Clinical and microbial oral health status in children and adolescents with type 1 diabetes mellitus.

OBJECTIVES: To study the oral health of young individuals with controlled and uncontrolled type 1 diabetes mellitus (T1DM) and compare the results with those for healthy counterparts. MATERIALS AND METHODS: One-hundred and forty-four youngsters (6-15 years of age) were assigned, according to glycaemic control, to three study groups: (i) diabetic patients with poor glycaemic control [glycated haemoglobin (HbA1c ≥7.5%)] (n = 35); (ii) diabetic patients with good glycaemic control (HbA1c <7.5%) (n = 39); and (iii) healthy individuals (n = 70). Plaque, gingival inflammation, calculus and decayed, missing and filled surfaces (DMFS) indices were recorded. Salivary parameters were determined, and stimulated saliva was collected to allow detection and determination of the levels of oral Candida albicans and Streptococcus mutans by real-time polymerase chain reaction (PCR). RESULTS: Significantly different amounts of plaque were found among the study groups (P = 0.024): youngsters with poor glycaemic control had significantly more plaque than youngsters in the other two groups. The gingival, calculus and DMFS indices were not significantly different among groups (P > 0.05). Candida albicans levels were not statistically significant different among groups, but the group with poor glycemic control showed an elevated frequency of detection. Streptococcus mutans was isolated from the oral cavity of 96 of the 144 individuals. A statistically significant difference in the level of S. mutans was found between the group with poor glycaemic control and the healthy control group (P = 0.032). CONCLUSIONS: The results imply that youngsters with T1DM have a lower level of oral hygiene and are potentially at a higher risk of future oral disease, particularly when their metabolic disorder is uncontrolled. However, factors outside the oral cavity may also have a considerable impact on the initiation and progression of oral diseases.

A comparative study on oral health status in Greek preschool children with neurodevelopmental disorders with movement limitations.

AIM: To assess the oral health status of preschool children with neurodevelopmental disorders (NDD) in Greece and compare it to that, of healthy children of the same age. METHODS AND RESULTS: The sample consisted of 146 preschool children with NDD and movement limitations attending the rehabilitation centers of ELEPAP and 165 healthy children matched for age and maternal origin. Caries prevalence, dmft index, precavitated carious lesions (WSL) prevalence Visual Plaque Index (VPI), Restorative Index (RI), Mutans Streptococci (MS) levels, saliva buffer capacity, gingival hyperplasia, tooth wear and developmental dental defects were assessed. Data were analyzed using parametric and nonparametric tests (P ≤.05). The NDD group, compared to the healthy controls, had significantly lower caries prevalence (P <.001), dmft index (P <.001), VPI (P <.001) and MS levels (P = .027), significantly higher WSL prevalence (P <.001), and visited the dentist at an older age (P <.001). Significant determinants of WSL in the NDD group was the VPI (P = .009) and the presence of MS (P <.028). CONCLUSION: Preschool children with NDD had lower prevalence of manifested caries but higher prevalence of WSL. However, most oral health parameters need improvement for both groups indicating the need for proper early interventions especially in the NDD group.

In vitro estrogenicity of dental resin sealants.

PURPOSE: This investigation assessed the estrogenic action of various types of sealants. METHODS: Three light-cured sealants (Denton Clear, Delton Opaque, Ultraseal XT Plus) were applied in polyethylene molds (Ø:10mm, h:2mm, n:8) and photopolymerized (40 seconds, halogen bulb unit, standard mode 650 mW/cm 2 intensity). All specimens were immersed in normal saline for 1 week at 37 °C. Samples of eluents at concentrations of 5% and 10% (volume per volume) were tested for estrogenicity by measuring their effect on the proliferation of the estrogen responsive MCF-7 breast cancer cells. In addition, an estrogen insensitive cell line was used as a control (MDA-MB-231) to exclude a possible cytostatic effect of the tested materials. All assays were repeated 4 times, and results analyzed with a 2-way analysis of variance and Tukey's test at the 0.05 level. RESULTS: Eluents of the sealants tested at concentrations of 5% and 10% did not possess estrogenicity, except for the eluent of one sealant (Delton Opaque) at concentration 10%, which caused an induction of the proliferation rate of the MCF-7 cells. CONCLUSIONS: Eluents of sealants tested at a concentration of 5% had no estrogenic activity. The eluent of Delton Opaque at a concentration of 10% possessed some estrogenic activity.

Periodontal and microbiological parameters in children and adolescents with cleft lip and /or palate.

Objective. To evaluate the oral hygiene and the periodontal condition of children and adolescents with cleft lip and/or palate (CLP). Methods. Forty-one children and adolescents, 4-18 years, with CLP and 41 normal controls participated. Clinical parameters examined were the plaque and gingival index and Community Periodontal Index of Treatment Needs. For teeth in the cleft area, probing pocket depth, bleeding on probing, and tooth mobility were also evaluated. Samples of subgingival plaque were collected from 21 randomly selected patients of each group. Results. The CLP group had generally poorer oral hygiene (plaque index significantly higher) compared with the control. Children in both groups presented mild degree of gingivitis. Teeth in the cleft area had significantly higher pocket probing depth and tooth mobility, compared with corresponding teeth in the control group. The microbial analysis did not reveal significant differences in the composition of the subgingival microbiota between groups. Teeth in the cleft presented higher isolation frequencies and mean percentages of periodontopathic bacteria. Conclusion. Youngsters with CLP showed poor oral hygiene and worse periodontal condition, compared with controls. The above results advocate their participation in an intensive preventive dental programme that should start at an early age, possibly decreasing the risk of future periodontal disease.

Distribution of selected cariogenic bacteria in five different intra-oral habitats in young children.

BACKGROUND: Knowledge of the colonization patterns and composition of the oral microbiota can lead to a better understanding of disease initiation. AIM: The aim of this study was to examine the distribution of selected cariogenic bacteria in samples from five different oral habitats in young Greek children. DESIGN: Ninety-three children 3-12 years old (mean + SD 7.9 +/- 2.5) (60.2% male, 39.8% female) participated and split into three different age groups: primary (3-6 years), early mixed (6-9 years), and mixed dentition (9-12 years). Samples for bacterial enumeration were taken from saliva, supragingival and subgingival plaque, tongue dorsum, and soft tissues from each child, and were further analysed using checkerboard DNA-DNA hybridization. RESULTS: Mean counts and proportions of all the test bacteria differed significantly among sample locations. Cariogenic bacteria were present in almost all healthy children. Mean proportions of Streptococcus mutans isolated from soft tissue and Streptococcus sanguinis from soft tissue, subgingival and saliva samples increased significantly with age, whereas the opposite was seen for Lactobacillus acidophilus. CONCLUSIONS: Cariogenic bacteria were present in almost all young children. Soft tissues, saliva, and tongue were more often colonized by cariogenic streptococcal species than teeth. These surfaces may serve as reservoirs for oral pathogens, requiring attention during preventive interventions.

Longitudinal study on types of injury, complications and treatment in permanent traumatized teeth with single and multiple dental trauma episodes.

The purpose of this study was to compare the type of injuries, complications and treatment in permanent traumatized teeth with single and multiple dental trauma episodes (MDTE). One hundred and fifty-five children, aged 6-14 years, sustaining one or more traumatic episodes to permanent teeth were included in this investigation. After the medical and dental history the patients were examined clinically and radiographically and the diagnosis of trauma, the treatment plan and the applied treatment were recorded. Also, information regarding the number of traumatic episodes, the number of injured permanent teeth and the vitality of the pulp was collected. In follow-ups, traumatized teeth were examined clinically and radiographically to evaluate the treatment applied and to detect any complication. The t-statistic was used to test differences in the mean number of teeth per patient with different types of injury, complications and treatment between permanent traumatized teeth with single and multiple trauma episodes. A 95% probability level was used. The results showed that MDTE significantly affected the mean number of teeth per patient with fractured restoration, root fracture, concussion, pulp canal obliteration, root replacement resorption, filling therapy, surgery and prosthetic treatment. It was concluded that MDTE increase the risk of having certain types of injury, complications and treatment.

Clinical evaluation of a compomer and an amalgam primary teeth class II restorations: a 2-year comparative study.

PURPOSE: This study was performed to compare the clinical performance between the compomer F2000 and amalgam Dispersalloy in Class II restorations in primary molars over a 2-year period. METHODS: Seventy-five amalgam and 75 compomer restorations were placed in 75 children based on a split-mouth design. The restorations were evaluated after 1 week and after 6, 12, 18, and 24 months of oral function. The evaluation consisted of a clinical assessment according to modified Ryge criteria, a radiographic examination using bite-wing radiographs, and an observation of epoxy casts under scanning electron microscopy. RESULTS: The results showed statistically significant differences in the marginal adaptation and anatomic form between amalgam and compomer restorations. A higher number of compomer restorations were rated as Bravo, while a higher number of amalgam restorations were rated as Alpha at 24 months. Significant differences in the failure of the restoration and development of secondary caries were not found between the materials. CONCLUSIONS: The use of compomer F2000 in Class II resorations in primary molars, although it presents a significantly higher number of restorations rated as Bravo regarding the marginal adaptation and anatomic form vs the amalgam, does not increase the risks of developing secondary caries and failure of the restoration over a period of 2 years.

Progression of proximal caries in the mixed dentition: a 4-year prospective study.

PURPOSE: The purpose of this study was to investigate the survival rate and median survival time of different stages of proximal caries in 196 children aged 6 to 8 years at baseline examination. METHODS: Proximal caries and its progression were diagnosed from bitewing radiographs taken at 1-year intervals over a period of 4 years. The mesial surface of the first permanent molars, the mesial and distal surfaces of the first and second primary molars, and the distal surface of the primary canine were examined. Sound surfaces, caries lesions in the external- and internal-half of the enamel and external-, middle-, and internal-third of the dentin, as well as filled, extracted, and exfoliated teeth were recorded. A life table analysis was performed to estimate the annual and cumulative survival rates and the median survival time of each state of proximal lesions. RESULTS: For the sound mesial surfaces of the first permanent molars, the cumulative survival rate was 76% and the median survival time was over 48 months. The corresponding values for the external-half of the enamel lesions were 41% and 45 months. Regarding the sound mesial and distal surfaces of the primary teeth, the cumulative survival rate was 92% and the median survival time was over 48 months. The corresponding values for the external and internal-half of the enamel lesions were 40% and 31 months, and 29% and 22 months, respectively. The value of the cumulative survival rate for the external-third of dentin lesions was 42%, with a median survival time of 34 months, and the value for the middle-third of the dentin was 38% with a median survival time of 17 months. CONCLUSIONS: The risk of developing carious lesions in the sound proximal surfaces of both primary teeth and first permanent molars is low during the mixed dentition period; the progression of the external-half of enamel lesions of the first permanent molars is low for the first 3 years and becomes faster thereafter; and as the time period that the tooth exposed to cariogenic factors increases, the progression of the proximal caries is faster for all stages of the lesion in the primary teeth.