Image-based evaluation of facial fractures in a child using computed tomography.

This article describes the case of a boy who had a fracture of the mandibular parasymphysis region associated with a fracture of the contralateral condyle. Panoramic and computed tomography images were used to monitor bone remodeling.

Prevalence of dental anomalies in nonsyndromic individuals with cleft lip and palate: a systematic review and meta-analysis.

OBJECTIVE: To assess whether individuals born with nonsyndromic oral clefts display a higher frequency of dental anomalies. DESIGN: A search of MEDLINE, BIREME, OVID ALL EMB Reviews, and The Cochrane Library was conducted. The methodologic quality of the papers selected was assessed and scored. Papers reporting observational controlled studies of nonsyndromic forms of oral cleft matched for dental anomalies in primary and/or permanent teeth were included without language restrictions. Eligible studies were scored as "A"-low risk of bias, "B"-moderate risk of bias, or "C"-high risk of bias and poor quality. Fixed and random effects models were used to aggregate individual odds ratios (OR) and to derive pooled estimates and 95% confidence intervals. RESULTS: Six studies fulfilled our selection criteria and were included in the meta-analysis. Three distinct subgroup analyses were carried out in terms of dental anomalies. In the tooth agenesis meta-analysis, a random effects model was used because of heterogeneity and showed a significant association between tooth agenesis and oral clefts (OR  =  12.31; 95% confidence interval [CI]  =  3.75 to 40.36). In the remaining analyses, the fixed effects model revealed a positive association between supernumerary (OR  =  4.99; 95% CI, 2.58 to 9.64) and crown morphologic abnormalities (OR  =  5.69; 95% CI, 3.96 to 8.19) with oral clefts. Most included studies were of low to moderate quality. CONCLUSION: Although general limitations in study design were observed, the evidence suggests that a higher number of dental anomalies in the permanent dentition are noted in individuals born with oral clefts.

Bruxism control in a child with cerebral palsy.

Cerebral palsy (CP) is one of the most severe childhood disabilities due to a lesion in the developing brain. Oral conditions often observed in this pathogenic are a tendency for the delayed eruption of permanent molars, higher percentages of malocclusion and parafunctional habits, including bruxism. The significance of oral conditions observed in CP patients demonstrates the need for intensive home and professional care for these individuals. This paper presents a 7-year-old boy, with cerebral palsy, severe mental retardation, who had high abrasion wear of the primary teeth related to bruxism. Dental care was carried out under oxide-induced sedation, and management of the bruxism was achieved after the use of a resin acrylic protective appliance fixed on both sides of the mandibula. The treatment performed offered efficiency advantages, was clinically viable, and should be a valuable option to practitioners considering appliance therapy to control parafunctional behavior.

Periodontal status of patients with dentin dysplasia type I: report of three cases within a family.

BACKGROUND: Dentin dysplasia type I (DDI) is a rare hereditary disturbance of dentin formation. It is characterized by clinically normal-appearing crowns; obliteration of pulp chambers; and short, blunted and malformed roots that are commonly associated with periodontal attachment loss (PAL). In this context, we report three cases within a family with similar clinical and radiographic features of DDI but with differing microbiologic and periodontal conditions. METHODS: A 42-year-old white female and her two daughters (25 and 10 years of age) presented with a diagnosis of DDI. Probing depth (PD), clinical attachment level (CAL), visible plaque, and bleeding on probing (BOP) were recorded. Subgingival biofilm samples were randomly collected and analyzed by checkerboard DNA-DNA hybridization. RESULTS: The mother presented 34.9% of sites with PD > or =4 mm, 41.3% of sites with CAL > or =4 mm, and 57% of sites with BOP; both daughters presented no sites with PD or CAL >3 mm and <10% of sites with BOP. Microbiologic analysis detected Gemella morbillorum, Neisseria mucosa, and Staphylococcus aureus in > or =50% of the mother's samples. The daughters showed high levels (>10(4) bacterial cells) of some periodontopathic bacteria, including members of the red (Porphyromonas gingivalis) and orange (Fusobacterium periodonticum and F. nucleatum polymorphum) complexes and beneficial species of the yellow (Streptococcus gordonii) and purple (Veillonella parvula) complexes. The mother presented high mean levels only for four tested species (N. mucosa, Prevotella melaninogenica, Treponema denticola, and V. parvula). CONCLUSION: A combination of radiographs, microbiologic analysis, and preventive professional monitoring care is important to avoid PAL and to provide oral health in patients with DDI.

Split mouth randomized controlled clinical trial of beveled cavity preparations in primary molars: an 18-Month follow up.

OBJECTIVES: This split-mouth, double-blind, randomized controlled study evaluated the clinical performance of composite restorations in Class I beveled margin cavity preparations in primary molars. METHODS: A total of 94 Class I cavity preparations were performed in the carious primary molars of 32 children aged 4-10 years. Two cavity designs were used: conventional conservative preparation (G1) and modified preparation with cavosurface bevel (G2). All teeth were restored using TPH Spectrumtrade mark. The restorations were evaluated by two calibrated investigators at baseline, 6, 12 and 18 months using slight modified USPH criteria. The visible plaque index and fiber optic transilumination (FOTI) were also used. The data were statistically evaluated using Wilcoxon and Friedman tests (p<0.05). The rank correlations between secondary caries, visible plaque index and FOTI were obtained using Pearson correlation (p<0.01). RESULTS: Of the 94 restorations performed and evaluated at baseline, 76 restorations were available after 18 months. Seventy-three restorations were considered as clinical success, 10 were censored for drop out reasons and 5 were lost by natural exfoliation. Four restorations failed by secondary caries and two failed by marginal adaptation discrepancies. For all evaluation there was difference between the baseline, 6, 12 and 18 months (p<0.05) but there were no statistically significant difference in G1 and G2 for any criteria evaluated (p>0.05) at any period of the study. The visible plaque index was correlated to secondary caries. CONCLUSION: Bevel cavity design preparations did not improve the success of composite restorations in primary molars over 18 months.