Restoring aesthetics and function in a young boy with hypomature amelogenesis imperfecta: a case report.

Amelogenesis imperfecta has been described as a complex group of inherited conditions that disturbs the developing enamel structure and exists independent of any related systemic disorder. It is a rare dental disease but represents a great restorative challenge for dentists. A 12-year-old boy presented with sensitive, discolored, and mutilated teeth and decreased vertical dimension of occlusion. Direct composite resin restorations were applied to all teeth to modify the occlusion, to restore mild crowding, and to improve aesthetics. The 24-month recall examination revealed no pathology associated with the rehabilitation, and the patient's aesthetic and functional expectations were satisfied. The rehabilitation included multiple anterior and posterior composite resins to eliminate tooth sensitivity, improve the aesthetics and occlusion, and restore function.

Types of rickets, dental and histologic findings: reviewof the literature / Tipos de raquitismo, aspectos dentários e histológicos: revisão de literatura

Introduction: A disease that occurs during childhood, rickets is the failure of growing bone to mineralize. Many skeletal and radiographic changes can ocur because of the lack of calcified osteoid and the buildup of un ossified cartilage. Proper bone formation requires a complex interplay of several organs and chemicals, and vitamin D deserves special mention because any disturbance in its production, absorption, or metabolism is paramount in the development of rickets. The pathophysiology of the disease is thought to be impaired phosphate transport, especially decreased phosphate resorption in the renal proximal tubule, as well as in the intestine. In most cases, the diagnosis is established with a thorough history and physical examination and confirmed by laboratory evaluation. Early diagnosis is essential because morbidity can be minimized if children are treated before eight months of age. Objective: The aim of this literature review is to present various types of rickets with clinical features and the dental findings, preventive measurements and treatments. Conclusion: The dentist as well as the pediatrician should be made aware of the features of this disorder so that early intervention can prevent subsequent serious and more invasive dental procedures.

Introdução: O raquitismo, uma doença que ocorre durante a infância, é a falta de crescimento ósseo necessário para a mineralização. Diversas alterações radiográficas esqueléticas podem ocorrer devido a ausência de osteóide calcificado e a formação de cartilagem. A formação óssea adequada requer uma complexa interação de vários órgãos e produtos químicos, e a vitamina D merece uma menção especial, pois qualquer alteração na sua produção, absorção ou no seu metabolismo é fundamental para o desenvolvimento do raquitismo. Acredita-se que a fisiopatologia da doença está no transporte inadequado do fosfato, especialmente na diminuição da reabsorção de fosfato no túbulo renal proximal bem como no intestino. Na maioria dos casos, o diagnóstico é estabelecido com uma história completa e exame físico, e confirmado por exames laboratoriais. O diagnóstico precoce é essencial, pois a morbidade pode ser minimizada se as crianças forem tratadas antes dos oito meses de idade. Objetivo: Apresentar os vários tipos de raquitismo com suas características clínicas, aspectos dentários, medidas preventivas e tratamento. Conclusão: O cirurgião-dentista, bem como o pediatra, devem ser informados das características desta desordem para que a intervenção precoce possa evitar seqüelas subsequentes e procedimentos odontológicos mais invasivos.

Multiple root fracture: a case report.

An 11-year-old boy was diagnosed with a horizontal root fracture in the maxillary right lateral incisor and a crown fracture in the maxillary right central incisor. This patient was treated endodontically and conservatively. At a follow-up examination 36 months after treatment, the teeth were functionally and esthetically normal. Radiographically, no pathosis was evident in periapical or fracture areas.

Antibacterial activity of 2% chlorhexidine gluconate and 5.25% sodium hypochlorite in infected root canal: in vivo study.

In this study, the antibacterial activity of the different antibacterial solutions using as root canal irrigant was compared in the teeth with pulpal necrosis and with periapical pathosis. Thirty root canals of incisors and premolars of 20 patients were used. Before and after the root canal preparation, two canal samples were obtained by a harvesting method using a sterile paper point in the first appointment. During the biomechanical preparation, both irrigant solutions were used for each tooth which were randomly divided into two groups. Last samples were also obtained before the root filling procedure. Samples obtained from the root canals were subjected to microbiologic processing, including anaerobic incubation on trypticase soy agar for 5 to 7 days. After counting of CFU on the plates, we concluded that both chlorhexidine gluconate and sodium hypochlorite were significantly effective to reduce the microorganisms in the teeth with necrotic pulp, periapical pathologies, or both, and could be used successfully as an irrigant solution.

Evaluation of caries risk factors and effects of a fluoride-releasing adhesive material in children with insulin-dependent diabetes mellitus (IDDM): initial first-year results.

The aims of this study were to evaluate the prevalence and risk factors of dental caries, and to determine whether there is any relationship between a fluoride-releasing adhesive material and the development of dental caries in the first year in children with insulin-dependent diabetics (IDDM). The average age of the subjects was 4-15 years, and they had been suffering from IDDM for at least 2 years. The DMF/df(t) indices of 70 patients were calculated and total HbA1 (%) (glucose levels of blood) values were recorded from the medical records after clinical examination. The mean DMF/df(t) values of poorly controlled subjects (HbA1 values over 13%) were significantly higher than those of moderately (HbA1, 10.0-12.9%) and well-controlled (HbA1 values, <10%) subjects. The levels of salivary mutans streptococci (MS) and lactobacilli (LB) and the pH of paraffin-stimulated whole saliva were measured in diabetic patients. Salivary MS and LB scores of the poorly controlled subjects were significantly higher (2.5+/-0.7 and 2.1+/-1.0) than those of the moderately (1.6+/-0.9 and 1.1+/-0.8) and well-controlled (1.2+/-1.0 and 0.8+/-0.8) subjects. The mean pH values among all subjects were not statistically significant. All dental caries were restored with a fluoride-releasing adhesive material. At the end of the first year, no new caries or lost restorations were observed in these patients. Moreover, the rate of MS in the poorly and moderately controlled subjects was considerably reduced. However, no significant statistical reduction of MS was determined in the well-controlled subjects. The level of lactobacilli in the poorly controlled, moderately controlled, and well-controlled subjects was reduced.

Evaluation of clinical and microbiological features of deep carious lesions in primary molars.

PURPOSE: Concern about the survival of microorganisms in deep carious lesions may often lead to unnecessary exposure of the pulp during excavation. This study evaluated the relationship between microbiological and clinical results of deep carious lesions in primary molars. METHODS: Clinical evaluation was performed on 72 deep carious lesions considered to have pulp perforation after traditional excavation. The dentin color and consistency were assessed by means of standardized scales using the technique of Bjorndal et al before restoration. For microbiological examination, dentin samples were taken by a sterile bur and transferred to transport fluid, then plated on tryptic soy agar for growth of total colony forming units. Samples werethen transferred on Rogosa SL agar for growth of oral lactobacilli and on mitis salivarius agar for growth of mutans streptococci. RESULTS: The proportion of mutans streptococci, lactobacilli, and total colony forming units increased when the dentin color and consistency increased. However, the proportion of lactobacilli was smaller than that of mutans streptococci in carious dentin samples. CONCLUSIONS: Contrary to expectations, the findings showed that the number of bacteria in carious dentin of primary molars was not significantly excessive.

Causes of dental fractures in the early permanent dentition: a retrospective study.

Two hundred eight patients, who applied to the Department of Pedodontics, Dental School, Dicle University between 1995 and 1998, were evaluated in terms of permanent teeth fracture. The aim of this retrospective study was to investigate the probable causes of the trauma, the effects of age and gender on dental trauma, prevalence of fracture types, and distribution of fracture type according to arch. It was observed that the falls or collisions were the main causes. It was also determined that the age group most frequently suffering fractures was ages 9 to 11 years. The majority of the patients were male. The enamel-dentin-pulp-type fracture and those causing the tooth to become nonvital were the most prevalent, and the majority of the fractures were observed in maxillary central teeth.