Can Salivary Biomarkers Be Used as Predictors of Dental Caries in Young Adolescents?

BACKGROUND Identifying caries predictors in the subpopulation at risk is one of the preconditions for developing effective caries prevention measures. The present exploratory study aimed to examine the significance of socio-demographic characteristics, dietary-hygiene habits, salivary pH, and salivary antimicrobial HNP-1, hBD-2, and LL-37 peptides as potential caries risk predictors in children ages 11-13 years. MATERIAL AND METHODS This prospective 1-year study enrolled 213 children ages 11-13 years. The subjects underwent a dental examination and their mothers were interviewed. Unstimulated saliva was collected from the subjects to determine its pH value, as well as the salivary levels of HNP-1, hBD-2, and LL-37 peptides in 85 of the subjects. After 12 months, the 1-year caries incidence rate was recorded. Logistic regression analysis was used to estimate the ability of selected variables to predict caries risk. RESULTS The univariable logistic regression analysis determined that the most significant independent caries risk predictors were: sex (female) (OR=2.132, p=0.007), mothers' education (OR=1.986, p=0.020), salivary pH (OR=0.270, p=0.043), oral hygiene index (OR=1.886, p=0.015), and daily tooth brushing frequency (OR=0.565, p=0.042). The multivariable model showed that sex and oral hygiene-related variables were the most important caries predictors. CONCLUSIONS Salivary HNP-1, hBD-2, and LL-37 peptides were not found to have a significant predictive value. Therefore, socio-demographic and oral hygiene variables remain important caries predictors in early adolescents, suggesting the importance of the mechanical control of biofilm as the key measure for preventing caries. However, there is still a need for effective caries risk biomarkers, and additional research is needed in this area of caries risk prediction.

Cytomorphometric and clinical investigation of the gingiva before and after low-level laser therapy of gingivitis in children.

Gingival epithelial cells are the first physical barrier against periodontal pathogenic microorganisms. Bacterial products may penetrate the epithelium and directly disturb its integrity. We investigated the clinical and cytomorphological status of the gingiva in children with gingivitis before and after low-level laser therapy. The study enrolled 130 children divided into three groups: group 1 comprised 50 children with chronic catarrhal gingivitis who received basic treatment, group 2 comprised 50 children with chronic catarrhal gingivitis who received low-level laser treatment in addition to basic treatment, and group 3 comprised 30 children with healthy gingiva as controls. Oral hygiene and the status of the gingiva were assessed using the appropriate indexes before and after treatment. Inflammation of the gingiva was monitored by cytomorphometric evaluation. Cytomorphometric analysis revealed a statistically significant difference (p < 0.001) in the size of the nuclei of the stratified squamous epithelial cells of the gingiva before and after treatment in chronic catarrhal gingivitis. Evaluation using clinical parameters showed that treatment of gingivitis with basic treatment was successful. Cytomorphometric analysis showed that after basic treatment the nuclei of the stratified squamous epithelial cells of the gingiva were reduced in size, although not to the size found in healthy gingiva. However, after adjuvant low-level laser therapy, the size of the nuclei of the stratified squamous epithelial cells in the gingiva matched the size of the nuclei in the cells in healthy gingiva.

Migration of fluoride ions from the permanent teeth into saliva in children with glass ionomer cement restorations: an in vitro study.

BACKGROUND/AIM: Glass ionomer cements (GIC) belong to the group of polycarboxyl cements, and one of the principal characteristics of these materials is their anticariogenic potential of fluorine release into saliva and enamel-dentin substance. The aim of this study was to examine the content of released fluorine from GIC restorations (Fuji IX, GC, Japan) of young permanent teeth in the medium of artificial saliva and similar releases in the same medium by the restorations of these teeth treated with a low concentration fluoride solution. METHODS: We examined 12 premolars extracted from orthodontic reasons. The GIC restored teeth were divided into the group treated daily with low concentration fluoride solution (334 ppm) and the control, not treated group. The samples of artificial saliva were analyzed for fluorine ion content using an ion selective electrode. RESULTS: Our comparative analysis of the mean values using the Student's t-test demonstrated a statistically significant difference in fluorine ion concentration in artificial saliva of fluoridated and non-fluoridated teeth with GIC fillings after 14 and 21 days (p < 0.05), while the difference detected after 7 days was with no statistical significance. CONCLUSION: The results of this in vitro study indicated that low-concentration fluoride solutions could serve to refluoridate GIC fillings and contribute to an increased fluorine content in saliva. The process of refluoridation of GIC fillings should be advised 2-3 weeks after the restoration, since the release of fluorine from GIC fillings diminishes in time.

[Efficacy of hyaluronic acid in the treatment of chronic gingivitis in children].

INTRODUCTION/AIM: Gingivitis is a common occurrence in children and may well be thought as a risk factor for the appearance and progression of the diseases of parodontal tissues. It is thus necessary to react in a timely and adequate fashion to prevent the disease to become serious and produce parodontopathy. The aim of the study was to establish the efficacy of hyaluronic acid in the treatment of chronic gingivitis in children. METHODS: The study enrolled 130 children with permanent dentition. All of the examinees were divided into three groups: group I--50 patients with chronic gingivitis in which only the basic treatment was applied; group II--50 patients with chronic gingivitis in which hyaluronic acid was applied in addition to basic treatment; group III--30 examinees with healthy gingiva (control group). Assessment of oral hygiene and status of the gingiva and parodontium was done using the appropriate indexes before and after the treatment. Inflammation of the gingiva was monitored by way of cytomorphometric studies. RESULTS: The pretreatment values of the plaque index (PI) were high: in the group I PI was 1.94; in the group II PI was 1.68. After the treatment, the PI value was reduced to null in both groups (PI = 0). In the group III PI was 0.17. The bleeding index (B1) in the group I was 2.02 before and 0.32 after the treatment; the BI value in the group II was 1.74 before and 0.16 after the treatment. In the group III BI was 0. In the group I, the Community Periodontal Index of Treatment Needs (CPITN) was 1.66 before and 0.32 after the treatment; in the group II, the CPITN value was 1.5 before and 0.24 after the treatment. In the group III, the CPITN value was 0. In the group I, the size of the nuclei of the stratified squamous epithelium of the gingiva was reduced, although not so much as the nuclear size in the group II of examinees. CONCLUSION. Basic treatment is able to successfully treat chronic gingivitis in children. The use of hyaluronic acid together with the basic treatment can markedly improve the treatment effect.

[The quantity of information which parents and their seven-year-old children have on the affects of nutrition, oral hygiene and fluoride prophylaxis on dental health].

INTRODUCTION: Health education plays a crucial road in maintaining good oral health of human population and, primarily, in reducing the incidence of caries as one of the most frequent oral diseases. This implies the need for a change in the behaviour of individuals, groups or the society as a whole, in terms of the following: establishing a proper nutrition regime, establishing the habit of maintaining oral hygiene and the use of fluorides. The goal of the paper is to determine the quantity of information which parents and their seven year old children have on the effects of nutrition, oral hygiene and fluoride prophylaxis on dental health in rural and urban environment. MATERIAL AND METHODS: The survey included 450 seven-year-old children and their parents in urban and rural environments. The quantity of information about proper nutrition, oral hygiene and fluoride prophylaxis was determined based on specific questionnaires for children and their parents. RESULTS: The quantity of information about the effects of proper nutrition, oral hygiene and fluoride prophylaxis on dental health of seven year old children is significantly larger in urban, as compared to the rural environment. The quantity of information of parents about the effects of proper nutrition, oral hygiene and fluoride prophylaxis on dental health is larger in urban, as compared to the rural environment. CONCLUSION: This research suggests a need to intensify health education activities, especially in the rural environment.

[Analysis of enzyme activity and the level of malondialdehyde in the saliva of children with gingivitis].

INTRODUCTION/AIM: By analysing activity of some of the enzymes normally present in the saliva and the level of malondialdehyde in gingivitis, it is possible to estimate the functional condition of parodontium, and the examined parametres can be considered as biochemical markers of its functional condition. The aim of this paper was to examine activity of alanine aminotransferase, aspartate aminotransferase, gamma glutamyl transferase, lactate dehydrogenase and the level of malondialdehyde in the saliva of children affected with gingivitis, as well as the values of the mentioned parametres in relation to the level of the inflammation of gingiva. METHODS: The research included 120 children at the age of 12.2 with permanent dentition. Löe and Silness gingival index was used to estimate the condition of gingiva, based on which the childen were classified into four groups: the children with healthy gingiva (the control groups), the children with mild, moderate and severe inflammation of gingiva (the study group). Enzymes of the saliva were determined by the use of original tests and measured by the autoanalyser (Bio Systems A25, Spain). A modified method with tiobarbituric acid was used to determine malondialdehyde in nonstimulated mixed saliva. RESULTS: The results of the examined enzyme activity and the level of malondialdehyde in the saliva of the study groups showed statistically considerably higher values for the level of malondialdehyde (p < 0.001), for the activity of aspartate aminotransferase and gamma glutamyl transferase (p < 0.01), as well as for alanine aminotransferase (p < 0.05) in comparison with the control group, whereas the activity of lactate dehydrogenase did not show a statistically significant increase. In relation to the level of the inflammation of gingiva, the results of the examination of the enzyme activity in the study groups showed statistically significantly higher values in the group with severe inflammation in comparison with those with mild, as well as the moderate inflamatiory, except for the gamma glutamyl transferase, and in the group with moderate inflammation compared to that with the mild one, except for alanine aminotransferase. The results of the examination of the level of malondialdehyde in the saliva of the study groups did not show a statistically significantly increase in relation to the level of the inflammation of gingiva. CONCLUSION: There is a higher level of alanine aminotransferase, aspartate aminotransferase, gamma glutamyl transferase and lactate dehydrogenase enzyme activity together with the higher level of malondialdehyde in the saliva of children with gingivitis in comparison with the activity of the same enzymes and the level of malondialdehyde in the saliva of children without gingivitis. The activity of the examined enzymes in the saliva of children with gingivitis increases in relation to the intensity of the pathological process, whereas the level of malondialdehyde shows no significant difference in relation to the level of the inflammation of gingiva.

[Low-level laser efficiency in the therapy of chronic gingivitis in children].

BACKGROUND/AIM: Gingivitis is a frequent phenomenon in children considered to be a risk factor for the occurrence and progression of paradontal tissue disease. So, it is necessary not only to identify inflammation, but also to react in due time and adequately in order to avoid further disease spread and the beginning of periodontitis. The aim of this study was to determine the efficiency of a low-level laser application in the therapy of chronic gingivitis in children. METHODS: The study a included hundred of children with permanent dentition suffering from chronic gingivitis. All the examinees were divided into two groups: group I--50 examinees with chronic gingivitis, who underwent the basic therapy; group II--50 examinees with chronic gingivitis, who underwent the basic therapy and also a therapy with a low-level laser. Evaluation of the condition of oral hygiene, the health of gingiva and periodontium were done using appropriate index before and after the therapy. RESULTS: For the plaque index (PI) following results were obtained: in the group I PI = 1.94, and in the group II PI = 1.82. After the therapy in both groups PI was 0. In the group I sulcus plaque index (SPI) was 2.02 before the therapy and 0.32 after the therapy. In the group II SPI was 1.90 before the therapy, and 0.08 after the therapy. In the group I Community Periodontal Index of Treatment Needs (CPITN) was 1.66 before the therapy, and 0.32 after the therapy, and in the group II CPITN was 1.60 before the therapy, and 0.08 after the therapy. CONCLUSION: Chronic gingivitis in children can be successfully cured by the basic treatment. The use of a low-level laser can significantly improve this effect.

[The importance of health education in prevention of oral health in children].

HEALTH EDUCATION: The aim of education is to impart knowledge on the causes of disease and decay of the teeth and periodontium, on the ways and possibilities of disease prevention and adequate treatment; to point out to the necessity of proper nutrition, regular and proper oral hygiene, proper use of fluoride products as well as to the significance of regular check-ups with a dentist. NUTRITION: Frequent intake of carbohydrates leads to a higher prevalence of caries. Taking into consideration that it is neither obtainable nor recommendable to completely eliminate glucoses from the nutrition components, it is necessary to advice parents and children to take glucose (if possible) only along with the regular meal when the saliva flow is increased. ORAL HYGIENE: In order to establish oral hygiene as an important prophylactic measure influencing successful protection of oral health of the whole population, it is necessary to inform as many people as possible about oral hygiene effectiveness and its necessity in preventing oral and dental diseases; to develop the habits of regular oral hygiene maintenance in the youngest children as well as to refer them to the use of most adequate paraphernalia and agents for performing the daily oral hygiene procedures. FLUORIDE PROPHYLAXIS: Undoubtedly, fluoride is currently the most efficient agent for the prevention of dental pathology. The anticaries efficacy of fluoride is a consequence of the cumulative effect of several different mechanisms. They can occur on the dental surface or directly influence the mineral phase in the enamel. Each dental hygiene preventive program must include the content about the use of fluoride as the basic prophylactic measure. It is recommended to be the sum of the combined effect of systemic (endogenic) and local (exogenic) application. CONCLUSION: Regarding high prevalence of caries in children, the issue of prophylaxis is of great significance and current interest. In that respect, health education should point out to the significance of proper nutrition, regular oral hygiene and fluoride prophylaxis, all aimed at preventing dental diseases. It is certain that parents must take an active part in these activities both as educators and controllers of the proposed measures.