Impacts of oligodontia on oral health-related quality of life reported by affected children and their parents.

BACKGROUND: Oligodontia (agenesis of six or more permanent teeth) affects functional, emotional, and social aspects of an individual's life. Few published studies have evaluated oral health-related quality of life (OHRQoL) in children with oligodontia and very limited have compared the child and parental perceptions. METHODS: Thirty-five 8- to 18-year-old patients with oligodontia (10 M, 25 F; mean age: 12.4 ± 2.9 years; mean number of permanent teeth missing due to agenesis: 8.9 ± 3.2) recruited from The Hospital for Sick Children, Toronto, and Holland Bloorview Kids Rehabilitation Hospital, Toronto, and their parents completed the short format of Child Perception Questionnaire (CPQ11-14) and the Parent Child Perception Questionnaire, respectively. RESULTS: Children reported significantly worse overall CPQ score than their parents. Correlations between children's and parents' overall CPQ score, oral symptoms and functional limitations, and social well-being were not statistically significant. However, as children's emotional well-being score increased, parents' score also increased. There was no association between child CPQ score and age, gender, number, and location of permanent tooth agenesis in this sample. There was a significant correlation between overall CPQ score and Site-Specific Tooth Absences. CONCLUSION: Children's overall CPQ score and domain scores were significantly worse than their parents indicating that children with oligodontia had poorer OHRQoL compared to what was perceived by their parents.

Group 5 ITI Consensus Report: Digital technologies.

OBJECTIVES: Working Group 5 was assigned the task to review the current knowledge in the area of digital technologies. Focused questions on accuracy of linear measurements when using CBCT, digital vs. conventional implant planning, using digital vs. conventional impressions and assessing the accuracy of static computer-aided implant surgery (s-CAIS) and patient-related outcome measurements when using s-CAIS were addressed. MATERIALS AND METHODS: The literature was systematically searched, and in total, 232 articles were selected and critically reviewed following PRISMA guidelines. Four systematic reviews were produced in the four subject areas and amply discussed in the group. After emendation, they were presented to the plenary where after further modification, they were accepted. RESULTS: Static computer-aided surgery (s-CAIS), in terms of pain & discomfort, economics and intraoperative complications, is beneficial compared with conventional implant surgery. When using s-CAIS in partially edentulous cases, a higher level of accuracy can be achieved when compared to fully edentulous cases. When using an intraoral scanner in edentulous cases, the results are dependent on the protocol that has been followed. The accuracy of measurements on CBCT scans is software dependent. CONCLUSIONS: Because the precision intraoral scans and of measurements on CBCT scans and is not high enough to allow for the required accuracy, s-CAIS should be considered as an additional tool for comprehensive diagnosis, treatment planning, and surgical procedures. Flapless s-CAIS can lead to implant placement outside of the zone of keratinized mucosa and thus must be executed with utmost care.

Prevalence and species of ticks on horses in central Oklahoma.

Ticks are common on horses, but there is a dearth of contemporary data on infestation prevalence, predominant species, and tick-borne disease agents important in this host. To determine the species of ticks most common on horses and the prevalence of equine exposure to and infection with tick-borne disease agents, ticks and blood samples were collected from 73 horses during May, June, and July of 2010. Adult ticks were identified to species, and antibodies to Ehrlichia spp., Anaplasma spp., and Borrelia burgdorferi were identified using indirect fluorescence antibody assay, a commercial point-of-care enzyme-linked immunosorbent assay, or both. In total, 1,721 ticks were recovered at the majority (85%) of equid examinations. Amblyomma americanum (L.) was the most common tick collected (1,598 out of 1,721; 92.9%) followed by Dermacentor variabilis (Say, 1821) (85 out of 1,721; 4.9%) and Amblyomma maculatum Koch, 1844 (36 out of 1,721; 2.1%); single specimens of Ixodes scapularis Say, 1821 and Dermacentor albipictus (Packard, 1869) were also identified. Antibodies reactive to Ehrlichia spp. were found in 18 out of 73 (24.7%) of horses tested, and were more commonly identified in horses with moderate or high tick infestations than those with low tick infestations (P < 0.001). These data support A. americanum as the most common tick species infesting horses in central Oklahoma from May through July and suggest horses are also commonly exposed to an Ehrlichia sp.

Association of Site-specific Tooth Absence with Severity of Oral Health-related Quality of Life Impacts in Girls Having Nonsyndromic Oligodontia.

PURPOSE: The purpose of this cross-sectional observational investigation was to explore associations of site-specific tooth absences (SSTA, edentate sites resulting from dental agenesis where no primary or permanent teeth exist at the sites of permanent tooth agenesis) with the severity of oral health-related quality of life (OHRQoL) impacts in girls having nonsyndromic oligodontia. METHODS: Data collected from 22 girls (mean aged 12.0±2.9, standard deviation years) having nonsyndromic oligodontia (mean permanent tooth agenesis equals 11.6±3.6; mean SSTA equals 1.9±2.5) who completed a 17-item short format Child Perceptions Questionnaire (CPQ11-14) questionnaire were analyzed. RESULTS: OHRQoL impacts were reported to be "often" or "every day/almost every day" by 63.6 percent of the sample. The mean total CPQ11-14 score was 15.6±9.9. Higher OHRQoL impact scores were associated significantly with having one or more SSTA in the maxillary anterior region. CONCLUSION: Clinicians should remain attentive to the wellbeing of the child with SSTA, and include the affected child in the treatment planning.

Metachronous carcinomas in colorectum and its clinicopathological significance.

PURPOSE: The study was designed to examine the significance of colorectal metachronous carcinoma in a large cohort of patients. METHODS: Over a mean follow-up period of 10 years, the clinicopathological features, microsatellite instability (MSI) and clinical follow-up of 56 patients with metachronous colorectal carcinoma were analysed. RESULTS: The prevalence of metachronous colorectal carcinoma was 2.1 %. The metachronous colorectal carcinomas appeared between 7 and 246 months (mean = 66 months) after surgical resection of the index colorectal carcinomas. Thirty-six per cent (n = 20) of the metachronous carcinoma occurred more than 5 years after the operation of the index carcinoma. Of the 56 patients, 20 % (n = 11) of the metachronous colorectal carcinomas were mucinous adenocarcinoma. Cancers detected in the secondary operations (metachronous colorectal carcinomas), when compared with the primary index cancers, were smaller, showed higher proportions of mucinous adenocarcinoma and more often located in the proximal colon. Patients with metachronous colorectal cancers had higher prevalence of mucinous adenocarcinoma, loss of staining for MSI markers and better survival rates than other patients with colorectal cancers. CONCLUSIONS: Patients with metachronous colorectal carcinomas have characteristic features, and attention to these features is important for better management of this group of cancer.

Marble bone disease: a review of osteopetrosis and its oral health implications for dentists.

Osteopetrosis is one cause of osteosclerosis and may result in such serious oral complications as osteomyelitis and exposed necrotic bone. Dentists should be aware of patients with the disease because of its effect on osteoclast function, which results in impaired wound healing. The purpose of this paper is to review the causes, pathogenesis and differential diagnosis of osteopetrosis and to provide guidance to dentists on the management of patients with osteopetrosis.

Primary squamous cell carcinoma of the maxillary alveolus in a 10-year-old girl.

Oral squamous cell carcinoma is rare in the pediatric population. When it does occur, it is most commonly seen on the tongue or lip. In this article, we report a rare case of squamous cell carcinoma of the maxillary gingiva and alveolus in a 10-year-old girl and review the literature concerning oral squamous cell carcinoma in the pediatric population.

Cleidocranial dysplasia: 2 generations of management.

Patients with cleidocranial dysplasia (CCD) commonly present with significant dental problems, such as retention of multiple deciduous teeth, impaction or delay in eruption of permanent teeth and, often, the presence of supernumerary teeth. Several approaches have been described for the management of such patients. We report 2 cases illustrating the shift in the management paradigm from edentulation and prosthetic replacement to orthodontically assisted forced eruption and fixed appliance orthodontic treatment combined with orthognathic surgery.

Safety of zygomatic bone harvesting: a prospective study of 32 consecutive patients with simultaneous zygomatic bone grafting and 1-stage implant placement.

PURPOSE: The purpose of this prospective study was to evaluate the safety of zygomatic bone harvesting and to determine whether a particulated zygomatic bone graft can be used simultaneously with 1-stage dental implants to reconstruct resorbed edentulous alveolar ridges. MATERIALS AND METHODS: Altogether, 82 dental implants were placed in 32 patients. Particulated bone grafts harvested from the zygomatic process were used in 72 of the implant sites. The volume of bone harvested, intraoperative complications, morbidity, and complications on follow-up visits were recorded. Implant survival was examined prospectively. RESULTS: As a harvest site, the zygoma yielded enough bone to complete the reconstructions in each case. The average zygomatic bone graft volume was 0.90 mL (SD 0.30). Perforation of the maxillary sinus occurred at 11 zygomatic sites. None of these perforations led to postoperative problems. No paresthesias or other complications were noted during follow-up examinations. Mean duration of postoperative swelling was 4.5 days, and patients used pain medication for a mean duration of 4 days. After the mean follow-up period of 26.9 months postplacement, 80 of 82 implants were osseointegrated (survival rate 97.6%). DISCUSSION: [corrected] Zygomatic bone is an alternative donor site for bone harvesting with low morbidity. The bone graft yielded is sufficient for use in 2 to 3 implant sites. CONCLUSIONS: The zygoma was a safe intraoral bone harvesting donor site in this patient population. Further, the use of simultaneous particulated zygomatic bone grafts and 1-stage implant placement appears to be an effective procedure.

Distraction osteogenesis of the midface.

Distraction osteogenesis has become an important part of pediatric oral and maxillofacial surgery. It is especially useful in the midface to overcome the perturbations of growth caused by congenital malformations, benign and malignant tumors, and traumatic injuries. Midfacial distraction osteogenesis can take various forms, depending on the exact anatomic site where it is applied in the midfacial skeleton. This article reviews the various locations in the midface in which distraction techniques might be used and highlights the important differences in application at these sites.

Comparison of conventional surgery with motorized trephine in bone harvest from the anterior iliac crest.

OBJECTIVE: A prospective study was performed to compare morbidity associated with the harvest of corticocancellous block grafts (CCBG) by conventional surgery and procurement of cancellous cores (CC) by means of a motorized trephine from the anterior ilium. STUDY DESIGN: Seventy-six patients requiring 30 mL or less of cancellous bone for maxillofacial reconstruction were placed into 2 treatment groups. One group underwent harvest of CCBGs in the traditional open medial approach to the anterior ilium. The second group had CCs harvested through a 0.5- to 1.0-cm incision with a motor-driven trephine. The following parameters were used to evaluate patient morbidity: number of days to unassisted ambulation, length of hospital stay, and pain scores for both the recipient and the donor sites. RESULTS: The mean time to patients' unassisted ambulation following a CCBG was significantly longer (2.8 days) than following CC (0.8 days). The mean length of hospital stay following a CCBG was significantly longer (4.1 days) than following a CC (2.2 days). The mean contemporaneous maxillofacial pain scores following procurement of CCs (day 1: 5.6; day 3: 4.2) and procurement of CCBGs (day 1: 5.8; day 3: 4.5) were not significantly different, whereas the mean hip pain was significantly greater (P <.05) on day 1 in patients having undergone a CCBG (pain score: 6.2) than in patients having undergone a CC graft (pain score: 3.0). Gait disturbance was identified in 15 of 22 patients (68%) who underwent a CCBG. Only 1 of the 54 patients (1.9%) who underwent a CC graft exhibited an abnormal gait. No other complications were noted. The results demonstrated a significant difference in morbidity between the 2 techniques in all variables. CONCLUSION: Where modest amounts of cancellous bone are required for maxillofacial grafting, trephining of cancellous cores results in significantly less morbidity than traditional open methods.

Dental erosion in gastroesophageal reflux disease.

Dentists are often the first health care professionals to diagnose dental erosion in patients with gastroesophageal reflux disease (GERD). Gastroesophageal reflux (GER) is the passage of gastric contents into the esophagus, and GERD is defined as symptoms or complications of GER. Twenty-four-hour monitoring of esophageal pH is helpful in diagnosing GERD. Treatment of dental erosion resulting from GERD involves a multidisciplinary approach among family physician, dentist, prosthodontist, orthodontist and gastroenterologist. When possible, dental erosion should be treated with minimal intervention, and such treatment should include control of microflora, remineralization, adhesive restorations and use of biomimetic materials.

Antibodies reactive to Ehrlichia spp. are common in Oklahoma horses.

Abstract Tick infestations and infection with tick-borne agents are commonly recognized in horses in North America, but equine infection with true Ehrlichia spp. has not been described. To determine the degree to which horses in the south-central United States are naturally exposed to and infected with tick-borne disease agents, serum samples were collected at random (n=240) or from horses with active tick infestations (n=73) and tested by immunofluorescence antibody assay (IFA) and/or enzyme-linked immunosorbent assay (ELISA) for evidence of antibodies reactive to Ehrlichia spp., Anaplasma spp., and Borrelia burgdorferi. Positive samples were further evaluated by species-specific serology for antibodies reactive to E. canis and E. chaffeensis, and whole blood samples were tested by PCR for evidence of infection with E. canis, E. chaffeensis, E. ewingii, and an E. ruminantium-like organism referred to as the Panola Mountain Ehrlichia. Antibodies reactive to Ehrlichia spp. were identified in 8.75% (21/240) of the randomly acquired samples and 24.7% (18/73) of the serum samples from tick-infested horses, but species-specific ELISA and PCR failed to confirm exposure to or infection with any known Ehrlichia spp. Antibodies to Anaplasma spp. (5/313; 1.6%) and B. burgdorferi (3/313; 1.0%) were uncommon. These data suggest that horses in the south-central United States are likely exposed to a novel Ehrlichia sp. Further research is needed to identify the etiologic agent responsible for the serologic activity seen and to determine the clinical significance, if any, of this finding.