Dental Topics for Plastic Surgeons, Part Three: Infection and Trauma of the Dentition.

ABSTRACT: Conditions that affect dental and periodontal structures receive sparse coverage in the plastic surgery literature, yet a working knowledge of this subject matter is important in certain areas of clinical practice and a fundamental understanding is part of plastic surgery competency tested on the in-service and written board examinations. This 4-part series written to provide plastic surgeons with a working knowledge of dental topics that may be relevant to their clinical practice. This section, Part III, covers inflammatory and infectious conditions of the dentition and related structures, as well as dentoalveolar trauma.

Dental Topics for Plastic Surgeons, Part Two: Abnormal Tooth Development, Conditions, and Treatment.

Conditions that affect dental and periodontal structures receive sparse coverage in the plastic surgery literature, yet a working knowledge of this subject matter is important in certain areas of clinical practice and a fundamental understanding is part of plastic surgery competency tested on the in-service and written board examinations. This four-part series written to provide plastic surgeons with a working knowledge of dental topics that may be relevant to their clinical practice. This section, Part II, covers abnormal tooth development and related conditions.

Dental Topics for Plastic Surgeons, Part One: Normal Anatomy, Growth and Development.

Normal and abnormal conditions affecting the dentition and the periodontal structures receive sparse coverage in the plastic surgery literature, textbooks, and training programs. Nevertheless, a working knowledge of this subject matter is important in certain areas of clinical practice, and a fundamental understanding is often part of plastic surgery competency tested for in the In-service and written board examinations. This four-part series is written to provide plastic surgeons with a working knowledge of relevant dental topics. Part 1 covers fundamental aspects of normal dental embryology, growth and anatomy.

The Oral Bacterial Communities of Children with Well-Controlled HIV Infection and without HIV Infection.

The oral microbial community (microbiota) plays a critical role in human health and disease. Alterations in the oral microbiota may be associated with disorders such as gingivitis, periodontitis, childhood caries, alveolar osteitis, oral candidiasis and endodontic infections. In the immunosuppressed population, the spectrum of potential oral disease is even broader, encompassing candidiasis, necrotizing gingivitis, parotid gland enlargement, Kaposi's sarcoma, oral warts and other diseases. Here, we used 454 pyrosequencing of bacterial 16S rRNA genes to examine the oral microbiome of saliva, mucosal and tooth samples from HIV-positive and negative children. Patient demographics and clinical characteristics were collected from a cross-section of patients undergoing routine dental care. Multiple specimens from different sampling sites in the mouth were collected for each patient. The goal of the study was to observe the potential diversity of the oral microbiota among individual patients, sample locations, HIV status and various dental characteristics. We found that there were significant differences in the microbiome among the enrolled patients, and between sampling locations. The analysis was complicated by uneven enrollment in the patient cohorts, with only five HIV-negative patients enrolled in the study and by the rapid improvement in the health of HIV-infected children between the time the study was conceived and completed. The generally good oral health of the HIV-negative patients limited the number of dental plaque samples that could be collected. We did not identify significant differences between well-controlled HIV-positive patients and HIV-negative controls, suggesting that well-controlled HIV-positive patients essentially harbor similar oral flora compared to patients without HIV. Nor were significant differences in the oral microbiota identified between different teeth or with different dental characteristics. Additional studies are needed to better characterize the oral microbiome in children and those with poorly-controlled HIV infections.

The role of pediatric dentistry in multidisciplinary cleft palate teams at advanced pediatric dental residency programs.

PURPOSE: The purpose of this study was to characterize the participation of pediatric dentistry in multidisciplinary cleft palate teams (CPTs) at advanced pediatric dental residency programs. METHODS: A survey was sent to the directors of advanced pediatric dentistry programs across the United States. RESULTS: Of the 60 (90%) surveys returned, 18% of the programs were university-based, 40% hospital-based, and 42% combined programs. Overall, 92% of the programs reported pediatric dentistry's participation in CPTs. Orthodontics, plastic surgery, oral surgery, otolaryngology, and speech therapy, are represented on at least 75% of the CPTs. Nursing and psychology are represented in less than 50% of the CPTs. A higher percentage of combined programs reported providing interceptive orthodontics, while more hospital-based programs reported providing presurgical infant orthopedic appliances (PIOAs). Of the 47% of the programs that reported use of POIA, 64% reported using removable appliances. Seventy-five percent of the programs reported that there has been no change, 22% reported an increase, and 3% reported a decrease in the CPT participation level in the post 5 years. CONCLUSIONS: This study highlights the role of pediatric dentistry as a part of cleft palate team. This role extends from preventive and restorative to infant orthopedics.