One-year clinical evaluation of a Glass Carbomer fissure sealant, a preliminary study.

Glass Carbomer is a new generation of restorative material developed from glass-ionomer cements with possibility of gradual mineralization into fluorapatite. The aim of this clinical trial was to investigate the retention of Glass Carbomer fissure sealant after 12 months, in comparison to a commonly used conventional resin-based sealant. Forty-eight teeth in 24 patients [mean (SD) = 8 (2.3) years] with well-delineated fissure morphology were randomly divided into two equal groups and sealed with Bis-GMA resin-based Helioseal F (group A, Ivoclar Vivadent, Liechtenstein) and Glass Carbomer (group B, Glass Carbomer Sealant, Glass Carbomer Products, Leiden, Netherlands) using the split mouth design. Materials were placed and set according to the manufacturer's instructions using a polymerization unit Bluephase 16i (Vivadent, Liechtenstein). Complete sealant retentions in both groups were 100% and 75% after 6 and 12 months of clinical service, respectively. There were there were no secondary caries lesions in both groups after 6 months; two new carious lesions were detected in both groups after 12 months. The Mann-Whitney U test revealed no significant difference between the two groups at both evaluations points (P > 0.05). Glass Carbomer material showed a similar retention rate when compared with a resin-based sealant. Future studies are required to examine the long-term performance of Glass Carbomer sealants.

Influence of ultrasonic excitation and heat application on the microleakage of glass ionomer cements.

BACKGROUND: The aim of this study was to assess the influence of externally applied 'command set' methods on the microleakage of several glass ionomer cements (GICs). METHODS: Four different restorative GICs were cured using three different methods: standard curing (SC), ultrasonic excitation (UC) and by an external heat source (HC). Different conditioning agents (10% polyacrylic and 10% citric acid) were used. The sample comprised 180 teeth with 360 Class V restorations placed on the lingual and vestibular tooth surface. After thermocycling, the teeth were immersed in a dye solution for 24 hours, embedded in acrylic resin, sectioned and evaluated. Oberholtzer criteria were used for margin evaluation. Data were analysed using three-way ANOVA. RESULTS: The heat cured GIC showed statistically significant better marginal adaptation compared to the other tested groups (SC, UC) (p < 0.001). GICs in groups with HC and conditioned cavities had lower microleakage scores. The highly viscous material Fuji IX GP Fast in the HC and conditioned cavities group demonstrated the best marginal adaptation. The other three products reacted similarly to heating treatment. Leakage at the enamel margins was significantly lower than the cementum/dentine margins (p < 0.001). CONCLUSIONS: Heating the GIC during setting decreased microleakage, improved marginal adaptation of the GIC restoration and is suitable for clinical practice.

Prevalence and significance of minor anomalies in children with impaired development.

AIM: To compare the prevalence of Waldrop's minor physical anomalies in children with developmental disorders (mental retardation, hearing and visual impairment) and healthy schoolchildren. METHODS: The study was carried out on a sample of 469 children (223 children with developmental disorders and 246 healthy schoolchildren). RESULTS: Significant differences were found between the children with developmental disorders and the healthy children with regard to the number of minor anomalies and their weighted scores according to Waldrop. Multivariate discriminant analysis with two discriminative functions explained as much as 96.51% of the total variability and significantly distinguished the healthy children from the children with developmental disorders. However, no clear distinction was found between the mentally retarded children and those with visual impairment. Interrelation of the number and sum of the weighted scores of minor anomalies showed similar minor anomalies in the mentally retarded children (mean per person 3.65 and 3.82, respectively), the children with visual impairment (3.24 and 3.50), the children with hearing impairment (3.84 and 3.67) and the control group (1.70 and 1.46), although at different levels. CONCLUSIONS: The high prevalence of multiple minor anomalies in children with developmental disorders suggests that during early development, factors which cause the specific developmental disorder and the occurrence of a minor anomaly have a joint effect.

Surface quality of Cerec CAD/CAM ceramic veneers treated with four different polishing systems.

AIM: To achieve satisfactory aesthetic appearance of ceramic veneers food debris retention and plaque formation, resulting in possible irritation of surrounding tissues, should be avoided. It is, therefore, necessary to decrease the roughness of ceramic surfaces as much as possible. The aim of this study was to evaluate surface roughness of ceramic veneers after polishin15038787 g with four different techniques. METHODS: Twenty veneers were fabricated using Cerec 2 CAD/CAM method (Sirona AG, Bensheim, Germany) from Cerec VITA MARK II ceramic blocks (Vita Zahnfabrik, Bad Säckingen, Germany) and cemented onto prepared extracted teeth. Veneers were divided into 4 groups of 5 specimens and polished with 4 different techniques: 1. Sof-lex discs grit 150, 360, 600, 1200 (3M, St. Paul, MN, USA); 2. Hawe brushes (Hawe Neos Dental, Bioggio, Switzerland); 3. Hawe brushes and diamond paste Diabrill (Oralia Dental GmbH, Kostanz, Germany); 4. Politip-P rubber cups (Vivadent, Schaan, Liechtenstein). Surface profile was measured using Perthometer Perthen S8P 4.5 (Feinprüf Perthen GmbH, Goettingen, Germany) profilometer. STATISTICS: Data were analysed using ANOVA with Tukey HSD test. RESULTS: Sof-lex discs revealed significant statistical differences for Rz, Ra, Rk, Rpk values (p=0.0002) (Rz=2.92 mm; Ra=0.462 mm; Rk=1.098 mm; Rpk=0.472 mm). Values for Rvk were statistically significant only for rubber cups with diamond paste (p=0,002) (Rvk 4=3.04 mm). Rvk values for all other techniques were not statistically significant (Rvk 1=1.148 mm; Rvk 2=1.936 mm; Rvk 3=2.18 mm). CONCLUSION: The best surface smoothness was achieved with Sof-lex discs polishing system. All other methods are clinically acceptable. Selection of polishing technique should be made according to geometric construction of the polishing instrument and possibility of reaching various restoration areas with the polishing instrument.

Reliability and validity of measures used in assessing dental anxiety in 5- to 15-year-old Croatian children.

AIM: The aim of the study was to evaluate reliability and validity of different questionnaires and predict related causes, as concomitant factors in assessing different aspects of children's dental anxiety. STUDY DESIGN: Children were interviewed on dental anxiety, dispositional risk factors and satisfaction with the dentist after dental treatment had been accomplished. Parents were interviewed on dental anxiety as well. METHODS: The study population included 165 children (91 boys) aged 5 to 15 years, referred to a university dental clinic by general dental practitioners because of a history of fear and uncooperative behaviour during previous dental visits. Children were treated by two dentists, both experienced in treating fearful children. STATISTICS: Statistical analysis was performed in Statistics for Windows, Release 5.5 and Release 7.5. Pearson's correlation coefficients were calculated for validity and Cronbach alpha for reliability of the measures. Spearman Brown prophecy formula was used for correction of the alpha scores. Results The children's total average CFSS-DS score was 27.02, with no significant difference with respect to gender. The highest Cronbach alpha scores regarding reliability were obtained for the S-DAI, the CFSS-DS and the PDAS. Pearson's correlations regarding validity presented significant correlations between the CMFQ, the CDAS and the S-DAI, between the OAS, the CDAS and the S-DAI, as well as between the OAS and the DVSS-SV. CONCLUSION: Previous negative medical experience had significant influence on children's dental anxiety, supporting Rachman's conditioning theory. Anxious children were more likely to show behaviour problems (aggression) and more introvert in expressing their judgement regarding the dentist. Both the S-DAI and the CFSS-DS, which were standardized in the Croatian population sample, showed the highest reliability in assessment of children's dental anxiety.

The prevalence of minor physical anomalies in mentally retarded children.

The prevalence of minor physical anomalies was examined in a sample of 109 children with idiopathic mental retardation (65 boys and 44 girls). Control group consisted of 246 healthy schoolchildren (123 boys and 123 girls) aged 8 to 12 years. A comparison was made between number of found minor anomalies per child (W1) and their Waldrop weight scores (W2) in healthy and mentally retarded (MR) children. The MR children were found to have a higher number of minor anomalies per child. In their group predominated those with four or more anomalies (56.9%), whereas among healthy children only 7.7% had four anomalies or more. In contrast to the high weighted score value (W2) of five or greater in 36.7% of MR children, it was absent in all control group subjects. There were highly significant differences between the MR and healthy children in the average value of the number of minor anomalies per child (W1) and in the average weighted score (W2). The average number of minor anomalies per child (W1) in MR and well children was 3.65 and 1.7, respectively. In MR children the average weighted score (W2) was 3.82, being 1.46 in healthy children. Our results suggest that common etiological factors, which had led to a physical and mental disorder, were active early in the development of MR children. The finding of high incidence of multiple minor anomalies in MR children indicates that genetic factors may play an important role in the etiology of the underlying disorder in the child group studied.

Factors predicting a child's dental fear.

The aim of the present study was to determine and assess the variables most involved in the etiology of a child's dental fear. The study was performed on a sample of 89 children aged from 5.5 to 12.5 years and their mothers. The sample comprised 37 children with experience of dental trauma (19 boys and 18 girls) and 52 children without experience of dental trauma (28 boys and 24 girls). Corah Dental Anxiety Scale (DAS) was applied to evaluate the level of the child's (CDAS) and mother's (MDAS) dental anxiety. Broome's Child Medical Fear Questionnaire (CMFQ) was used to assess the child's fear of medical treatment. Hollingshead Two Factor Index of Social Position (ISP) was calculated to assess socio-economic status of the family. Cluster analysis differentiated one group of dentally anxious children with the highest level of maternal anxiety (MDAS = 14.44) and the lowest socio-economic status (ISP = 41.94). Another group of extremely anxious children (CDAS = 14.31) showed the highest fear of medical treatment (CMFQ = 22.08) and rather low socio-economic status. One group represented children with the lowest CDAS (5.63), lowest MDAS (8.46), and lowest CMFQ (13.54). Linear regression analysis showed high correlation between previous traumatic medical experiences and a child's dental anxiety using the linear model CDAS' = b0 + b1 x CMFQ. The analysis revealed that a child's dental fear mostly depends on early negative medical experience, while material dental anxiety and socio-economic circumstances seem to be of less importance.

Inheritance of hypodontia in twins.

The aim of this study was to establish prevalence of hypodontia in the twin sample and to assess the degree of its heritability. A study was performed in a sample of 96 twin pairs, 38 pairs being monozygotic (MZ) and 58 pairs dizygotic (DZ), from north-west Croatia. The sample included 25.82% of all twins born in the region during a ten-year period. The twin zygosity was determined according to the WHO recommendations (1996). A revised Holzinger's index (Hc') according to Allen was applied to calculate the degree of heritability. Hypodontia was found in 22 out of the total of 192 twins analyzed (11.5%). Among 96 pairs of twins, hypodontia was observed in 17 pairs (7 MZ and 10 DZ pairs). Among the MZ, 4 pairs were found to be concordant for hypodontia, among the DZ one pair only. The heritability index was 0825. A prevalence of hypodontia in twins observed in this study is significantly higher than in the general population. A high index of heritability (Hc' = 0.825) points to a high genetic determination.

[Double teeth in primary dentition and findings of permanent successors]. / Dvostruki zubi u mlijecnoj denticiji i stanje trajnih nasljednika.

Prevalence of double teeth in primary dentition of 0.5% was established in the sample of 2.987 preschool children of Zagreb. Between children with double teeth 60% were female and 40% males. Fusion ocurred in 66.7 percent and germination in 33.3 percent in the sample of children having double teeth. In all children with double teeth orthopantomograms were taken. Analysis of radiographs revealed anomalies of permanent successors in 53.3 percent of all children with double primary teeth. In children with germination in primary dentition anomalies of permanent teeth were present in 20 percent (hyperdontia in all cases), while fusion of deciduous teeth was accompanied by abnormal finding (hypodontia) in permanent dentition in 70 percent. Obtained results pointed out to the need of distinction between type of double teeth in primary dentition, i.e. between fusion and germination because chance of lacking the permanent successors is considerably dependent on the type of anomaly.

[Dentin hypersensitivity: etiology and methods of treatment]. / Dentinska preosjetljivost: etiologija i metode lijecenja.

This work presents review on etiology of dentinal hypersensitivity and mechanisms of dentin desensitization. The main theories on dentin sensitivity are discussed in details. Particularly are stressed hydrodynamic and transducer theories. Two main approaches to the dentin desensitization by tubule occlusion and blocking pulpal nerve activity by altering the sensory nerves excitability are presented. The aim of dentin desensitization is to apply various agents that occlude dentinal tubules and so decrease dentin sensitivity or to apply agents that reduce nerve excitability. Between many different agents in use the most wide use and best results in decreasing dentin sensitivity have topical application of oxalate salts and application of unfilled resins. Different toothpaste with strontium chloride or potassium nitrate as active ingredients have been commonly used as very effective desensitizing agents.

[Anomalies of deciduous teeth and findings in permanent dentition]. / Anomalije mlijecnih zuba i stanje trajne denticije.

Prevalence of anomalies of deciduous teeth has been analyzed in the general population of Zagreb preschool children. The sample comprised 2,987 children from 3 to 6 years of age (1,582 boys and 1,405 girls). Hypodontia was found in 0.47%, hyperdontia in 0.10%, and double teeth in 0.43% of total sample. Total prevalence of all anomalies in the sample was 1.0%. The sample for the analysis of permanent dentition has been enlarged with the clinical sample of children having the same anomalies and comprised 48 children. In all children with anomalies of primary teeth the orthopantomograms were taken and the status of permanent dentition was analyzed. In children with hypodontia in primary dentition hypodontia of permanent teeth was found in 100% of cases. Patients with hyperdontia of primary teeth displayed anomalies in permanent dentition in 85.7%, while in children with primary double teeth, anomalies of permanent teeth were present in 61.1% of cases. Missing deciduous teeth were found in both jaws in only 8.7% of cases, and in 34.8% in permanent dentition. Symmetrical occurrence of hypodontia of primary teeth (i.e. in both sides of jaws) was significantly higher in boys (56.3%) than in girls (28.6%). In permanent dentition symmetrical occurrence of hypodontia was significantly higher than in primary dentition (81.3% in boys and 57.1% in girls). The most frequently missing primary teeth were maxillary lateral incisors (48.8%) followed by mandibular central incisors (34.9%). Hyperdontia of primary teeth has been found only in boys, and it related only to the maxillary lateral incisors. Anomalies of deciduous teeth show a high degree of association with the finding in the permanent dentition.(ABSTRACT TRUNCATED AT 250 WORDS)

Hereditary gingival fibromatosis: report on three families and dermatoglyphic analysis.

Some syndromes that include gingival fibromatosis are associated with abnormalities of the hands and feet. The purpose of this work was to establish whether gingival fibromatosis, as an isolated disease, can be connected with disturbances in the development of the digitopalmar structures. In three families with 40 members, fibromatosis manifested in 16 (7 males and 9 females). The disease was transmitted as an autosomal dominant trait. Dermatoglyphics were analyzed in the proband in each family and in their fathers who had fibromatosis. The analysis showed the presence of patterns in IV interdigital areas in all patients. The fathers of 2 probands had double loops in the IV interdigital area, which is very rare in the general population (frequency, 0.6%). The position of the axial triradius was moderately distal (t') in 1, and markedly distal (t") in another, and in 4 it was borderline (tb). Total finger ridge count was increased, which indicated the increased size of the volar embryonal pads. Distorted dermatoglyphic findings may be considered microform abnormalities of the fingers and hands. Since dermatoglyphics are highly genetically controlled and reflect the status of the embryonal pads, the results suggest disharmony in the development of the mesodermal structures of the hands.

[Variations in expressivity and penetrance of hypodontia]. / Varijacije u ekspresivnosti i penetrantnosti hipodoncije.

The intensity of expressivity and penetrance of anomalies through generations can be established by means of genealogical analysis. In the present study thirty five family pedigrees, including three generation family members, have been analysed. Variable expressivity of hypodontia has been established in 48.57% families. Pedigrees of 21 families showed the autosomal dominant mode of inheritance. Three families expressed hypodontia only in one (third) generation. In 12 families hypodontia has been established only in the proband what was compatible with the polygenic inheritance. In 12 (34.28%) families hypodontia showed penetrance through two generations, and in 9 (25.71%) families penetrance has been observed through three generations.

[The inheritance of hypodontia in families--the segregational analysis]. / Nasljedivanje hipodoncije u obiteljima--segregacijska analiza.

The aim of this study was to establish the mode of inheritance of hypodontia based on family data, and by means of segregational analysis to test whether this anomaly follows the expected ratio of segregation for the expected mode of inheritance. The research has been performed by analysing pedigrees of 35 families with hypodontia. Genealogical analyses suggest that hypodontia follows an autosomal dominant (AD) mode of inheritance in 21 families. The sample has been obtained by single incomplete ascertainment. The following methods have been applied for segregational analysis: Weinberger's proband method, Davie's method, Fisher's method, Robert's method, and finally Penrose's of a "relative frequency" method. Weinberger's method showed the value of 0.27 (27%) of the segregation of genes for hypodontia of the chosen sample and in case of Davie's method 0.28 (28.57%). Fisher's "sib" method gave the same results as Davie's method (28.57%). Roberts's formula showed that the value of X2 was 1.76, what means that there is no significant deviation from the expected 1:1 ratio. The results obtained are in favor of the autosomal dominant mode of inheritance. Penrose's method of a "relative frequency", suitable for differencing monogenic from polygenic inheritance, also showed autosomal dominant mode of inheritance of hypodontia in the analyzed sample.