Root-crown ratios of permanent teeth in healthy and young Hungarian, German, and Japanese populations / A maradó fogak gyökér-korona aránya egészséges, fiatal magyar, német és japán populációkban.

Összefoglaló. Bevezetés: A maradó fogak gyökér-korona arányának meghatározása nagy jelentoséggel bír a fogászati kezelési terv kialakításában és késobbi módosításában. Célkituzés: Egészséges magyar, német és japán fiatalok maradó fogai gyökér-korona arányának meghatározása és összehasonlítása. Módszer: Hölttä módszerét alkalmaztuk. A mérés 95 magyar, 104 japán és 110 német fiatal páciens 2001 és 2006 között készült panorámaröntgen-felvételén történt. Eredmények: A gyökér-korona arány különbsége a nemek között nem szignifikáns, az egymásnak megfelelo antagonista fogak között sok esetben, de nem mindig, szignifikáns. A legnagyobb gyökér-korona arányt mindhárom populációban az alsó szemfogakon és az alsó második praemolaris fogakon mértük; a felso molarisok esetén a legkisebb az arány. A három nemzetet összehasonlítva szignifikáns különbséget (p≤0,001) nem találtunk egyetlen fogtípus esetében sem. A japán és a német populáció között minden fogtípus esetén szignifikáns volt a különbség a gyökér-korona arányokban. A japán és a magyar populáció összehasonlításakor a fogtípusok felénél találtunk szignifikáns különbséget. A magyar és a német populációt összehasonlítva nagyon kevés fogtípusnál találtunk szignifikáns különbséget. Megbeszélés: Az alsó állcsont fogainak gyökér-korona arányértékei nagyobb mértékben térnek el a populációk között, mint a felso állcsont fogainak esetében. A gyökér-korona arány átlagértéke a német populációban a legnagyobb. A második legnagyobb arányértékkel a magyar populáció rendelkezik, utána pedig a japán, néhány fogtípus kivételével: felso kismetszok, felso szemfogak és felso elso molarisok. Következtetés: A legnagyobb gyökér-korona arány különbséget a német és a japán populáció között, a legkisebbet a magyar és a német populáció között találtuk. Cikkünk megmutatja az egyes fogtípusok gyökér-korona arányának normálértékét fiatal, egészséges magyar, német és japán populációban. Orv Hetil. 2021; 162(46): 1848-1855. INTRODUCTION: Defining the root-crown ratio of the permanent teeth is important in making or changing proper treatment plans in dentistry. OBJECTIVE: To define and compare the root-crown ratios of the permanent teeth of healthy, young Hungarian, German, and Japanese populations. METHOD: We adapted Hölttä's method. 95 Hungarian, 104 Japanese and 110 German young patients' panoramic X-rays (made between 2001 and 2006) were involved in the investigation. RESULTS: Difference between the genders was found non-significant; between the corresponding antagonists many times, but not all significant. The highest root-crown ratios were found in all investigated populations by the lower canines and premolars, the lowest by the upper molars. P≤0,001 was not found among the three populations. Significant differences were found between Japanese and German populations by all tooth-types; between Japanese and Hungarian populations by near half of the tooth-types; between Hungarian and German populations by only a few tooth-types. DISCUSSION: More significant differences were found in root-crown ratios in the lower jaw among the populations. The mean value of the root-crown ratios was the highest in the German population; medium in the Hungarian population; and the least in the Japanese population, with a few exceptions: upper lateral incisors, canines and first molars. CONCLUSION: The biggest differences were found between the German and Japanese populations; the least between the Hungarian and the German populations. Our paper describes the control values of the root-crown ratios of the tooth types in young, healthy Hungarian, German, and Japanese populations. Orv Hetil. 2021; 162(46): 1848-1855.

Complex analysis of multiple single nucleotide polymorphisms as putative risk factors of tooth agenesis in the Hungarian population.

OBJECTIVES: The role was studied of multiple single nucleotide polymorphisms in tooth agenesis in the Hungarian population using a complex approach. METHODS: Eight SNPs, PAX9 -912 C/T, PAX9 -1031 A/G, MSX1 3755 A/G, FGFR1 T/C rs881301, IRF6 T/C rs764093, AXIN2-8150 A/G, AXIN2-8434 A/G and AXIN2-30224 C/T, were studied in 192 hypodontia and 17 oligodontia cases and in 260 healthy volunteers. Case-control analysis was performed to test both allelic and genotypic associations as well as associations at the level of haplotypes. Multivariate exploratory Bayesian network-based multi-level analysis of relevance (BN-BMLA) as well as logistic regression analysis were performed. RESULTS: Conventional statistics showed that PAX9 SNP -912 C/T and the MSX1 SNP changed the incidence of hypodontia, although after Bonferroni correction for multiple hypothesis testing, the effects were only borderline tendencies. Using a statistical analysis better suited for handling multiple hypotheses, the BN-BMLA, PAX9 SNPs clearly showed a synergistic effect. This was confirmed by other multivariate analyses and it remained significant after corrections for multiple hypothesis testing (p < 0.0025). The PAX9-1031-A-PAX9-912-T haplotype was the most relevant combination causing hypodontia. Interaction was weaker between PAX9 and MSX1, while other SNPs had no joint effect on hypodontia. CONCLUSION: This complex analysis shows the important role of PAX9 and MSX1 SNPs and of their interactions in tooth agenesis, while IRF6, FGFR1 and AXIN2 SNPs had no detectable role in the Hungarian population. These results also reveal that risk factors in hypodontia need to be identified in various populations, since there is considerable variability among them.

Novel possible pharmaceutical research tools: stem cells, gene delivery and their combination.

Both stem cell research and gene delivery are very promising fields of today's biomedical research. In the present review we first attempt to summarize the state of the art in stem cell research. We describe the major categories of stem cells based on cell sources: embryonic, fetal, postnatal and induced pluripotent stem cells. We then present new data on stem cell cultures of dental pulp origin as examples of the progress of postnatal stem cell research. Afterwards, we briefly summarize the most promising achievements in the field of gene delivery. As an example of such advances, we describe novel in vitro and in vivo gene delivery studies to demonstrate that salivary glands are highly potential targets for gene therapy: they can be used to produce therapeutic peptides delivered either into the oral cavity or into the systemic circulation. Finally, we describe and compare studies combining the use of stem cells and gene delivery. We conclude that stem cell therapy and gene delivery alone are both very exciting research areas, and they may act in synergy when used in combination.

[Changing approaches to traumatic injuries to primary and permanent teeth based on the reports published in 'Fogorvosi Szemle' in the past 100 years]. / A tej- és maradó fogak baleseti sérüléseivel kapcsolatos szemléltváltozás jellemzôi a Fogorvosi Szemlében 100 év alatt megjelent közlemények alapján.

Most of the external forces hitting the body (automobile injuries, sport injuries, job accidents, falls, hits and fights) reach the head, and especially the oral and maxillofacial region. Statistics show the head is injured in more than 70 per cent of car accidents. The incidence of head injuries, specifically tooth injuries, is high among both infancy and school children. Authors give a review about the changing approaches of treatment principles in the reports published in the Hungarian dental journal 'Fogorvosi Szemle' in the past 100 years, and how today's modern treatment trends have evolved.

Safety and immunogenicity of a prepandemic influenza A (H5N1) vaccine in children.

BACKGROUND: The avian influenza A (H5N1) virus is considered to be a potential cause of the next influenza pandemic. Children may be particularly vulnerable to the pandemic virus, and they may react differently than adults to vaccines. We report the results of the first clinical trial of an H5N1 vaccine in children. METHODS: Twelve healthy children (mean age +/- SD: 12.73 +/- 2.77 years) received a single dose of 6 microg of the inactivated whole virus vaccine Fluval. Twenty-one days after vaccination, immunogenicity was assessed by hemagglutination inhibition and microneutralization assays. Safety information was collected for 180 days. RESULTS: No side-effects were observed, and the vaccine fulfilled all applicable U.S. and European immunogenicity criteria for licensure. The post/prevaccination geometric mean titer ratio was 16.95, the rate of seroconversion was 75% and the rate of seroprotection was also 75% 21 days after vaccination. CONCLUSIONS: We confirmed our earlier findings of the present vaccine in adults showing encouraging safety and immunogenicity properties in children. Studies with the present vaccine in elderly subjects are underway.

[Changing methods of pain- and fear-relief in dental treatments based on reports published in 'Fogorvosi Szemle']. / A fájdalom- és félelemmentes fogászati kezelés módszereinek alakulása a Fogorvosi Szemlében megjelent dolgozatok tükrében.

In the dental practice--for more than a 100 years--it has been a vital topic how to prevent, eliminate, or at least relieve pain and fear associated with dental treatments. 'Fogorvosi Szemle,' the scientific journal of the Hungarian Dental Association is now a 100 years old. Authors present how the approaches and methods of relieving pain and fear have changed in the past century, based on the reports published in this journal. The reports are grouped in three main topics: local anaesthetics and sedatives; ambulatory narcosis and sedative analgesia; hypnosis and hypnotherapy. Based on the publications of the last one hundred years, it can be concluded that the Hungarian dental practice has followed the trends and principles of the well-known international dental schools.

Comparison of Streptococcus mutans strains from children with caries-active, caries-free and gingivitis clinical diagnosis by pulsed-field gel electrophoresis.

A study was conducted to compare the DNA structure of Streptococcus mutans strains in children with caries-active, caries-free, and gingivitis clinical diagnosis. Twenty-eight Streptococcus mutans strains from 100 children's plaques were examined by pulsed-field gel electrophoresis (PFGE) method. The classified strains were closely related to one another, though the strains originated from different disease groups. Three identical pairs were found, but the pairs in two cases belonged to different disease groups. The results of the PFGE experiments suggest that there is no correlation between the different DNA patterns ofS. mutans strains and their cariogenecity. So the different DNA strains ofS. mutans are not the only determining factor in the development of dental caries.

Gene polymorphisms in periodontitis and hypodontia: methodological basis of investigations.

An increasing number of evidence supports the assumption that genetic factors have crucial role in the development of periodontitis and hypodontia. The strategic purpose of the authors is to identify the genetic background of these disorders and to map the gene polymorphisms involved in their development. As a first step of an experimental series, we aimed to set and optimize multiple individual gene polymorphism identification methods by the combination of polymerase chain reaction and restriction fragment length polymorphism analysis methods. We have successfully optimized eight single nucleotide polymorphism procedures that are potentially involved in periodontitis (IL-1 alpha -889, IL-1 beta -511, IL-1 beta +3954, IL-6 -174, IL-10 -1082, TLR-4 -299, TLR-4 -399, TNF-alpha -308), and another two that might be related to the appearance of hypodontia (PAX9 -1032, PAX9 -912). Besides the dominant allele, we also observed the presence of the rare allele in each polymorphism although at present we have a small sample number. These preliminary studies provide evidence for the feasibility of further investigations with large sample numbers comparing control and patient groups. These studies may lead to the development of new diagnostic strategies and provide novel tools for the early recognition of genetic predisposition and the primary control of the diseases. Furthermore, they project future therapeutic avenues for gene therapy in the cure and prevention of oral disorders.

[Mixed odontogenic tumors in children and adolescents]. / Fogelotörési zavarokkal járó vegyes odontogén daganatok.

Mixed odontogenic tumors in the jaws of children and adolescents usually cause dentition anomalies. The typical forms of these are ameloblastic fibroma, ameloblastic fibroodontoma, complex odontoma and compound odontoma. In the present study mixed odontogenic tumor cases are presented in patients under 20 years of age. All of them were associated with tooth eruption disturbances. Further aim of this study was to discuss the nature and interrelationships of this group of lesions. Ameloblastic fibromas (AFs) are true, mixed, soft tissue neoplasms, deriving from the proliferation of both odontogenic epithelium and mesenchyma. They have a potential to both recurrence and malignant transformation. Ameloblastic fibroodontomas (AFOs) may be regarded as hamartomas, which exhibit epithelial, mesenchymal and abundant hard tissue components of the developing teeth. Odontomas are calcifying benign hamartomas, and represent the most common type of odontogenic jaw tumors among patients less than 20y, having complex and compound variants. Complex odontomas (CXOs) are built up from amorphous hard tissue elements, and generally occur in the premolar or molar regions of the maxilla. Compound odontomas (CDOs) usually appear in the maxilla, in the region of the incisors and canines, and contain small, radio-opaque structures reminiscent of rudimentary teeth. Early diagnosis and treatment of mixed odontogenic jaw tumors in children may prevent the serious orthodontic complications and jaw deformations.

[Orthodontic and oral surgery therapy in cleidocranial dysplasia]. / Orthodontiai és szájsebészeti terápia cleidocranialis dysplasia esetében.

A cleidocranial dysplasia is an autosomal dominant inherited condition consisting of generalized skeletal disorder. Associated dental signs are present in 93,5%; failure of tooth eruption with multiple supernumerary teeth, dilaceration of roots, crown germination, microdontia, high arched palate, midface hypoplasia, high gonion angle. The molecular- genetic analysis revealed a missense mutation in the CBFA1 gene located on chromosome 6p21, which is considered to be etiological factor for CCD. Orthodontic and oral surgery therapy of a 13 year-old child with CCD was performed due to aesthetic and functional problems. The supernumerary germs were removed and the teeth were aligned with orthodontic appliances. Temporary functional rehabilitation was solved with partial denture. The presented case and the literature data support the importance of early diagnosis of CCD. The good collaboration of the orthodontic and maxillo-facial surgery specialists help achieve the correct rehabilitation of the patient.

Skull base chordoma mimicking a preauricular neoplasm in a child: clinicopathological features and biological behaviour.

INTRODUCTION: The extreme rarity of chordomas in childhood, the slow growing nature of these tumours and the diverse symptoms may cause many diagnostic problems. PATIENT: A 9-year-old girl presented with an unusual manifestation of a skull base chordoma. The clinical and pathological features were analysed. RESULT: In the present case, the initial symptoms of the skull base tumour were completely misleading. The otodynia, the masticatory difficulties and the mass in the preauricular region were not characteristic of skull base chordomas. The female sex, the young age, the large tumour size and the atypical histological pattern of the tumour all indicated a very poor prognosis. CONCLUSION: The rarity of this tumour in childhood and the atypical lateral and intracranial spread resulted in a serious delay of the diagnosis and in a fatal outcome.

Echocardiographic findings in patients with Williams-Beuren syndrome.

BACKGROUND: Williams-Beuren syndrome is a multisystem developmental disorder caused by a microdeletion at chromosome 7q11.23. In its classic form it includes dysmorphic facial features, joint contractures, retardation of growth and mental development, gregarious personality, visuospatial cognitive deficits, hypercalcemia, primary or secondary hypertension and cardiovascular disorders. AIM: Clinical diagnosis of Williams-Beuren syndrome can be a challenge in young patients if none of the characteristic cardiovascular features, i.e. supravalvular aortic stenosis or pulmonary artery stenosis, are present. Our aim was to demonstrate the changes in cardiovascular lesions during the postnatal development of Williams-Beuren patients and to follow all cardiovascular findings beyond the most common ones. METHODS: The cardiovascular status of 29 patients with Williams-Beuren syndrome (mean age 12.8 years) was recorded in correlation with age. RESULTS: Cardiovascular diagnoses changed in the majority (72.4%) of patients. Interestingly, 44.8% of the patients had periods with no reported cardiovascular disease. Furthermore, 65.5% of the patients experienced periods when none of the typical cardiovascular lesions, i.e. diffuse or localized supravalvular aortic stenosis and/or pulmonary artery stenosis, were detected. Spontaneous regression and progression of both supravalvular aortic stenosis and pulmonary artery stenosis were observed. An unexpectedly high frequency (41%) of mitral valve disorders was found. CONCLUSIONS: Our study showed that temporary absence of and changes in cardiovascular findings are frequent in Williams-Beuren syndrome. These results could contribute to the refinement of diagnostic criteria and recommendations for cardiovascular follow-up of patients with this syndrome.

Prevalence of hypodontia and hyperdontia in paedodontic and orthodontic patients in Budapest.

Various publications have reported the prevalence of accessory teeth to be between 1 and 3%. In contrast, hypodontia has a much higher prevalence. In the current work, the authors studied OP radiographs on 2,219 patients aged 6 to 18 years who presented at the Department of Paedodontics and Orthodontics at Semmelweis University in Budapest (patients with systemic disease were excluded). The examined radiographs revealed a prevalence of accessory teeth of 1.53%. The sequence of prevalence was as follows: mesiodens > second incisor > first incisor. 77.5% of the accessory teeth were located in the upper jaw, with 97.5% of those being present in the incisor region. Hypodontia was detected in 326 patients (14.69%); missing wisdom germs were not considered. The sequence of prevalence of missing germ was as follows: upper second incisor > lower second premolar > upper second premolar > lower first incisor. Hypodontia in the molar region was observed in 15 cases (0.68%). The prevalence of oligodontia was 1.04%.

Tuberculate and odontoma type supernumerary teeth.

An 8-and-a-half-year-old girl with supernumerary teeth of tuberculate and odontoma type is described. Treatment of the patient is carried out on conventional lines with a combination of surgical and orthodontic methods. The upper tuberculate type supernumerary teeth were extracted and, after surgical exposure, the upper permanent first incisors were aligned with removable appliances. After secondary dentition was completed, the lower odontoma type supernumerary tooth was removed surgically, and also the maxillary and mandibular first premolars were extracted because of severe crowding, and fixed orthodontic appliances were used to align the permanent dentition. Early diagnosis and treatment of this anomaly is necessary to avoid more serious consequences and to prevent severe orthodontic disturbances.

Cleidocranial dysplasia: diagnostic criteria and combined treatment.

Cleidocranial dysplasia (CCD) is an uncommon, generalized skeletal disorder characterized by delayed ossification of the skull, aplastic or hypoplastic clavicles, and serious, complex dental abnormalities. There are many difficulties in the early diagnosis of CCD because a majority of the craniofacial abnormalities becomes obvious only during adolescence. In the present case, a hypoplastic midface, a relative prognathia of the mandible, and close approximation of the shoulders in the anterior plane were the conspicuous extraoral findings. Prolonged exfoliation of the primary dentition, unerupted supernumerary teeth, and the irregularly and partially erupted secondary dentition produced occlusional anomalies. The presence of the second permanent molars together with the primary dentition and wide spacing in the lower incisor area were typical dental signs. Gradual extraction of the supernumerary teeth and over-retained primary teeth was the first step of oral surgery. This was followed by a surgical exposure of the unerupted teeth by thinning of the cortical bone. Orthodontic treatment was aimed at parallel growth of the jaws. Removable appliances were used to expand the narrow maxillary and mandibular arches, and a Delaire mask compensated for the lack of sagittal growth of the upper jaw. Temporary functional rehabilitation was solved by partial denture. When the jaws have been fully developed, implant insertions and bridges are the therapeutic measures. The reported case and the literature data support the importance of the early diagnosis and interdisciplinary treatment of CCD.

Endotoxin can decrease isolated rat parotid acinar cell amylase secretion in a nitric oxide-independent manner.

Salivary mucus and amylase have an anti-bacterial nature. Bacterial endotoxin is considered to decrease mucus secreting cell activity by nitric oxide-dependent mechanisms. In this study, the actions of endotoxin on amylase secreting cell activity have been studied. Endotoxin (Escherichia coli lipopolysaccharide; 3 mg/kg, i.v., 5 h) evoked nitric oxide synthase 2 (NOS2) induction in the rat whole parotid tissue (assessed by Western blot and the citrulline assay) and in rat isolated parotid acinar cells (assessed by Western blot and immunohistochemistry), and reduced basal and acetylcholine-stimulated amylase secretion from these isolated cells. However, N(G)-nitro-L-arginine methyl ester (0.1 mg/ml, 4 days in drinking water, yielding a dose of 25 mg/kg/day) did not affect amylase release under basal or acetylcholine-stimulated conditions, either in control acinar cells or those from endotoxin challenged rats. Thus, basal, acetylcholine-evoked or endotoxin-decreased cellular amylase secretion from rat isolated parotid acinar cells does not appear to be modulated by endogenous nitric oxide.

The role of dental evaluation and cephalometric analysis in the diagnosis of Williams-Beuren syndrome.

Williams-Beuren syndrome (WS) is a genetic condition with an incidence of 1 in 20,000-50,000 live births. The syndrome consists of supravalvular aortic stenosis, characteristic dysmorphic facial features named "elf face" and intellectual disability. Early diagnosis of the syndrome is important since many of its features require treatment, and the prognosis can be dramatically improved by early recognition and management. This developmental disorder is well known to be clinically heterogeneous, making diagnosis difficult if based on the clinical picture. However, genetic testing is expensive and it is not cost effective to screen all patients based on clinical suspicion. Our goal was to develop a novel clinical screening method that would be sensitive, specific, inexpensive and readily available. We performed cephalometric analysis and dental evaluation of 33 patients with genetically proven WS. Cephalometric analysis of soft tissues showed that with normal SNA, SNB and ANB angles, the lips were in front of the line of harmony. This finding was present in all WS patients (n = 33) but in none of the age-matched controls (n = 100). No other differences were found between WS and control patients. This cephalometric finding is specific and sensitive for WS and can be used in the diagnostic procedure, whereas none of the conventional dental evaluations are useful.

Early prosthetic treatment of patients with ectodermal dysplasia: a clinical report.

Hypohidrotic ectodermal dysplasia is a hereditary disorder of ectodermal origin. The early orthodontic treatment of 2 young boys suffering from hypohidrotic ectodermal dysplasia with partial maxillary and complete mandibular anodontia of the primary dentition is described. Both were treated with removable maxillary partial and mandibular complete dentures with individualized occlusion and age-appropriate artificial teeth. The results were significant improvements in speech, masticatory function, and facial esthetics, contributing to the development of normal dietary habits, and the improved and more rapid social integration of these children.

[Literature survey of apexification in connection with three cases]. / Az apexifikáció irodalmi áttekintése három eset kapcsán.

Endodontic treatment of three non-vital immature teeth is discussed. According Moorrees et al. root formation was in the stage two, six and four respectively. After access to the root canal, removing necrotic pulp and effective chemo-mechanical cleansing, Ca(OH)2 paste was used as a temporary filling material in each case. In two cases after closing the apical opening, permanent obturation was performed with half heated gutta-percha and lateral condensation to obtain a good seal. In one case permanent filling of the canal occurred with gutta-percha and AH26 as a sealer. In the first case two years, in the second case five years after obturation of the root canal with gutta-percha, periapical healing was evident in the control radiograph. In the third case using gutta-percha with AH26 as a sealer after two years new periapical lesion has developed. On the bases of literature data and our experiences in the case of non-vital immature teeth. Ca(OH)2 paste is the best temporary filling material to induce apexification process, and the half heated gutta-percha obturation is the most suitable permanent root filling material.

[Retention of Ultra Seal XT third generation fissure sealant in systematic pedodontic care]. / A szervezett gyermekfogászati ellátás keretein belül alkalmazott Ultra Seal XT harmadik generációs barázdazáró anyag retenciójának vizsgálata.

The aim of the present study was to clinically evaluate Ultra Seal XT third generation light cured fissure sealant on the occlusal pits and fissures of permanent first and second molars for a period of two years. The examined population consisted of 112 Hungarian school-children, aged 8 to 14 years who presented for treatment at the Department of Dentistry for Children and Orthodontics in Budapest. The 1120 participants had a total of 247 permanent molars sealed. All teeth were monitorized and controlled after 6 months, 1 year and 2 years. Retentivity of fissure sealants were after 6 months 92.7%, one year 87.8%, two years 79.9%. These results are in accordance with data of literature. This longitudinal study showed that modern pit and fissure sealants can be applied during childhood in systematic pedodontic care. It has high retentivity and a directly proportional optimal caries-preventive effect.