Parent-child interaction and stimulation in early life can be related to caries in primary dentition? Hypotheses from a life-course approach.

Dental caries has common risk factors with impairments in growth, cognitive development and child general health. Identifying socioeconomic contexts and parental behaviors in early life that may be associated with negative outcomes in the child's future and their causal mechanisms can contribute to planning early interventions. Therefore, the aim of this paper is to propose and discuss possible ways to explain how early childhood stimulation may be associated with future oral health status, based on the life-course theory of chain-of-risk model and accumulation of risk model. Two hypotheses were suggested: (1) each social exposure or parental behavior in the child's first years of life increase the risk of chronic diseases, such as dental caries in primary dentition, in a simply additive effect; (2) parental factors could negatively influence the establishment of the pattern of child stimulation (child care) or lead to a modification of the established behavior on the risk of dental caries in the child primary dentition. Prevention of dental caries seems to be the most feasible way of solving this serious public health problem. It therefore justifies the importance of identifying exposures in the child's early life that may lead to the occurrence of chronic diseases in the future. The evidence seem to converge to the idea that child stimulation in early life may be associated with future health problems related to behaviors and care by parents, including caries.

Interproximal caries and premature tooth loss in primary dentition as risk factors for loss of space in the posterior sector: A cross-sectional study.

Dental caries-a highly prevalent public health problem in preschoolers and school children-is the main cause of premature dental loss during childhood, and this may be related to loss of space in the posterior sector. The objective of this study was to evaluate whether interproximal caries and premature tooth loss (D and/or E) are risk factors for loss of space in the posterior sector.A comparative cross-sectional study (split-mouth type) was performed in schoolchildren (6-8 years old). Seventeen gypsum models were evaluated. These children presented with unilateral loss of a dental organ or interproximal caries (teeth D and/or E) and without such affectations on the other side. Measurements were made with a digital Vernier caliper. The dependent variable was the difference (loss of space, mm) between the control and case sides. The independent variables were type of affectation (interproximal caries or tooth loss), sex, age, arcade, and number of interproximal surfaces affected.The mean age was 6.82 ±â€Š0.44 years and 64.7% were boys. The average space loss was 1.09 ±â€Š0.18 mm (control vs case; P < .0001). A greater loss of space was observed among those who lost a dental organ than those with interproximal caries (P = .0119). A correlation was observed between the variable loss of space and the number of interproximal surfaces affected (r = 0.5712, P = .0166).Interproximal caries and tooth loss were risk factors for loss of space in the posterior segment in this sample of Mexican schoolchildren.

Reabilitação neuroclusal em paciente odontopediátrico com mordida cruzada posterior unilateral: relato de caso clínico / Neuro-occlusal rehabilitation in pediatric dental patient with unilateral posterior crossbite: clinical case report

Objetivo: relatar a sequência clínica de tratamento para descruzar uma mordida cruzada posterior unilateral na dentição decídua por meio da reabilitação neuroclusal. Relato de caso: o caso clínico foi realizado em um paciente do sexo masculino, com 5 anos de idade, diagnosticado com mordida cruzada posterior unilateral funcional do lado direito. Após a verificação de interferências dentais nos caninos e molares em oclusão cêntrica, realizaram-se os ajustes oclusais. Seguiu-se então o protocolo para confecção de pistas diretas de Planas, utilizando resina composta em planos inclinados na metade vestibular da face oclusal dos dentes 84 e 85 e na face vestibular dos dentes 53, 54 e 55. Logo após a confecção das pistas, observou-se a correção da mordida cruzada e a estabilidade na mudança postural da mandíbula. Considerações finais: a reabilitação neuroclusal por meio de pistas diretas de Planas apresenta grande eficácia na correção da mordida cruzada posterior, proporcionando estabilidade mandibular e estímulo para o crescimento e desenvolvimento crânio-maxilo-facial. (AU)

Objective: To report the clinical treatment sequence to uncross a unilateral posterior crossbite in deciduous dentition using neuro-occlusal rehabilitation. Case report: The clinical case was performed in a 5-year-old male patient diagnosed with a functional unilateral posterior crossbite on the right side. After verifying dental interferences with canines and molars in centric occlusion, the occlusal adjustments were performed. The protocol for producing Planas direct tracks was followed using composite resin in inclined planes in the buccal half of the occlusal surface of teeth 84 and 85 and in the buccal surface of teeth 53, 54, and 55. After the preparation of tracks, the crossbite correction and the stability in postural mandibular change were observed. Final considerations: Neuro-occlusal rehabilitation using Planas direct tracks is highly effective in correcting posterior crossbite, providing mandibular stability and stimulus for the growth and development of the maxillofacial skull. (AU)

Socioeconomic Factors and Oral Health-Related Behaviours Associated with Dental Caries in Preschool Children from Central Italy (Province of Ascoli Piceno).

BACKGROUND: Dental caries is a serious oral health concern with high prevalence in preschool children. AIM: To assess the association among oral health-related behaviors, socioeconomic factors, and dental caries in Italian preschool children. DESIGN: 513 preschool children from 3 to 6 years of age, enrolled in nursery schools in central Italy, represent the population of the present study. The children underwent dental clinical examination and were divided on the basis of their caries experience in the primary dentition ("Yes" or "No"). Nonparametric analysis and univariate and multivariate logistic regression models were applied to evaluate the contribution of oral health-related behaviors and socioeconomic factors to the caries experience in the primary dentition. RESULTS: 419 children were caries free, and 94 children had caries experience in the primary dentition, corresponding to the 18.4% of participants. Different oral health-related behaviors and socioeconomic factors resulted to be associated with caries development. In particular, the mother's foreign nationality results in a strong predictive factor. CONCLUSIONS: The multivariate logistic model revealed factors significantly affecting caries experience in the primary dentition, which were the mother's nationality, the number of dental visits in a year, and the personal impression by the mother.

Comparison of resorption rate of primary teeth treated with alternative lesion sterilization and tissue repair and conventional endodontic treatment: An in vivo randomized clinical trial.

BACKGROUND: Complete pulpectomy and elimination of wide range of microorganisms from infected primary root canals is not possible through conventional endodontic procedures. Thus, lesion sterilization and tissue repair (LSTR) therapy employing 3Mix tri-antibiotic paste have been used as an alternative endodontic modality for infected primary teeth. AIM: This study aims to evaluate the root resorption rate of endodontically treated mandibular primary molars with conventional endodontic treatment or LSTR therapy and to compare it with their healthy contralateral teeth. MATERIALS AND METHODS: Fifty carious first and second primary mandibular molars from 25 healthy children aged 7-10 years were treated with two different endodontic procedures using LSTR Therapy and conventional endodontic treatment. The resorption rate of these teeth with healthy contralateral teeth was compared clinically and radiographically at 3, 6, 12 and 36 months using Chi-square test. RESULTS: At 12 months, clinically, there was no difference in the outcomes of both groups but radiographically, statistically significant difference (P < 0.001) in root resorption between treated teeth and their controls in both the groups was observed. At 36 months, interradicular bone resorption around the crown of succedaneous teeth and their delayed eruption was noted in LSTR group. CONCLUSIONS: LSTR therapy could be a viable treatment modality for infected/nonvital primary molars with poor prognosis and intended to be maintained for shorter duration in the oral cavity as natural space maintainers.

Gingival, oral hygiene and periodontal status of the teeth restored with stainless steel crown: A prospective study.

AIM: To compare the gingival health and periodontal status in primary molars restored with stainless steel crowns with unrestored contralateral teeth. MATERIALS AND METHODS: A split mouth design study was conducted on 60 children aged 5- 10 years who required stainless steel crown restoration on deciduous molars. The molar teeth restored with stainless steel crown were selected for study and healthy unrestored contralateral teeth were selected as controls. Bitewing radiograph of study and control tooth was taken at initial, three months and at six months. The gingival status, oral hygiene status was evaluated at three months and six month intervals using gingival index and oral hygiene index respectively. RESULT: On evaluating the oral hygiene status at three months study group showed the mean value of 0.7±0.700 whereas in control group it was 1±0.368. At six months it was 1.183±0.390 in study group and 1.5±0.504 in control group. Chi square test shows that the crown marginal adaptation produced statistically significant difference at six months. Crown marginal extension did not produce any difference on gingival index and oral hygiene index. CONCLUSION: When compared to control teeth, the teeth restored with stainless steel crown showed lesser plaque and debris accumulation at three months and six months. Radiographic bone level the control teeth showed higher level of bone resorption compared to the teeth restored with stainless steel crown.

No consistent association found between dental caries and body mass index in children.

Data sourcesPubMed, Embase, the Cochrane Library and reference lists of identified studies.Study selectionObservational studies comparing dental caries and body mass index (BMI) where BMI was clearly defined were considered.Data extraction and synthesisTwo reviewers independently abstracted data using standard forms with study quality being assessed using a modified version of the Agency for Healthcare Research and Quality (AHRQ) methodology checklist for cross-sectional studies. The weighted mean differences and corresponding 95% confidence intervals for dental caries between children with abnormal weight and those with normal weight were analysed.ResultsFourteen cross-sectional studies including 43,860 children (boys: 23,299; girls: 20,561) were included. Only two studies were considered to be of high quality, eight of medium quality and four of low quality. Four main patterns of associations between dental caries and BMI were found: five studies showed no association, five studies found a positive association, three an inverse association and one found a U-shaped pattern, which meant that the deft score was significantly higher in underweight children and there was a higher DMFT score in overweight and obese children.ConclusionsThis meta-analysis showed no differences in dental caries between underweight and normal weight children. Further studies are recommended using suitable sample sizes, to unify the criteria for BMI categorisation and the dental caries index, and investigate the confounding factors that might influence dental caries and BMI.

Prevalence of malocclusion in primary dentition in mainland China, 1988-2017: a systematic review and meta-analysis.

Malocclusion is a common oral disease affecting children with various reported prevalence rates. This meta-analysis aimed to determine the epidemiological characteristics of malocclusion among pre-schoolers in mainland China from 1988 to 2017. A total of 31 qualified papers describing 51,100 Chinese children aged 2-7 years were selected. The pooled malocclusion prevalence was 45.50% (95% confidence interval (CI): 38.08-52.81%) with 26.50% Class I (CI: 19.96-33.12%), 7.97% Class II (CI: 6.06-9.87%) and 12.60% Class III (CI: 9.45-15.68%) cases. The most common type of malocclusion was overbite (33.66%, CI: 27.66-39.67%), and the flush terminal type (47.10%, CI: 28.76-65.44%) was the most common in the terminal plane relationship. An increasing trend and wide variations across the country were observed. Additionally, there was no significant difference in malocclusion by gender (relative risk (RR) = 1.01, [0.96-1.06]) or urban/rural area (RR = 0.99, [0.82-1.20]). Although this study represents a narrow view of deciduous-dentition malocclusion in mainland China, the results provide sample evidence that can aid clinicians and policy makers towards early prevention and timely treatment.

Factores de riesgo maternos y neonatales asociados al retardo de la dentición temporal / Maternal and neonatal risk factors associated with the temporary teething delay

Se realizó un estudio analítico, observacional, de casos y controles, en niños de los círculos infantiles Pétalos de Rosa y La Espiguita, pertenecientes al área de salud del Policlínico Docente Armando García Aspurú de Santiago de Cuba, durante el período de febrero de 2015 a marzo de 2016, con vistas a determinar los factores maternos y neonatales asociados al retraso en la aparición de dientes temporales. La población quedó conformada por 150 niños de 2do a 4to años de vida, de los cuales se tomaron 2 controles (N=100) por cada caso (N=50). En la serie se obtuvo asociación estadísticamente significativa de las variables estado nutricional de la madre, ganancia de peso de la madre, enfermedades maternas, lactancia materna y peso del niño al nacer, con la alteración del brote dentario temporal en los niños. Se recomendó realizar intervenciones educativas en los círculos infantiles y las comunidades para apoyar el trabajo del médico de la familia

An analytic, observational, of cases and controls study, in children from Pétalos de Rosa and La Espiguita day care centers, belonging to the health area of Armando García Aspurú Teaching Polyclinic was carried out in Santiago de Cuba, during February, 2015 to March, 2016, aimed at determining the maternal and neonatal factors associated with the delay in the emergence of the temporary teeth. The population was conformed by 150 children from 2nd to 4th years of life, from whom 2 controls were taken (N=100) for each case (N=50). In the series a statistically significant association of the variables mother's nutritional state, mother's weight gain, maternal diseases, breast feeding and child birth weight was obtained, with the disorder of the temporary teething eruption in the children. It was suggested to carry out educational interventions in the day care centers and communities to support the family doctor's work

Direct effects of mitochondrial dysfunction on poor bone health in Leigh syndrome.

Mitochondrial diseases are the result of aberrant mitochondrial function caused by mutations in either nuclear or mitochondrial DNA. Poor bone health has recently been suggested as a symptom of mitochondrial diseases; however, a direct link between decreased mitochondrial function and poor bone health in mitochondrial disease has not been demonstrated. In this study, stem cells from human exfoliated deciduous teeth (SHED) were isolated from a child with Leigh syndrome (LS), a mitochondrial disease, and the effects of decreased mitochondrial function on poor bone health were analyzed. Compared with control SHED, LS SHED displayed decreased osteoblastic differentiation and calcium mineralization. The intracellular and mitochondrial calcium levels were lower in LS SHED than in control SHED. Furthermore, the mitochondrial activity of LS SHED was decreased compared with control SHED both with and without osteoblastic differentiation. Our results indicate that decreased osteoblast differentiation potential and osteoblast function contribute to poor bone health in mitochondrial diseases.

AN ERUPTION PATTERN OF DECIDUOUS TEETH IN CHILDREN BORN WITH FETAL MACROSOMIA DURING THE FIRST YEAR OF LIFE.

The paper aims at studying the effect of body overweight at birth on the dental health of 482 children in the Kharkiv City (Ukraine) during their first year of life over the 2001 and 2013 interval. The macrosomia set is comprised of the medical records of the children born with fetal macrosomia, and the normosimia set of the medical records of the children born with weight and height that correspond to the gestation age. The gestation age of all children is 37 to 42 weeks'. To determine the average time of first tooth eruption and deciduous teeth growth rate for each of the sets under study, we have used the hypothesis about a linear dependence between the number of erupted teeth and the age of the child. Processing statistical data is performed applying the multiple linear regression analysis. The reasons for macrosomia in the children are examined. The number of pregnancies and deliveries influence the likelihood of having a child with fetal macrosomia. A greater likelihood of having a child with fetal macrosomia in the older parents is not found. The correlation between the states of a child at birth (macrosomia/normosimia) and terms of deciduous tooth eruption (the delayed/timely/early eruption) expressed in a number of teeth at the age of one year is determined. The difference in the teeth growth rate between the boys and girls within the both sets are insignificant. The children born with macrosomia have a lower rate (approximately 0.1 tooth per month) of teeth growth and a greater spread in the number of teeth that erupt by a certain age.

Molar incisor hypomineralisation.

Data sourcesThe Medline and Embase databases and hand searches in the journals International Journal of Paediatric Dentistry and European Archives of Paediatric Dentistry.Study selectionEnglish language cohort and case-control studies.Data extraction and synthesisStudy selection was carried out independently by two reviewers with data abstraction being conducted by a single reviewer and checked by a second reviewer. Risk of bias was assessed using a modified version of the Newcastle-Ottawa Scale (NOS). Adjusted (aOR) and unadjusted odds ratios (uOR), P-values and 95% confidence intervals (CI) were obtained from the studies. Meta-analysis was not conducted.ResultsTwenty-eight studies were included; 25 reported on MIH, three on hypomineralised second primary molars (HSPM). Nineteen of the studies were of cohort design (six prospective,13 retrospective) and nine were case controls. There was little evidence of an association between the most frequently investigated prenatal factors (smoking, maternal illness, maternal medication, maternal stress) and MIH. Similarly there was little evidence of an association between MIH and perinatal factors such as prematurity, low birth weight, caesarean delivery and birth complications. Early childhood illness, up to three or four years of age, was widely investigated, with six studies reporting a crude association. Associations between antibiotics, anti-asthma medication and breastfeeding were also evaluated. Only three studies looked at HSPM; one study suggested that maternal antibiotic use during pregnancy is unlikely to be associated with HSPM but maternal alcohol intake may be. Another study reported possible associations with a large number of factors, with perinatal factors and neonatal illness being most common, followed by prenatal factors.ConclusionsPrenatal and perinatal factors are infrequently associated with MIH. However, despite a lack of prospective studies, early childhood illness (in particular fever) appears to be associated with MIH. Further prospective studies that adjust for confounding based on biological principles, as well as genetic and epigenetic studies, are needed because the aetiology is likely to be multifactorial.

In Vitro Comparative Analysis of Fracture Resistance in Inlay Restoration Prepared with CAD-CAM and Different Systems in the Primary Teeth.

Objective. The aim of this study was to compare to fracture resistance test of inlay restorations prepared using direct inlay technique (Gradia® Direct Composite) and Indirect Restoration System® (Gradia Indirect Composite) and CAD/CAD system (Vita Enamic® Block). Study Design. 48 noncarious extracted maxillary second primary molars were randomly divided into 4 groups with 12 in each group. All the teeth were prepared based on inlay class II preparations except for the control group. Other groups were restored with Gradia Direct Composite, Gradia Indirect Composite, and Vita Enamic Block, respectively. All restorations were cemented self-adhesive dual cure resin (3M Espe, RelyX™ Unicem Aplicap). A fracture test was performed using a compressive load. Results were analyzed using one-way analysis of variance and Duncan's post hoc multiple comparison tests (α = 0.05). Results. Vita Enamic Block and Gradia Indirect Composite showed significantly higher fracture resistance than Gradia Direct Composite (p < 0.05). There was no significant difference fracture resistance between Vita Enamic Block and Gradia Indirect Composite (p > 0.05). All restorations tested led to a significant reduction in fracture resistance (p < 0.05). Conclusion. In inlay restorations, Indirect Restoration Systems and CAD/CAM systems were applied successfully together with the self-adhesive dual cure resin cements in primary molars.

Effect of a thin-neck pacifier on primary dentition: a randomized controlled trial.

OBJECTIVES: To evaluate changes in occlusal characteristics in the primary dentition that occur after introducing a thin-neck pacifier (TNP) to children with previously diagnosed pacifier-associated anterior open bite (AOB) and increased overjet. SETTING AND SAMPLE POPULATION: Department of Preventive and Pediatric Dentistry, Jena University Hospital, Germany. Subjects were 86 children (mean age 20.3 months) with a pacifier-associated open bite or overjet ≥2 mm. MATERIAL & METHODS: Randomized controlled trial. Subjects were randomly assigned: group I (n = 28), intervention group using a TNP; group II (n = 30), control group, using a conventional or physiological pacifier; and group III (n = 28), intervention group, Gold standard, weaned off pacifier. Participants were re-examined after 3, 6, 9 and 12 months by an operator, blinded for the treatment. RESULTS: After 12 months data for 63 children (mean age 33.1 months) were analyzed (I: n = 24; II: n = 22; III: n = 17). There was a significant difference between the groups regarding mean overjet (group I: 2.7 ± 0.5 mm, group II: 3.2 ± 0.7 mm, group III: 2.4 ± 0.5 mm, Kruskal-Wallis, p = 0.002) and AOB (group I: -1.2 ± 0.3 mm, group II: -2.2 ± 0.3 mm, group III: -0.8 ± 0.8 mm, Kruskal-Wallis, p < 0.001). The differences between group I and II regarding increased overjet (3.1 ± 0.2 mm vs. 3.6 ± 0.3 mm, Mann-Whitney, p < 0.001) and extent of AOB (-1.2 ± 0.3 mm vs. -2.2 ± 0.3 mm, Mann-Whitney, p < 0.001) were statistically significant. CONCLUSION: Use of TNP resulted in better clinical measurements for in overjet and overbite compared with the continuing use of conventional or physiological pacifiers.

Induced ankylosis of a primary molar for skeletal anchorage in the mandible as alternative to mini-implants.

BACKGROUND: Mesial protraction of mandibular posterior teeth requires increased anchorage to avoid undesired tooth movements. Orthodontic mini-implants have become a popular and successful way to increase skeletal anchorage in such cases. However, mini-implants may cause injury to adjacent teeth or anatomical structures and may lead to tissue inflammation. Induced ankylosed primary teeth have been used in the past as abutments for the protraction of the maxilla in cases of maxillary retrognathism. However, this technique has not been described in the literature for the protraction of mandibular molars. The aim of this paper is to present, through a case report, an alternative to mini-implant devices to maximize anchorage in the mandible by inducing ankylosis on a primary molar. FINDINGS: A 13-year-old female with class II right malocclusion, deep bite, and congenitally missing right second premolars was referred for orthodontic treatment. Treatment plan involved removal of the primary teeth and mesial protraction of the posterior. In the mandible, ankylosis was induced on the retained primary second molar by extraction, bisection, replantation of the mesial part after endodontic treatment, and bonding of a rigid splint. Ankylosis was diagnosed after 10 weeks and a closing T-loop sectional wire was inserted to move the permanent first molar mesially. At 6 months, the remaining space was closed using elastic chain on a rectangular stainless steel wire with tip-back bends, supported by class II elastics. CONCLUSIONS: Induced ankylosis of primary teeth can be an alternative to orthodontic mini-implants in selected cases, with minimal risks and maximum biocompatibility.

Treatment considerations in hutchinson-gilford progeria syndrome: a case report.

Hutchinson-Guilford progeria syndrome is an extremely rare condition classified as one of the premature ageing syndromes. This case presents a 16-year-old Israeli female patient, suffering from a variant of Hutchinson-Guilford progeria with a history of treatment with oral biphosphnates. The patient presented with typical cranial and facial features of the syndrome including delayed teeth eruption and root development probably due to insufficient jaw growth and severs retrognatic position of the maxilla and mandible. Orthodontic treatment considerations are described along with those required in light of the previous treatment by oral biphosphonates.All primary teeth were extracted in three appointments while creating as minimal trauma as possible to the surrounding tissue and alveolar bone. For now, the patient refuses to begin the orthodontic treatment course. There are no limitations to conduct any dental procedures in progeria patients, however, extreme caution must be exercised during oral surgery due to the inelasticity of tissues and dermal atrophy. Orthodontic procedure commencement should be early enough to manage the delayed development and eruption of teeth. Patients taking oral biphosphonates should be advised of this potential complication. If orthodontic treatment is considered appropriate, plans should be assessed and modified to include compromises.

[The Presence of Non-Carious Lesions in Children].

INTRODUCTION: A non-carious lesion (NCL) is the loss of hard dental tissue on the neck, tuberculum and incisal edges of the teeth. Interest in clinical presence and in unclear etiology of these lesions allows for their future prevention and treatment. OBJECTIVE: The aim of the study was to determine presence and clinical characteristics of NCLs and dentine hypersensitivity (DH), as well as their possible risk factors in children, in the population of the city of Novi Sad. METHODS: A total of 55 subjects were included in the present study, aged between three and 18 years. Each subject completed a structured questionnaire related to the etiological factors, and all teeth of each subject were examined by two independent clinical dentists to determine NCLs and DH. In the case of small children, their parents or guardians filled out the questionnaire. Teeth with NCLs and DH were diagnosed according to the Basic Erosive Wear Examination (BEWE) index and by a blast of air according to Schiff and Hypersensitivity Index. The review was carried out by inspection and probing. RESULTS: The data were analyzed by clinical examination and comparison of the answers to the questionnaires. We observed an increased presence of non-caries lesions on primary teeth, compared to permanent teeth, with a statistically significant difference (X2=3.86, df=1, p=0.04). The changes were observed in 82 teeth, and were most frequent on the canine deciduous teeth (65%) and canine permanent teeth (51%). BEWE index was 10-11% to 92-100% in permanent, and 51-57% in deciduous teeth. Majority of patients with primary teeth (89.36%) did not respond to air stimulus, while most patients with permanent teeth (74.29%) did not react to Schiff Index. In the estimate of sensitivity, the respondents reported hypersensitivity on 6.38% of the deciduous teeth and 22.86% of the permanent teeth. Comparison of etiology factors did not reveal a direct link with the appearance of NCLs. CONCLUSION: Research has shown that despite the lack of subjective symptoms, these lesions have distinct clinical characteristics. The fact that they occur even in deciduous dentition justifies the need for further investigations.

[Complex treatment approach for preschool children with impaired nasal breathing].

During the treatment of children with impaired nasal breathing (INB) cooperation of medical specialists is needed in order to reveal risk factors. The objective of the study was to prove the necessity of complex approach to the treatment of children with risk factors for INB. Multi-variant analysis of somatic and dental health of 170 children aged 4-6 was performed. The dental health was examined gradually in several steps, including physical examination. The following risk factors of antenatal and postnatal development of a child were revealed: genetic predisposition, complication of pregnancy, birth defects, somatic pathology, mastication dyspraxia, respiratory impairment, and various speech impediments. The following dentofacial anomalies prevailed: disorder of abrasion of primary dentition tubercle, development discord of cranio-facial area. The necessity of doctors' cooperation was proved during the treatment of children with impaired nasal breathing. Accurate execution of proposed treatment schemes allows eliminating risk factors promptly and decreasing the pathology severity.

Langerhans cell histiocytosis in childhood - review, symptoms in the oral cavity, differential diagnosis and report of two cases.

BACKGROUND: Langerhans cell histiocytosis is a rare disease characterized by monoclonal proliferation and migration of special dendritic cells. This disease primarily affects bones, but occurs less frequently in other organ systems or may manifest as a multisystem disease. CASE REPORTS: Extraoral and intraoral symptoms of Langerhans cell histiocytosis are described in a 13-month-old female and a 5-month-old male infant. Dermatitis was found on the scalp, abdomen, flexures and in intertrigineous areas in both patients. The intraoral examination of the 13-month-old infant showed premature eruption of all maxillary deciduous molars, loosening and significant damage of periodontal tissues (gingivitis with bleeding, swelling of palatal mucosa, periodontal pockets) resembling severe periodontitis. In the oral cavity of the 5-month-old predentate infant bilateral swellings of maxillary alveolar mucosa with deep ulcerations were seen. The oral and skin symptoms in both infants were indications for biopsy. Langerhans cell histiocytosis was confirmed histologically and immunohistochemically. CONCLUSION: Oral findings in Langerhans cell histiocytosis may be the only clinical symptom of the disease; therefore the role of dentists in establishing diagnosis is very important.

Establishing the diagnostic criteria for eruption disorders based on genetic and clinical data.

INTRODUCTION: Proper diagnosis and management of eruption disturbances remains challenging but is critical to a functional occlusion. The objective of this study was to establish definitive criteria to differentiate and diagnose eruption disorders, specifically primary failure of eruption (PFE) and ankylosis. METHODS: Sixty-four affected persons were placed into 3 cohorts: PFE diagnosed through confirmed PTH1R mutation (n = 11), PFE diagnosed based on clinical criteria (n = 47), and ankylosis diagnosed based on clinical criteria (n = 6). These groups were assessed to identify clinical features that differentiate PFE and ankylosis. RESULTS: Ninety-three percent of the subjects in the genetic and clinical PFE cohorts combined (n = 58) and 100% in the genetic PFE cohort had at least 1 infraoccluded first permanent molar. Additionally, a novel functional PTH1R mutation, 1092delG, was identified and linked to PFE in the deciduous dentition. CONCLUSIONS: An infraoccluded, supracrestal first molar is a hallmark of PFE, often involving both arches in the permanent or deciduous dentition, and with unilateral or bilateral affection, infraoccluded second premolar or second molar, and multiple affected adjacent teeth. Our results further suggest that PFE and ankylosis might be clinically indistinguishable without knowledge of prior trauma, treatment history, genetic information, or obliteration of the periodontal ligament space.