Oral health in children and adolescents with haemophilia.

INTRODUCTION: Bleeding disorders are certainly one of the most difficult health conditions among health professionals. The haemophilia requires special care in dentistry mainly due to highly vascularized oral cavity. AIM: The objective of this study was to determine oral health conditions of children and adolescents with haemophilia at a haematology centre. METHODS: The sample was composed of 40 children and adolescents aged 1-18 years. Data collection occurred by means of a questionnaire about social and economical conditions, and an examination of the oral cavity. The decayed, missing and filled deciduous teeth (dmft), decayed, missing and filled permanent teeth (DMFT) and gingival bleeding (allows the determination of gingival bleeding) epidemiological indexes were evaluated. RESULTS: When evaluating caries experience, the mean value for the dmft index was 3.4 for the deciduous dentition, DMFT score of 0.9 for mixed-dentition, and 2.9 for permanent dentition. The mean value for the gingival bleeding index was similar in all three phases of development, showing a mean value of 1.74. CONCLUSION: The majority of the children and adolescents demonstrated unsatisfactory oral health.

Biocompatibility of root filling pastes used in primary teeth.

AIM: To evaluate the biocompatibility of two pastes designed to fill the root canals of primary teeth. METHODOLOGY: A study group of 54 mice received subcutaneous tissue implants of polyethylene tubes containing CTZ or calcium hydroxide paste or, as a negative control, empty tubes. Biocompatibility was evaluated on days 7, 21 and 63, yielding a total of nine groups of six animals each. Following the experimental intervals, the implant areas were removed and subjected to histologic processing. After the tissues were stained with HE and Masson trichrome, two pathologists performed a histologic analysis of the samples in a blinded manner. Collagen fibre formation, tissue thickness and inflammatory cell infiltration were analysed qualitatively. Quantitative morphometry was performed for the thickness, perimeter length and tissue area of the region in direct contact with the open tube. anova with the Tukey post-test and Kruskal-Wallis analysis followed by Dunn's post-test, with significance established as P < 0.05, were used for data analysis. RESULTS: At 7 days, all groups had severe acute inflammatory infiltrates. Inflammation was reduced at 21 days in the CTZ paste group. Mild chronic inflammatory infiltrates were observed after 63 days in the CTZ and Ca(OH)2 paste groups; these groups also showed a significant decrease in collagen fibre density (P < 0.05), which was not observed in the control group. The average tissue thickness, perimeter length and area in contact with the tube decreased during the experimental periods in all groups. CONCLUSION: The CTZ and calcium hydroxide pastes demonstrated biocompatibility with subcutaneous tissue in this experimental model.

Treatment of a crown-root fracture with intentional replantation - case report with 16-year follow-up.

AIM: To report the intentional replantation of a maxillary central incisor with a crown-root fracture. SUMMARY: An 11-year-old girl was referred to a paediatric clinic with an extensive crown-root fracture of the maxillary right central incisor (tooth 11) with pulp exposure. Radiographs revealed that tooth 11 had a periapical radiolucent lesion, which suggested pulpal necrosis. The treatment option chosen was planned extraction and immediate intentional replantation of tooth 11 in a more coronal position. Sixteen years after treatment, tooth 11 was aesthetically and functionally sound, suggesting that the treatment was successful. KEY LEARNING POINT: Intentional replantation may be considered as a treatment option for teeth with crown-root fractures.

Oral koilocytic dysplasia: long-term clinical control. A case report.

Leukoplakia, a common lesion in the oral cavity, is considered a premalignant lesion that can develop into carcinoma. In 1986, a group of pathologists described a variant of epithelial dysplasia and named it "koilocytic dysplasia" (KD). This article presents a case of KD that was identified for 12 years as "carcinoma in situ". Even after removal of the lesion, it recurred with no signs of malignancy. The histopathological findings revealed all of the signs of KD (koilocytosis, acanthosis, multinucleated keratinocytes and atypical mitoses). Liquid-based cytology and hybrid capture were performed to confirm the diagnosis. Despite a professional recommendation to have the lesion removed surgically, the patient chose periodic clinical control. The mechanism of HPV transmission in the oral cavity still remains partially unknown. Additional studies on this subject are required to better understand the role of HPV in cell transformation in the oral cavity.