Alterations of panoramic radiomorphometric indices in children and adolescents with beta-thalassemia major: A fractal analysis study.

BACKGROUND: Beta-thalassemia major is an inherited disorder that can cause bone deformity and loss of bone mineral density. The objective of this study is to evaluate the cortical and trabecular mandibular bone morphology of children and adolescents who have beta-thalassemia major (ß-TM) using a fractal dimension (FD) analysis and different panoramic radiomorphometric indices with digital panoramic radiographic images (DPRIs). MATERIAL AND METHODS: The study included 80 patients (with 40 patients each of ß-TM and control). The mandibular cortical width (MCW), panoramic mandibular index (PMI), mandibular cortical index (MCI), and simple visual estimation (SVE) were evaluated, and an FD analysis of five regions of interest (ROIs) (ROI 1: in basal cortical bone; ROI 2: in premolar region; ROI 3: in molar region; ROI 4: in angulus mandible and ROI 5: in condyle region) was obtained in all DPRIs. Quantitative variables were analyzed using the student's t-test , Kruskal-Wallis and Mann-Whitney U tests. RESULTS: When the ß-TM groups were compared with controls, there were no statistically significant differences found in the mean FD values, the ROIs of the trabecular bone, or the SVE. There was a significant correlation in the mean MCW, PMI, ROI of cortical bone (ROI 1), and MCI between ß-TM and control groups (p < 0.001, p < 0.001, p = 0.047, and p = 0.046, respectively). The mean MCW values correlated with the SVE in both the ß-TM and control groups (p = 0.031 and p < 0.001, respectively). While the mean MCW values correlated with the MCI (p = 0.04) in the control group, the mean MCW values were not correlated with the MCI (p = 0.493) in ß-TM group. CONCLUSIONS: The current study revealed lower MCW and PMI values in the ß-TM group. While the mean FD values of trabecular bone is similar to the control groups, the mean FD value is lower in cortical bone in the ß-TM group. MCW, PMI, FD of cortical bone and MCI may be key indicators in individuals with beta-thalassemia major.

Effects of blood contamination and hemostatic agents on bond strength in primary teeth dentin.

BACKGROUND: Contamination is a common problem in pediatric restorative dentistry and there are a few studies that investigate blood contamination, hemostatic agents, and tooth dentin. AIM: The purpose of this study was to evaluate the effects of blood contamination and hemostatic agents on the bond strength of two different bonding systems with the dentin of primary teeth. MATERIALS AND METHODS: Buccal and lingual dentin surfaces of 40 primary second molar teeth were used for this study. Specimens were divided into 4 groups according to the contamination and hemostatic agents (Blood-B, Ankaferd Blood Stopper-A, ViscoStat-V, Control-C) and then every group was further divided into two subgroups according to the bonding systems (Clearfil SE Bond-I, All Bond Universal-II, n = 10 per group). A bulk-fill composite resin was built-up on the surfaces. The specimens were tested in the micro shear mode at a crosshead speed of 1 mm/min on a universal test machine. Statistical analysis was performed with ANOVA and Tukey's tests at P < 0.05. RESULTS: Significant differences have been detected in the micro shear bond strengths only between the Ankaferd Blood Stopper (ABS) (AI = 13.72 ± 4.47 and AII = 9.12 ± 4.4) and control groups (CI = 22.78 ± 10.86 and CII = 16.49 ± 6.55) without regards to the bonding systems. The highest scores were obtained in the control groups. Clearfil SE Bond showed better performance than All Bond Universal in all groups. CONCLUSION: It was determined that only the ABS contamination groups showed statistically significant decreases in the bond strengths when compared with control groups.

Evaluation the oral hygiene conditions, oral Candida colonization and salivary Streptococcus mutans and Lactobacilli density in a group of ß-thalassemic children and adolescence.

BACKGROUND: In this study, the prevalence and distribution of dental caries and oral hygiene conditions in a group of patients with ß-TM are evaluated and the results compared to age-and gender-matched healthy patients. In addition, oral candida colonization and the density of Streptococcus mutans (S.mutans) and Lactobacilli in the total saliva are assessed. MATERIAL AND METHODS: This study involved 59 ß-TM patients between 6-16 years old (mean:11.59±3.22), who applied to the Department of Pedodontics, Faculty of Dentistry, Akdeniz University, with ongoing follow-up, treatment and regular blood transfusions. All enrolled patients were diagnosed with ß-TM by the Department of Pediatric Hematology and Oncology, Faculty of Medicine, Akdeniz University. As a control group, age-and gender-matched healthy 50 patients were included to the study. RESULTS: Plaque ( p=0.001), DMFT ( p=0.009) and DMFS ( p=0.039) indices were significantly higher in the ß-TM patients, whereas, the oral hygiene status was significantly lower ( p=0.004). Saliva buffering capacity average was insignificantly but slightly more in ß-TM patients( p=0.131). While S.mutans values were significantly higher in the ß-TM patients ( p=0.002), no significant difference was found in the Lactobacillus ( p=0.131) and Candida values ( p=0.33). CONCLUSIONS: DMFT, DMFS, Plaque and oral hygiene indices and S.mutans values were found significantly different in ß-TM patients than healthy, control group patients, in this study.

The efficacy of resin infiltrate on the treatment of white spot lesions and developmental opacities.

OBJECTIVES: The aim of this study was to evaluate the changes in opacities by applying resin infiltrate to developmental enamel opacities and applying resin infiltrate or fluoride varnish to white spot lesions (WSLs). MATERIALS AND METHODS: A total of 132 teeth with WSLs and developmental enamel opacities were included in the study. WSLs were treated with resin infiltrate (Group 1) and fluoride varnish (Group 2), and developmental enamel opacities were treated with only resin infiltrate (Group 3). Lesions were evaluated in accordance with International Caries Detection and Assessment System (ICDAS II) criteria and DIAGNOdent Pen scores before applying the material (T0), just after the application (T1), and after 1 month (T2) and 3 months (T3). RESULTS: A significant decrease in DIAGNOdent Pen scores was observed in all the groups and the most important decrease was seen in Group 2 (P < 0.05). A significant decrease in ICDAS II scores was observed in Groups 2 and 3 (T0-T1) and Group 1 (T1-T2) (P < 0.05). CONCLUSION: DIAGNOdent pen scores decreased and the lesion was partially masked after resin infiltrate was applied to treat developmental enamel opacities; the resin infiltrate application, however, was more successful than fluoride varnish on WSLs. Treating WSLs with resin infiltrate was a good option due to shorter term esthetic recovery and high patient satisfaction.

Oro-dental characteristics of three siblings with Papillon-Lefevre syndrome.

Papillon-Lefevre syndrome (PLS) is a rare autosomal recessive disorder, showing oral and dermatological manifestations in the form of aggressive periodontitis, leading to the premature loss of both primary and permanent teeth at a very young age and palmar-plantar hyperkeratosis. It was first described by two French physicians, Papillon and Lefevre in 1924. Immunologic, genetic, or possible bacterial etiologies have been thought to account for etiopathogenesis of PLS. Severe gingival inflammation and periodontal destruction occurred after the eruption of primary teeth. This condition should warn the physicians and dentists as a one of the important sign for the diagnosis of PLS. There have been over 250 cases reported in literature about PLS, but a few of these were in the same family. This study presents oro-dental characteristics, dental treatments, and follow-up of three siblings (age of sisters are 13, 6, and 4 years) with PLS, which is rarely seen in the same family.

Comprehensive dental management in a Hallermann-Streiff syndrome patient with unusual radiographic appearance of teeth.

Hallermann-Streiff syndrome (HSS) is a genetic disorder characterized by proportionate dwarfism, birdlike facies, hypotrichosis, skin atrophy, dyscephaly, bilateral microphthalmia, congenital cataracts, a narrow, weak, beaked nose, a hypoplastic mandible, and orodental anomalies. Occurrence is sporadic and distinct patterns of inheritance have not been found. This case report describes the dental management of a 3-year-old girl patient with HSS, who had unusual radiographic appearance of teeth. Furthermore, dental treatments and a 30-month follow-up period of the patient with this rare tooth structure malformation have been presented.

Comparison of the reliability of laser Doppler flowmetry, pulse oximetry and electric pulp tester in assessing the pulp vitality of human teeth.

This study was designed to evaluate and compare the reliability of laser Doppler flowmetry (LDF), pulse oximetry (PO) and electric pulp tester (EPT) for assessing the pulpal status as a vitality test method by calculating their sensitivity, specificity and predictive values. Data were collected from 59 pairs of maxillary anterior teeth (38 pairs of central, 21 pairs of lateral incisors) in 51 patients (range 12-18years, mean age 14·6±1·73years, 28 women, 23 men). The teeth with complete endodontic fillings constituted the study group, and the healthy, contralateral teeth of the same patients were constituted the control group. The calculated sensitivity was 0·915 for the EPT and 0·813 for the PO. And the specificity of EPT was 0·881 and PO was 0·949. The difference between the LDF values obtained from the study, and control group was statistically significant (P=0·0001). The findings of this study indicated that LDF can reliably discriminate the vitality of the teeth with a sensitivity and specificity of 1·0 for this sample. Laser Doppler flowmetry was found to be a more reliable and effective method than PO and EPT of assessing the pulpal status of human teeth.

Case series: a clinical study of 27 cases of dentoalveolar root fractures in children and adolescents.

AIM: This was to assess fracture type, treatment delay, splinting periods and various treatment methods on periradicular healing of root fractures in a group of patients attending a Paediatric Dentistry clinic. METHODS: Records and radiographs of children with root-fractured teeth, referred during 1999-2003, were assessed. STATISTICS: Correlation analysis was performed using Spearman rank test. RESULTS: There were 27 root-fractured teeth in 20 patients aged between 8-18 years. One root-fracture occurred in 13 patients (65%) and 7 (35%) had two root-fractured teeth; all maxillary teeth and the most affected teeth were central, followed by lateral, incisors. Only 4 patients were seen on the day of the trauma. The commonest cause of injury was a fall (12 patients), followed by collisions, bicycle and motorcycle accidents. Treatments consisted of: splinting, splinting+pulp therapy, extraction of coronal fragment accompanied with orthodontic interventions and restorative procedures, and surgical operations. Healing was related to treatment delay, location and type of fracture, and splinting time. Statistical analysis showed significant correlations only between healing type and splinting time. CONCLUSIONS: Preventive educational programs concerning traumatic dental injuries are needed in Turkey and mandatory use of mouthguards and preventive use of helmets with bicycles and motorcycles.

Clinical features of hypodontia and associated dental anomalies: a retrospective study.

OBJECTIVE: Hypodontia is the most commonly known developmental dental anomaly in man. This paper aims to investigate the characteristics of tooth absence and associated dental anomalies among the patients attending our paediatric dentistry clinic. SUBJECTS AND METHODS: For this study, 192 patients aged between 1 and 18 years with congenitally missing teeth were selected among the patients who attended the Department of Paediatric Dentistry of Süleyman Demirel University between January 2000 and December 2003. Clinical and radiographic examinations were performed by two dentists in order to detect the missing teeth. RESULTS: We determined 503 congenitally missing teeth in 192 patients (male = 93, female = 99), excluding third molars. Twelve of these teeth were deciduous and 491 were permanent. A higher incidence of missing teeth was observed in girls than boys, in mandibular arch than maxillary and on the right side than left side. However the differences between arches and sides were not statistically significant in both sexes. CONCLUSION: The diagnosis of the hypodontia should be performed as early as possible, thus alternative treatment modalities can be planned and performed in a multidisciplinary team approach, in order to establish an aesthetic and functional dentition in the future.