Effects of iron accumulation on dental caries, gingivitis, and candida albicans infection in children with beta thalassemia major: A narrative review

Background@#Thalassemia is a common inherited hemolytic disorder characterized by the absence or reduction of one of the globin chains. Beta thalassemia major generally has oral cavity manifestations. Patients with beta thalassemia major often require routine blood transfusion. However, this treatment has the side effect of accumulating iron in the salivary glands, which increase the risk of dental caries, gingivitis, and secondary infection from Candida albicans.@*Objective@#The aim of this review is to explain the relationship of salivary iron levels and the effects of iron accumulation on dental caries, gingivitis, and Candida albicans infection.@*Methods@#A comprehensive search was performed on PubMed, Scopus, and Google Scholar databases using the keywords beta thalassemia major, iron, dental caries, gingivitis, Candida albicans.@*Results@#Iron is an essential micronutrient needed by Candida albicans for its growth and virulence. Blood transfusion in patients with beta thalassemia major can lead to a buildup of iron in the salivary glands and trigger the formation of non-transferrin bound iron (NTBI). NTBI can circulate in plasma and form a reactive oxygen species (ROS) that stimulate the formation of biofilms and increase dental caries. ROS may affect several genes associated with the inflammatory process and increase the incidence of gingivitis. It can also reduce salivary secretion in patients with thalassemia-β major that cause dysbiosis, which triggers an overgrowth of Candida albicans.@*Conclusion@#The excess iron in patients with beta thalassemia major increase the risk of dental caries, gingivitis, and Candida albicans infection.

Pubertal growth spurt peak in angle class I and II Malocclusions using cervical vertebrae maturation analysis in Deutero-Malay children

Background@#The incidence rate of Angle Class I and Class II malocclusions in mixed dentition is higher than Class III. In orthodontic interceptive treatment, it is necessary to identify pubertal growth spurt peak individually because the best growth modification could be obtained during this period. One of the methods in assessing the pubertal growth spurt peak is cervical vertebrae maturation (CVM), which is done using a lateral cephalometric radiograph. CVM evaluates potential growth and skeletal maturity by assessing cervical vertebrae anatomy. Identifying the duration of growth spurt peak on both malocclusion classes is the most pivotal aspect of optimizing remodeling and correction of children’s malocclusion. @*Objective@#Distinguishing the duration of pubertal growth spurt peak of children with Angle Class I and II malocclusions based on CVM analysis in Deutero-Malay children so that it can be used in determining optimal orthodontic treatment plan and timing in children with Class I and Angle II malocclusion for Deutero-Malay children. @*Methods@#Analytical observational with cross-sectional approach was applied using lateral cephalometric radiographic images from patients’ medical records attending or had attended orthodontic treatment in the Pediatric Dentistry Clinic, Airlangga University Dental Hospital, Surabaya, Indonesia, in 2014-2019 that met the inclusion criteria and were analyzed with Baccetti’s method of CVM analysis. This study involved 66 conventional lateral cephalometric photographs that were selected using total sampling. The data were analyzed using Independent T-Test and Mann Whitney U Test. @*Result@#The duration of pubertal growth spurt peak in Angle Class I and II malocclusions was 11 and 7 months, respectively. The age of onset for Class I with CS3 was 9 years and 5 months, while for Angle Class II malocclusion starts entering the stage at 10 years 3 months of age, while for CS4 skeletal maturity we found that the age of onset for subjects with Angle Class I and II were 11 years 2 months and 12 years 4 months, respectively. The average duration of the pubertal growth spurt peak in female and male patients was 11.3 months and 18.2 months, respectively. All of these results were statistically significant (p ≤ 0.001) and representative of the population, in this case, Deutero-Malays. @*Conclusion@#Four-month differences in the duration of pubertal growth spurt peak of children with Angle Class I and II were found. This may lead to a shorter treatment duration of 4 months in children with Angle Class II malocclusion when compared to children with Angle Class I malocclusion. Angle Class II malocclusion exhibit shorter pubertal growth spurt peak duration, which may account for the difference in mandibular growth on the two malocclusion classes.

The Relation Between Decay Missing Filled-Teeth (DMF-t), Body Mass Index (BMI) with Salivary Human Beta-3 (HBD-3) Secretion in Children with Caries and Free Caries

@#Introduction: Dental caries in children is a major problem of mouth disease throughout the world, so too is there currently an increase in health problems in children due to obesity. Human Beta defensing(HBD) has been found in saliva and from several studies stated that HBD aside from being a broad-spectrum antimicrobial can act as an immunomodulator. The purpose of this study is to reveal whether there is a relationship between obesity and HBD-3 salivary concentration in caries patients and caries-free patients. Methods: This cross-sectional observational study was involved 62 children with caries and caries-free, aged 9-11 years, students at Qommarudin Islamic Boarding School, Gresik, East Java Indonesia. dental caries examination, carried out in accordance with World Health Organization (WHO) diagnostic criteria. Body mass index (BMI) was measured from the height and weight of individuals, HBD3 concentrations were tested with an ELISA kit from Bioassay Technology Laboratory (China) from saliva samples. Evaluate the results with the Kruskal Wallis test, followed by the Mann-Whitney test. The level of significance used in this statistical test was 0.05. Results: there was a relationship between BMI level and HBD-3 concentration in the caries group (p <0.05, p = 0.009) with a moderate level of association. but there was no significant relationship in the caries-free group (p> 0.05, p = 0.189). Conclusion: There was an association between BMI and HBD-3 salivary concentration in caries patients but there was no relationship in the caries-free group.

Suspected non-syndromic Oligodontia - A rare case with 13 agenesis

@#Oligodontia is a condition in which the patient has more than six ageneses, excluding the third molars. Whereas the absence of one tooth is quite common, oligodontia is a rare congenital condition that can happen with or without the syndrome. The condition happens due to disturbances during odontogenesis process. Management of oligodontia is a long-term process, and it involves prosthetic, restorative, and orthodontic treatment to support the oral function and esthetic of the patient. This article aims to report a rare case of agenesis of 13 permanent teeth (excluding third molars) in an 11-year-old girl and her treatment plan.