed. CONCLUSION: No variables could be identified as risk factors of DDE in this Hong Kong birth cohort.

[Evaluation on improved tooth pulp electrical stimulation rat model].

OBJECTIVE: To improve tooth pulp electrical stimulation rat model to study analgesic effect of drugs. METHODS: Expose lower mandible and incisor and isolate them with rubber dam, two holes with distance 1.5 mm were drilled below the cemento-enamel junction by a thin diamond bur in 22 adult male rats anesthetized with sodium pentobarbital. A pair of insulated stainless stimulating electrodes were inserted through the holes and knotted to fix them. Drilled holes were filled with zinc polycarboxylate cement. Finally, the stimulating electrodes were directed to the top of the skull. Pain threshold of rats was determined by an electrical stimulator under awake, free conditions to evaluate the stability of the model and the analgesic effect of drugs. RESULTS: A valid tooth pulp pain model were set up successfully in 22 rats. Rats regain consciousness at 1 to 2 hours after operation. The inserted electrodes keep efficiency for 6 weeks. Neither tissue morphology change nor inflammation cell infiltration can be found in tooth pulp after 6 weeks under the light microscope. Threshold voltages remained constant under the repeat electric stimulations within 300 min (P > 0.05, CV < 15%) until 4 weeks (P > 0.05, CV < 15%). The dose-dependent and time-dependent analgesic effects of capsaicin were showed in this model. CONCLUSION: The improved tooth pulp electrical stimulation rat model is easily performed and shows constant electrical stimulation-induced pain threshold and is suitable for research on analgesic effect of drugs.

[Clinical effect of pit and fissure sealant used in combination with self-etching adhesive on permanent teeth].

PURPOSE: To determine the role of pit and fissure sealant used in combination with self-etching adhesive in retention of the sealants and caries decrease of the permanent teeth. METHODS: Sixty two children aged 6-14 years old were chosen from the outpatients in the Department of Pediatric Dentistry, the first or the second permanent molars (n= 156) were sealed with two kinds of sealant. The tooth in one side was sealed with sealant (Concise, 3M-ESPE) and self-etching system (Adper and Prompt, 3M-ESPE) while the tooth in the other side was sealed with sealant (Concise, 3M-ESPE) and phosphate acid system. All the patients were followed up and reexamined 3, 6 and 12 months after treatment. Statistical analysis was carried out with SPSS 12.0 (SPSS Inc., Chicago, IL, USA) software package for Chi-square test and t test. RESULTS: The operating time using self-etching system was (122 +/- 13)s, shorter than (219 +/- 13)s using phosphate acid system (P < 0.05). The self-etching system used only one step to finish etching, adhesion and treatment of tooth surface, saving the steps of rinsing and drying. The retention rates of pit and fissure sealant in self-etching system and phosphate acid system were 97.4% and 96.2% respectively at the third month, 94.9% and 92.3% at the sixth month, 91.0% and 88.4% at the end of one year after treatment. The prevalence rate of caries in both groups had no significant difference (P>0.05); No caries in both groups were found in the first three months; In patients using self-etching system, caries decreased by 100% at the sixth month and by 50% at the end of one year. CONCLUSION: Adper Prompt self-etching adhesive, with an advantage of simple operation and shorter operation period, is effective in bonding sealant to the enamel. The retention rates of pit and fissure sealant were not different between the two groups.