Oral Findings in Children, Adolescents and Adults with Tuberous Sclerosis Complex.

Objectives: Tuberous sclerosis complex (TSC) is a multisystem genetic disorder characterized by the development of benign tumors. The aim of the study was to assess the prevalence of oral lesions in patients with TSC and healthy individuals. Study design: The study included 120 patients aged 1.1 to 42.7 years: 60 patients with TSC and 60 controls. Clinical assessment of oral hygiene (Plaque Index-PLI), gingiva (Gingival Index-GI, Gingival Overgrowth Index-GOI), oral mucosa and dentition (caries, tooth wear, enamel defects) was performed. Statistical analysis was performed. Results: 40 patients with TSC received anticonvulsants. Neglected hygiene (PLI: 1.50±0.96 vs 0.92±0.72), gingival hyperplasia (50.0% vs.1.7%), gingivitis (80.7% vs. 53.4%), oral mucosal fibromas (10.0% vs. 0.0%), mucous membrane traumatic lesions (11.7% vs. 1.7%), enamel pits and hypoplasia of incisal borders (41.7% vs. 6.7%), tooth wear (35.0% vs. 11.7%) were more common in patients with TSC compared to controls; increased gingival hyperplasia was correlated with vigabatrin and levetiracetam treatment (r = 0.266 and 0.279, respectively), gingivitis was correlated with PLI (r= 0.635). Conclusions: Although gingival fibromas in TSC are independent of patient's age, young age, anticonvulsant therapy and local factors increase their severity. Enamel defects in TSC include pits, but also enamel loss on the incisal edges and tooth wear.

Oral findings in children and adolescents with Prader-Willi syndrome.

OBJECTIVE: To assess the significance of changes in the saliva in the etiology of gingivitis and tooth wear in children and adolescents with Prader-Willi syndrome (PWS). MATERIALS AND METHODS: The study included 80 (2.8-18 years old; 39 girls and 41 boys): 40 in PWS group (mean age 8.0 ± 4.24 years) and 40 in control group (mean age 7.9 ± 4.12 years). General condition, oral para-functional habits, tooth wear (modified TWI), oral hygiene and gingival status (Plaque Index (PLI) and Gingival Index (GI)), localization of gingivitis, and salivary characteristics were assessed. The chi-square test, the Mann-Whitney U test, Spearman's rank correlation, and odds ratio based on logistic regression in a statistical analysis were applied. RESULTS: Chances of gingivitis were increased by low PLI (odds ratio (OR) = 32.53), low resting salivary flow (OR = 3.96), increased viscosity of saliva (OR = 3.54), and mouth breathing (OR = 8.17). For gingivitis in anterior regions, low PLI (OR = 107.67), low resting (OR = 5.73) and stimulated (OR = 1.86) salivary flow, increased viscosity of saliva (OR = 5.87), mouth breathing (OR = 10.00), and low stimulated salivary flow (OR = 3.18) were observed. Tooth wear rates were increased by teeth grinding (OR = 16.20), mouth breathing (OR = 4.33), increased viscosity of saliva (OR = 11.67) and low resting (OR = 6.07), and stimulated (OR = 4.22) salivary flow. CONCLUSIONS: In PWS, reduced salivary secretion, increased viscosity, of saliva and mouth breathing increase the risk of plaque-induced gingivitis and tooth wear. CLINICAL RELEVANCE: The prevention and treatment of tooth wear and gingivitis in PWS patients is necessary not only to treat bruxism and mouth breathing but also to limit the influence of negative changes of saliva.

Clinical study on resin composite and glass ionomer materials in II class restorations in permanent teeth.

BACKGROUND: Glass ionomer cements (GIC) used for restoration of missing dental structures have high biocompatibility and remineralization potential. However, low mechanical resistance excludes their use for long-term restorations of extensive lesions, particularly on approximal surfaces in permanent dentition. GIC with increased viscosity have much better physical properties, which involves better bonding and wear resistance, so they can be considered as an alternative to composite resin materials. The aim of this study was to perform a clinical and radiological assessment of restorations in permanent teeth, made with an increased viscosity GIC - Equia Fil (Ivoclar Vivadent) with Equia Coat (Ivoclar Vivadent) and composite material - Tetric EvoCeram (Ivoclar Vivadent) in young patients. MATERIAL AND METHODS: A total of 100 cavities on approximal surfaces were filled with the composite material or GIC in 49 patients aged from 12.08 to 19.58 years. During control examinations, the condition of each restoration was assessed with criteria acc. to Hickel et al. Bitewing radiographs had been taken before fillings were placed and after 12 and 24 months. RESULTS: After two years of observations, two GIC restorations were replaced due to loss of retention and staining. The other 96 restorations were given a satisfactory grade. The clinical efficacy of Equia Fil after 24 months was assessed at 95.83%, the Tetric EvoCeram at 100%. The difference was not statistically significant (P=0.145). When GIC was used, there was a higher risk of marginal adaptation deterioration and the occurrence of staining and erosion. Radiographic efficacy of the Equia Fil material for cavity restoration after 24 months was assessed at 93.75%, for the Tetric EvoCeram material at 100%. Differences were not significant statistically (P=0.073). CONCLUSIONS: Tetric EvoCeram and Equia Fil used for the restoration of approximal lesions in premolars and permanent molars have similar efficacy in a 2-year period of observation. Key words:Dental restoration, permanent, composite resins, glass ionomer cements, clinical study.