ABSTRACT
Molar-incisor malformation (MIM) is a newly described dental developmental anomaly that predominantly affects primary second molars, permanent first molars, and, in some cases, permanent central incisors. Diagnosis is usually made upon radiographic examination. The molars usually present with significant cervical constriction, flattened pulp chambers, and absent or thin, short, and narrow roots, whereas the incisors usually exhibit coronal dilaceration. Loss of these compromised teeth in the long term may be inevitable. Thus, clinicians should be aware of this condition and the factors to consider to advise their patients as early as possible. The purpose of this paper is to present two cases of MIM and discuss the factors clinicians should take into consideration to make a care plan in these cases.
Subject(s)
Incisor , Tooth Abnormalities , Dental Pulp Cavity , Humans , Incisor/abnormalities , Incisor/diagnostic imaging , Incisor/surgery , Molar/abnormalities , Molar/diagnostic imaging , Molar/surgery , Radiography, PanoramicABSTRACT
OBJECTIVE: To investigate the role of the Mediterranean diet and physical activity with relation to living environment and childhood asthma. METHODS: 1125 children (529 boys), 10 to 12 years old were recruited either in an urban environment (Athens, n = 700) or rural environment (n = 425) in Greece. A path analytic model was developed to assess the causal relation between urban environment and asthma prevalence (standardized ISAAC questionnaire), through the mediation of the Mediterranean diet (evaluated by the KIDMED food frequency questionnaire) and physical activity (evaluated by the PALQ physical activity questionnaire). RESULTS: The proposed model had a very good fit (χ2/df ratio =1.05, RMSEA=0.007, 90% confidence interval: 0.01 to 0.046, p=0.97, CFI = 0.98). A significant total positive effect was found between urban environment and asthma symptoms (standardized beta= 0.09, p<0.001). Adherence to the Mediterranean diet was related negatively with asthma symptoms (standardized beta = -0.224, p<0.001). An inverse mediating effect of the Mediterranean diet was observed for the urban environment - asthma relation (standardized beta=-0.029, p<0.001) while physical activity had no significant contribution (p=0.62), adjusted for several confounders. CONCLUSIONS: The Mediterranean diet may protect against the harmful effect of urban environment on childhood asthma.
Subject(s)
Asthma/epidemiology , Diet, Mediterranean , Environment , Motor Activity/physiology , Residence Characteristics , Child , Female , Greece/epidemiology , Humans , Life Style , Male , Prevalence , Residence Characteristics/statistics & numerical data , Rural Population/statistics & numerical data , Surveys and Questionnaires , Urban Population/statistics & numerical dataABSTRACT
The stress of dental treatment often elicits negative emotions in children, expressed as dental fear or anxiety. Highly anxious children obstruct treatment and avoid therapy, further amplifying oral health problems. The aim of this study was to examine the neuroendocrine and autonomic nervous system responses to dental treatment and their possible interactions and associations with psychometric indices of anxiety, caries, previous dental experience, anesthesia, age and gender in school children. Upon informed consent, saliva was obtained from 97 children (59% males, mean age ± SD: 89.73 ± 15 months) in the Clinic of pediatric dentistry before treatment, immediately post-treatment and at the recall visit to determine cortisol and salivary alpha-amylase (sAA) levels. Dental and general anxiety was assessed through specific questionnaires completed by the children. Compared to pre-treatment, cortisol levels were increased following treatment, while sAA levels were higher at the recall. Pre- and post-treatment cortisol and sAA responses were positively correlated. Dental and general anxiety questionnaire scores were also significantly correlated with each other. The integrated autonomic and neuroendocrine responses prior to treatment were correlated with state anxiety and those following treatment with dental anxiety. However, univariable and multivariable linear regression analysis associated post-treatment cortisol, but not sAA, levels with dental anxiety. No associations of cortisol or sAA responses with caries, age, gender, previous dental experience or anesthesia were detected. These data provide some evidence that both sAA and cortisol levels are altered in children in anticipation or during dental treatment, but only cortisol levels are associated to dental anxiety.
Subject(s)
Dental Anxiety/metabolism , Hydrocortisone/metabolism , Salivary alpha-Amylases/metabolism , Stress, Psychological/metabolism , Child , Cohort Studies , Female , Humans , Male , Prospective Studies , Surveys and QuestionnairesABSTRACT
OBJECTIVE: This study evaluated the interrelationships of living environment, physical activity, lifestyle/dietary habits, and nutritional status on the prevalence of childhood asthma. METHODS: In a cross-sectional survey 1125 children (529 boys), 10 to 12 years old, were selected from 18 schools located in an urban environment (Athens, n = 700) and from 10 schools located in rural areas (n = 425) in Greece. RESULTS: Children living in Athens had higher likelihood of "ever had" asthma compared with children living in rural areas (odds ratio (OR) = 1.78, 95% confidence interval (CI) = 1.25-2.54), after adjusting for age and sex. After adjusting for age, sex, body mass index, and adherence to the Mediterranean diet (KIDMED score), leisure-time physical activity was inversely associated with "ever had" asthma. When stratifying by county of residence, a trend toward reduced asthma symptoms among children engaged in outdoor physical activities during their leisure time who reside in rural (but not urban) environment was observed (OR = 0.88, 95% CI = 0.77-1.01). CONCLUSIONS: The inverse relationship between asthma symptoms and leisure-time physical activity in the rural environment and the lack of an association between asthma symptoms and organized sports-related activities should draw the attention of public healthcare authorities. Their efforts should focus on the planning of a sustainable natural environment, which will promote the physical health of children and reduce the burden of childhood asthma.
Subject(s)
Asthma/epidemiology , Diet , Environment , Exercise , Leisure Activities , Asthma/physiopathology , Body Weights and Measures , Child , Female , Health Behavior , Health Surveys , Humans , Life Style , Male , Residence Characteristics , Rural Population , Socioeconomic Factors , Urban PopulationABSTRACT
Epidemiological studies have revealed several associations between asthma symptoms and environmental and dietary factors, but the potential environment- diet interactions on asthma incidence have rarely been investigated. The aim of this work was to evaluate the interrelationships between urban/rural environment, adherence to a healthy dietary pattern, the Mediterranean diet, and childhood asthma. A cross-sectional survey was performed and 1125 (529 boys), 10- to 12-year-old children were selected from 18 schools located in urban Athens area (n = 700) and from 10 schools located in rural areas of Ilia and Viotia (n = 425), Greece. Children and their parents completed standardized questionnaires, which evaluated, among others, environmental factors and dietary habits. Asthma was defined according to Phase II of the International Study on Allergies and Asthma in Childhood criteria. Adherence to the Mediterranean diet was assessed using the Mediterranean and Diet Quality Index for children and adolescents (KIDMED) score. Living in urban areas was associated with higher odds of ever had asthma symptoms by 1.78 times (95% confidence interval [CI], 1.25-2.54) when compared with rural areas. In contrast, 1-unit increase in the KIDMED score was associated with 16% lower likelihood of having asthma symptoms (95% CI, 0.77-0.91), after adjusting for various confounders. When stratifying the analysis by area of living it was observed that adherence to the Mediterranean diet was associated with lower likelihood of asthma in both urban and rural areas (urban, odds ratio [OR] = 0.81, 95% CI, 0.73-0.91; rural, OR = 0.87, 95% CI, 0.75-1.00). Urban environment seems to increase the likelihood of childhood asthma, whereas adherence to the healthy Mediterranean dietary pattern could mediate the aforementioned association and confers significant protection.