Child dental fear and past dental experience: comparison of parents' and children's ratings.

PURPOSE: To compare the parental and child versions of the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) and the parental and child evaluations of the Child's Past Dental Experience (CPDE) in 4- to 12-year-old children in a sample from Greece. METHODS: 537 families (652 children) with 4- to 12-year-old children seeking dental care either at a University paediatric dental clinic (UC) (50.8%) or a paediatric private practice (PP) participated. Parents completed a sociodemographic questionnaire and the parental Greek version of the CFSS-DS, and children independently completed the child's Greek version. All family members answered questions about CPDE. Statistical analyses were based on multilevel models (p < 0.05). RESULTS: Mothers' and fathers' mean CFSS-DS total scores were not significantly different from each other (p = 0.655), but were significantly higher than the scores of their sons and daughters (p < 0.001), regardless of the child's age. There was a negative association between mother's age and CFSS-DS agreement, but not for fathers. There was poor agreement for CPDE ratings between children and both parents, regardless of gender. Parents' ratings of CPDE were not related to their assessment of their children's dental fear, whilst the children's ratings of their CPDE were significantly related to their current dental fear. Location (UC or PP) had no significant influence on CFSS-DS or CPDE parental-child differences. CONCLUSIONS: Both parents overestimated their sons' and daughters' dental fear. There was poor agreement on CPDE evaluation between parents and children. Parental CFSS-DS and CPDE evaluations are poor indicators of children's dental fear and prior dental experience.

Dental fear and caries in 6-12 year old children in Greece. Determination of dental fear cut-off points.

AIM: To present: the normative data on dental fear and caries status; the dental fear cut-off points of young children in the city of Thessaloniki, Greece. METHODS: Study Design: This is a cross-sectional study with two independent study groups. A first representative sample consisted of 1484 children from 15 primary public schools of Thessaloniki. A second sample consisted of 195 randomly selected age-matched children, all patients of the Postgraduate Paediatric Dental Clinic of Aristotle University of Thessaloniki. First sample: In order to select data on dental fear and caries, dental examination took place in the classroom with disposable mirrors and a penlight. All the children completed the Dental Subscale of the Children's Fear Survey Schedule (CFSS-DS). Second sample: In order to define the cut-off points of the CFSS-DS, dental treatment of the 195 children was performed at the University Clinic. Children⁁s dental fear was assessed using the CFSS-DS and their behaviour during dental treatment was observed by one calibrated examiner using the Venham scale. STATISTICS: Statistical analysis of the data was performed with IBM SPSS Statistics 20 at a statistical significance level of <0.05. RESULTS: First sample: The mean CFSS-DS score was 27.1±10.8. Age was significantly (p<0.05) related to dental fear. Mean differences between boys and girls were not significant. Caries was not correlated with dental fear. Second sample: CFSS-DS< 33 was defined as 'no dental fear', scores 33-37 as 'borderline' and scores > 37 as 'dental fear'. In the first sample, 84.6% of the children did not suffer from dental fear (CFSS-DS<33). CONCLUSION: Dental fear was correlated to age and not to caries and gender. The dental fear cut-off point for the CFSS-DS was estimated at 37 for 6-12 year old children (33-37 borderlines).

Dental caries and oral health-related factors in a sample of Greek preschool children.

AIM: To assess the caries prevalence and some background factors in 3- to 5.5-year-old children in the municipality of Thessaloniki, Greece. METHODS: One calibrated examiner examined the children of all municipal day care centres for dmfs, existence of visible dental plaque and presence of black stain. Examination was made on site using disposable dental mirrors. Questionnaires were given to parents for assessing socio-economic status, oral hygiene habits (brushing frequency, toothpaste use) and sucking/feeding at sleep habits (nursing bottle, its content and pacifier use). RESULTS: Out of a total of 950 children, both clinical examination and questionnaire data were available for 804 children. The overall mean dmfs was 1.3 (SD = 3.8). The caries prevalence was 22.6 %, while the presence of black stain was evident in 2.4 % of the children. Intra-examiner agreement was estimated with Kendall's τ b = 0.99. A generalised linear model used to fit a Poisson regression for the analysis of count outcome data (dmfs) and logistic regression was used for binary outcome data (presence or absence of visible dental plaque). Statistically significant association was found between dmfs and the presence of visible dental plaque. The country of origin and education status of the parents were found to be significant factors for dmfs. The presence of black stain was negatively correlated with dmfs. CONCLUSIONS: The mean dmfs was lower than earlier Greek data. Country of origin, education status of the parents and visible dental plaque seemed to be important caries risk factors, while the presence of black stain was a strong caries resistance predictor.

Crown discoloration induced by endodontic sealers: spectrophotometric measurement of Commission International de I'Eclairage's L*, a*, b* chromatic parameters.

Despite the improvement of endodontic materials, crown discoloration induced by root canal sealers remains a concerning clinical issue. The aim of this study is the measurement of the alterations in CIE L*, a*, b* chromatic parameters of tooth crowns after placement of commonly used and new-generation endodontic sealers in pulp chambers. Eighty intact, fully developed third mandibular molars were randomly assigned in five groups. Crowns were cross-sectioned from the root complex 1 mm below the cement-enamel junction. The internal axial walls of the pulp chambers were debrided and coated with endodontic sealers (Roth-811, AH-26, Guttaflow, Epiphany SE). The apical access was sealed with glass-ionomer cement. The control group was only debrided. Crowns were stored in individually marked vials in standard conditions (100% humidity, 37°C). The spectral reflectance lines were recorded with a UV-Vis spectrophotometer in the visual spectrum. The CIE L*a*b* parameters were obtained by a linked computer software before sealer placement (baseline), after one week, one, three, and six months, respectively. Statistical analysis was performed with two-way mixed ANOVA models. The level of statistical significance was set at p<0.05. With the exception of the control group, experimental groups presented varying chromatic alterations. Among all experimental groups, Roth-811 sealer induced the most severe alterations in CIE L*, a*, b* chromatic parameters, during all observation periods. After root canal obturation, the clinician should be aware of the presence of remaining root canal filling materials. Thorough debridement of the pulp chamber is essential for the prevention of sealer-induced discoloration.

Association between oral malodour and periodontal disease-related parameters in the general population.

AIM: To determine the association between halitosis detection and periodontal status in systemically healthy non-smokers and to assess whether halitosis was related to quantities of Fusobacterium nucleatum and Porphyromonas gingivalis on the tongue dorsum. METHODS: Periodontal examinations, tongue coating determination, Halimeter® readings and organoleptic assessments of mouth odour were performed in 28 chronic periodontitis patients, 23 chronic gingivitis patients and 27 healthy individuals. The quantities of P. gingivalis and F. nucleatum were determined in tongue specimens by real-time PCR. RESULTS: Halitosis was more likely to be detected in patients with periodontitis (OR = 9.2) and gingivitis (OR = 4.6) than in healthy subjects. The posterior tongue odour was similar for all groups; had the highest score of all organoleptic assessments and was significantly correlated with Halimeter® scores and the odour of the whole mouth air. Periodontitis patients harboured significantly greater amounts of P. gingivalis on their tongue, yet similar quantities of F. nucleatum compared to gingivitis patients and healthy subjects. The amount of P. gingivalis residing on the tongue dorsum of periodontitis patients was significantly associated with halitosis recordings, while the amount of F. nucleatum was related to tongue coating in healthy controls, which corroborates its role in biofilm formation. CONCLUSIONS: Patients with periodontal disease were at higher risk for halitosis detection than healthy individuals. The posterior portion of the tongue dorsum seems to be an important source of odourous compounds, regardless of periodontal condition. P. gingivalis residing on the tongue of periodontitis patients may play a key role in oral malodour production.

Spectrophotometric analysis of coronal discolouration induced by grey and white MTA.

AIM: To evaluate the specific alterations in tooth colour with white and grey MTA when used to fill pulp chambers. METHODOLOGY: Forty-five fully developed, intact, mandibular third molars were sectioned 1 mm below their cemento-enamel junction (CEJ). Their pulp chambers were chemo-mechanically debrided, and the specimens were randomly assigned into three groups: Group 1-white MTA (Angelus(™)), Group 2-grey MTA (Angelus(™)) and Group 3-negative control (unfilled). During the experimental period, specimens were immersed in vials containing distilled water up to the CEJ (37±1 °C). Spectral reflectance lines were recorded by utilizing a UV-vis spectrophotometer equipped with an integration sphere in the visual spectrum, at baseline, 1 week and 1, 2 and 3 months after placement of the materials. Data were transformed into values of the CIE L*a*b* colour system, and the corresponding ΔΕ values were calculated. The results were analysed using two-way mixed anova models, whilst pairwise comparisons were conducted with Bonferroni's method at P < 0.05 level of significance. RESULTS: Both types of MTA induced significant decreases in L*, a* and b* values. The colour change was greater with grey MTA. Grey MTA led to clinically perceptible crown discolouration after 1 month, whilst the total colour change caused by white MTA exceeded the perceptible threshold for the human eye after 3 months. CONCLUSIONS: The application of both grey and white MTA formulations induced a decrease in lightness and reduction in redness and yellowness in teeth. The present findings suggest that application of grey MTA in the aesthetic zone should be avoided, whilst white MTA should be used with caution when filling pulp chambers with the materials.

Treatment of vibriosis in European sea bass larvae, Dicentrarchus labrax L., with oxolinic acid administered by bath or through medicated nauplii of Artemia franciscana (Kellogg): efficacy and residual kinetics.

European sea bass larvae were challenged by bath with Listonella anguillarum strain 332A, 2.5×10(7) CFUmL(-1) for 1h. Fish either received no treatment or oral treatment with Artemia franciscana (Kellog) nauplii enriched with oxolinic acid, or bath treatments with oxolinic acid. Medication commenced 1day following challenge and was performed on days 1, 3 and 5 post-challenge at a dosage of 20mgL(-1) for 2h for bath treatments, while two doses each of 750 nauplii per fish were administered daily for five consecutive days in oral treatments. Cumulative mortality reached 96% for the unmedicated challenged group, 32% in the group receiving bath treatments and 17% in the group receiving medicated nauplii. Pharmacokinetic parameters of oxolinic acid were calculated in sea bass larvae, for both treatments. Steady-state concentrations of oxolinic acid of 48.0 and 75.2µgg(-1) were achieved for bath treatment and oral treatment, respectively, while the elimination half-life was calculated to be 25.1h for bath treatment and 21.7h for oral treatment.

Isolation of mesenchymal stem cells using the total length of umbilical cord for transplantation purposes.

BACKGROUND: Umbilical cord (UC) mesenchymal cells have the ability to differentiate into various cell types, which make them an easily obtainable source for therapeutic uses. Different approaches have been used to isolate mesenchymal stem cells (MSC). AIM: Here, we report a detailed enzymatic method where large number of cells can be efficiently isolated from the cord matrix and cryopreserved on the same day of arrival at the laboratory. METHODS/MATERIALS: Cells were successfully isolated from 12 samples, with a new procedure that uses the total length of the UC. MSC have been isolated using a detailed enzymatic method with collagenase and hyaluronidase followed by trypsin, without removing the vessels and without mincing the cord. Stem cells were measured with flow cytometry before cryopreservation and post-thaw. Cultured cells were assessed for MSC marker expression and adherence plasticity for three passages. Multilineage differentiation was performed. RESULTS: Nucleated cell yield was calculated at 0·95 × 10(6) /cm. MSC yield was calculated at 0·65 × 10(6) /cm of cord with flow cytometry while the mean length was 31 cm. Cultured cells expressed the mesenchymal markers CD29, CD90, CD105 and CD44. Mesenchymal marker expression remained intact over the three passages and post-thaw. Osteogenic and adipogenic differentiation was evaluated. CONCLUSIONS: Our findings provide a fast and efficient method for mesenchymal cell isolation from Wharton's jelly using the total length of the UC. This method resulted in a large number of cells while the cells retained their mesenchymal character after thawing. This method can be easily applied, along with UC blood, for UC banking.

Short communication: Dmfs and BMI in preschool Greek children. An epidemiological study.

AIM: To investigate the relationship between dental caries (dmfs) and body mass index (BMI) categories in 3-5.5 year old children in Thessaloniki, Greece. METHODS: The study was conducted in 18 municipal day care centres and involved 361 children. The dmfs was determined on site by one calibrated examiner using disposable dental mirrors and a penlight. The height and weight of the children were measured on site by a nutritionist, who grouped them into four BMI categories, shown in the results. STATISTICS: The estimation of the relationship between the BMI and dmfs values was based on a generalized linear model (Poisson log-linear regression) while the sequential Bonferroni method was used for pair-wise comparisons between BMI categories. RESULTS: Mean dmfs values for each BMI category were: 1.02 (SD=2.41) for the underweight (n=44), 0.74 (SD=2.24) for the normal weight (n=281), 1.88 (SD=4.28) for the overweight (n=26) and 0.80 (SD=2.53) for the obese (n=10). Overweight children were found to show statistically significant differences in dmfs values compared with both children of normal weight (p<0.001) and those underweight (p=0.015). CONCLUSION: Overweight Greek pre-school children are at higher risk of dental caries.

Addition of adipose-derived stem cells in cord blood cultures stimulates their pluripotent differentiation.

INTRODUCTION: Adipose tissue is recognized as an important source of postnatal mesenchymal stem cells for generative medicine applications. Moreover, cord blood stem cells have been shown to contain pluripotent stem cells called unrestricted somatic stem cells (USSCs). However, this population is rare and cannot be generated from every cord blood sample. In this study, we have presented a new method of co-culture of adipose-derived stem cells (ADPCs) and cord blood stem cells that results in pluripotent differentiation. MATERIALS AND METHODS: ADPCs were obtained from a piece of adipose tissue after treatment with 0.075% collagenase, which was subsequently inactivated with DMEM/10% FBS. The cellular pellet of centrifugation was plated at 5-7 x 10(6) cells/mL in T25 culture flasks in a low-glycose DMEM with 30% FCS. Cord blood stem cells were obtained by centrifugation following double-processing in the presence of 2% HES 200/0.5 and plated at 5-7 x 10(6) cells/mL in the same medium. To investigate the crucial role of ADPCs in pluripotent cord blood differentiation, we added a ADPCS as (1 x 10(4) cells/mL) to the cord blood cultures and analyzed the contribution of ADPCs using a microscope as well as with flow cytometry. RESULTS: After only 3 days, adherent cells (USSC colonies) of fibroblastic morphology were detected in all co-cultured samples, whereas this was observed later or not at all in the non-co-cultured samples. The greater density of colonies in the co-coltured samples was another point. Hematopoietic CD45 cells were no longer detected after the first passage. Pluripotent stem cells were obtained from all co-cultured samples that contained stem cells positive for CD29, CD44, CD49e, CD90, CD105, CD51 Stro, and C-kit antibodies but negative for CD34, CD45, CD133, and glycophorin A. CONCLUSION: Addition of ADPCs was crucial to generate pluripotent-derived stem cells from cord blood samples. This double culture may be a useful tool for a universal allogeneic stem cell source for tissue repair or regeneration.

Cell recovery sufficient for adult transplantation by additional cord blood collection from placenta.

The amount of newborn blood that can be collected from a single cord donor is limited, but a significant amount remains in the placenta. We used a simplified perfusion method to collect this additional blood. Umbilical cord blood from 15 newborns was collected before placental delivery by umbilical vein puncture. After delivery, the placenta was placed on sterile gauze and 63 mL of citrate-phosphate-dextrose-adenine anticoagulant were injected into the umbilical vein that was then clamped near the placenta. The placenta was gently massaged, hung over a sterile vessel, and the umbilical cord cut sterilely near the embryonic surface. Additional blood was collected into the sterile vessel by pressuring a gauze bag around the placenta. We assessed the contribution of this second fraction to the total volume, total nucleated cell (NC), CD34+, hematopoietic progenitors cell, and colony forming unit count and bacterial contamination risk. The total collected volume was 127.3 mL (range 92-170) and the NC content was 1.6+/-0.73x10(9). The mean second fraction contribution from 15 units to the total nucleated and mononuclear cell content was 54+/-9.87% and 54+/-9.52%, respectively. The added percentage of CD34+ and hematopoietic progenitor cells was 54.3+/-10.35% and 46.7+/-11.5%, respectively, while the additional percentages of colony forming-granulocyte macrophage and colony forming-erythroid in the second fraction were 43.2+/-5.5% and 39.8+/-4.3%, respectively, indicating that the cells collected after placental perfusion (second fraction) had similar HPC content and in vitro hematopoietic potential. The method did not increase the risk of bacterial contamination.

A novel high-yield volume-reduction method for the cryopreservation of UC blood units.

BACKGROUND: For the application of umbilical cord blood (UCB) units as hematopoietic grafts, a dose of 3.7 x 10(7) nucleated cells (NC)/kg body weight is required. NC can be lost during volume-reduction processing and during thawing. A novel modification of the double-processing protocol with the aim of minimizing NC loss is described and evaluated. METHODS: One-hundred and fifty UCB were collected. The volume was reduced by a centrifugation step following double-processing in the presence of 2% HES 200/0.5. Pre- and post-processing cell counts and platelet parameters were measured with an automatic counter. The number of viable CD34+ hemopoietic stem cells was measured by flow cytometry. In 25 of the samples, colony-forming units (CFU) were also determined. The same samples were thawed 6 months after cryopreservation and re-evaluated. RESULTS: The volume was reduced to 6 +/- 1.5 mL. The recovery of NC, MNC, CD34+ hemopoietic stem cells, RBC depletion and CFU following double-processing was 93.6 +/- 3.2%, 95.8 +/- 2.2%, 98.4 +/- 1.5%, 96.8 +/- 1.1% and 107.1 +/- 6.1% (for 25 samples), respectively. The post-thaw recoveries of NC, MNC, CD34+ hemopoietic stem cells and CFU (for 25 samples) were 78.6 +/- 5.4%, 90.8 +/- 4.4%, 96.4 +/- 2.5%, 89.1 +/- 4.1%, respectively. No post-thaw cell aggregation was observed. A significant (P<0.05) post-thaw loss of platelets and signs of platelet activation was observed. DISCUSSION: The protocol uses non-expensive equipment and clinically approved materials and results in samples that can be used in patients with a mean weight of 32.7 kg.

Delayed interval delivery in twin pregnancy: a case report. We present a case of delayed interval delivery in twins.

We report a case of diamniotic, dichorionic pregnancy presented at 24 weeks with premature rupture of the first amnionic sac. Seven days later, premature labour and delivery of the first twin took place, with unfortunate outcome. The second twin was left in utero. The management included combination of tocolytics, antibiotics and cervical cerclage. Caesarean section was performed 48 days later, at 32 weeks and we delivered a live male infant, successfully.

Epithelial ovarian cancer. Risk factors, screening and the role of prophylactic oophorectomy.

Epithelial ovarian cancer is the seventh most frequent cancer in European women. Many theories have been postulated regarding the pathogenesis of ovarian cancer. Risk factors are not well defined, with the exception of low parity and oral contraceptive use. Approximately 10% of ovarian cancer are hereditary, with BRCA1 and BRCA2 explaining the majority (approximately 90%) of hereditary ovarian cancer cases. The lifetime risk varies between 15 and 66%, suggesting the existence of modifying genetic or environmental factors.Family history can be used to define women who are at increased risk of ovarian cancer. Individuals at high risk are those with a first degree relative (mother, father, sister, brother, daughter or son) affected by cancer. It must be noted that currently available tests do not attain the aforementioned high level of sensitivity. Evidence suggest that presymptomatic screening by grey scale ultrasound (with or without Doppler), CA125, pelvic examination, or combinations of these, are not effective in detecting tumors at an early stage. Women identified as being at high risk of ovarian cancer can be offered prophylactic oophorectomy. The decision whether or not to proceed to prophylactic oophorectomy is influenced by the fact that most women at increased risk of ovarian cancer are also at increased risk of breast cancer and there is evidence that oophorectomy reduces breast cancer in these cases.

Experience from the use of absorbable type I collagen as haemostatic agent in obstetric and gynecological operations.

UNLABELLED: During the third stage of labour there are a lot of causes of significant hemorrhage. The commonest causes of acute hemorrhage are the uterine atony, the retained placenta, the lower tract lacerations, uterine rupture, placenta accreta, hereditary coagulopathy. Also, there could be significant bleeding, during caesarian section, usually at the time of removal of the placenta in cases of low lying placenta or placenta previa. A lot of times we have to confront serious hemorrhages in gynecological procedures like hysterectomies in cases of cervical, uterine or ovarian cancers. In order to deal with these problems successfully, general and specific measures are being taken. In cases of atonic uterus when all the other methods are unsuccessful we have to proceed to ligation of the internal iliac artery or even hysterectomy. MATERIAL-METHODS: We have tried to use the hemostatic type I collagen in obstetrical and gynecological cases in order to control the bleeding. We have used the collagen type I totally in 8 cases. Five of them were cases of atonic uterus after normal delivery or caesarian section and three of them were gynecological cases of uterine fibroids and ovarian cancer. RESULTS: By placing the collagen type I over the bleeding surfaces we have realized that in a very short period of time, there has been satisfactory control of the bleeding and immediate clinical improvement of the patient. In four out of five obstetrical cases that we have used the type I collagen, we have managed to avoid the hysterectomy.

Chlamydia trachomatis in infertile Greek women. A serologic and laparoscopic study.

This study investigates the prevalence of antichlamydial antibodies in infertile women, who underwent diagnostic laparoscopy. The patients were divided into two groups based on the presence or absence of damage of the fallopian tubes. Antichlamydial IgG antibodies were found in 22 of 27 (81.5%) infertile women with damaged fallopian tubes and 10 of 23 (43.5%) women with normal tubes. Mean geometric IgG titres for C. trachomatis were significantly higher in the patients with damaged tubes (187.4 vs. 39.39). C. trachomatis was not isolated from the peritoneal fluids. Only two chlamydial cultures of cervical specimens were positive, one in each group. These findings confirm that C. trachomatis may be a major cause of tubal damage with resultant infertility.