The dental perspective on osteogenesis imperfecta in a Danish adult population.

BACKGROUND: To report on dental characteristics and treatment load in Danish adult patients with osteogenesis imperfecta (OI). METHODS: Oral examination of 73 patients with OI was performed and OI type I, III, and IV were represented by 75.3%, 8.2%, and 16.4%, respectively. Patients were diagnosed as having dentinogenesis imperfecta (DI) if they had clinical and radiological signs of DI. In the data analysis, mild OI (type I) was compared to moderate-severe OI (type III and IV). RESULTS: Discoloration of teeth was prevalent in patients with moderate-severe compared to mild OI (83.3% vs. 5.5%, p < 0.001). Cervical constriction and pulpal obliteration were frequent findings in patients with moderate-severe OI (61.1% and 88.9%, respectively), whereas pulp stones and taurodontism were diagnosed in patients with mild OI only (29.1% and 9.1%, respectively). DI was found in 24.7% of OI patients and considerably more frequent in patients with moderate-severe (94.4%) compared to mild OI (1.8%) (p < 0.001). The number of teeth with artificial crowns was significantly higher in patients with moderate-severe OI than in patients with mild OI (median 1.5, range 0-23 vs. median 0, range 0-14) (p < 0.001). The number of teeth with fillings in patients with mild OI was significantly higher than in patients with moderate-severe OI (mean 9.7, SD 5.1, median 9.0, range 1-21 vs. mean 5.0, SD 4.4, median 4.0, range 0-16) (p < 0.001). CONCLUSIONS: One fourth of patients with OI had DI, and the vast majority of them had moderate-severe OI. Whereas discoloration of teeth, cervical constriction and pulp obliteration were frequent findings in patients with moderate-severe OI, pulp stones and taurodontism were found in patients with mild OI only. In patients with moderate-severe OI, the dental treatment load was dominated by prosthetic treatment, whereas restorative treatment with fillings was more prevalent in patients with mild OI.

Five-year evaluation of a low-shrinkage Silorane resin composite material: a randomized clinical trial.

OBJECTIVES: The aim of the present study was to investigate the clinical performance of a low-shrinkage silorane-based composite material (Filtek™ Silorane, 3 M-Espe) by comparing it with a methacrylate-based composite material (Ceram•X™, Dentsply DeTrey). MATERIAL AND METHODS: A number of 72 patients (158 restorations) participated in the study. After 5 years, a total of 107 restorations (52 Filtek™ Silorane, 55 Ceram•X™) in 48 patients were evaluated. Only class II restorations were included. All the restorations were placed by the same dentist, and the restorations were scored by one experienced dentist/evaluator. Materials were applied following the manufacturer's instructions. The primary outcome was marginal adaptation. Secondary outcomes were: marginal discoloration, approximal contact, anatomic form, fracture, secondary caries, and hypersensitivity. RESULTS: After 5 years, no statistically significant differences between the two materials were found in marginal adaptation either occlusally (p = 0.96) or approximally (p = 0.62). No statistically significant differences were found between the two materials in terms of approximal contact, anatomic form, fractures, or discoloration. Secondary caries was found in two teeth (Filtek™ Silorane). One tooth showed hypersensitivity (Ceram•X™). CONCLUSION: Restorations of both materials were clinically acceptable after 5 years. This study did not find any advantage of the silorane-based composite over the methacrylate-based composite, which indicates that the low-shrinkage of Filtek™ Silorane may not be a determinant factor for clinical success in class II cavities. CLINICAL RELEVANCE: This paper is the first to evaluate the 5-year clinical performance of a low-shrinkage composite material.

Microdontia and hypodontia of premolars and permanent molars in childhood cancer survivors after chemotherapy.

BACKGROUND: Adverse long-term general and dental health effects of cancer and cancer therapy during childhood have been reported. AIM: To examine the association between chemotherapy before the age of 8 years and (1): microdontia; (2): hypodontia of premolars and permanent molars. MATERIAL AND METHODS: In The Danish Registry of Childhood Cancer (DBCR), we identified 203 children who met the following inclusion criteria: (1) age below 8 years at the start of treatment; (2) age between 12 to 18 years upon dental examination; (3) had received chemotherapy The exclusion criterion was radiotherapy to the head and neck. A total of 150 children fulfilled the inclusion criteria. As controls, a random sample of 193 age-matched unexposed children was included. RESULTS: Microdontia was found in a total of 88 teeth in 29 (19.3%) of the 150 children who had been exposed to chemotherapy, while none of the controls had microdontia of premolars or permanent molars (difference: 19.3%; 95% CL: 13.5%; 26.4%). The earlier the exposure, the more frequent was microdontia. We found a total of 27 missing premolars and permanent molars in 14 (9.3%) of the exposed children and a total of 18 missing premolars and permanent molars in 8 (4.1%) of the controls (difference: 5.2%; 95% CL: -0.1%; 11.3%). CONCLUSION: The present study confirms findings from previous studies that chemotherapy, especially in very young children, causes microdontia and hypodontia of premolars and permanent molars.

Marginal adaptation of a low-shrinkage silorane-based composite: 1-year randomized clinical trial.

The aim of the present study was to examine the marginal adaptation of a new low-shrinkage silorane-based composite material (Filtek™ Silorane, 3M-Espe) by comparing it with a methacrylate-based composite material (CeramX™, Dentsply DeTrey). In particular, we wanted to test the hypothesis that reduced polymerization shrinkage would improve the marginal adaptation. Seventy-two patients participated in the study. A total of 158 restorations were placed in 80 premolars and 78 molars. Only Class II restorations were included, and each patient could contribute with more than one tooth. The restorations were scored at baseline and after one year. While statistical comparison of marginal adaptation at follow-up indicated better performance of CeramX™ both occlusally and approximally (p = 0.01 and p < 0.01), the low kappa value (32%) reflects the difficulty to assess marginal adaptation clinically. The reduction in polymerization shrinkage demonstrated in the laboratory was not clinically significant in the present study.

Elution of substances from a silorane-based dental composite.

Previous studies have shown that residual monomers, initiators, and additives are eluted from methacrylate-based dental composite materials. Recently, a composite material (Filtek Silorane), based on a new resin chemistry, was introduced. The purpose of this study was to investigate substances eluted from Filtek Silorane in water and ethanol. Polymerized specimen discs of the material were immersed in either distilled water or 75 vol% ethanol at 37 degrees C, and the solutions were analyzed using liquid chromatography-mass spectrometry after 1, 4, 24, and 72 h eluting time. No substances were found to leach from Filtek Silorane in water, whereas silorane monomers and an initiator component were eluted from the material into the ethanol solution.