Oral health status and its relation with medication and dental fear in children with attention-deficit hyperactivity disorder.

OBJECTIVE: The objective of this study was to determine the ora-dental health and its relation with medication and dental fear in a group of Turkish children with attention-deficit hyperactivity disorder (ADHD). SUBJECTS AND METHODS: The levels of dental fear of children were determined with The Dental Subscale of Children's Fear Survey Schedule (CFSS-DS). The oral and dental health evaluation was performed. This study included a total of 117 children aged between 6 and 15 years and they were examined under two groups as "ADHD" (n = 59) and "Control" (n = 58). Ora-dental health variables were compared between the groups and were also analyzed in accordance with dental fear and medication. RESULTS: ADHD children and the control group exhibited similar CFSS-DS scores (15-32). No significant differences existed in df(t)/df(s), DMF(T)/DMF(S), d/D values, and presence of the white spot lesions. ADHD children's Mutans streptococci and Lactobacillus quantities were found significantly higher than the control group. The incidence of parafunctional habits of the ADHD children was also found high. CONCLUSIONS: ADHD children that were medicated exhibited similar dental caries prevalence and periodontal health status. Although ADHD group had similar dental-periodontal health status and dental fear level with the control group and using ADHD medicines did not make a significant effect on the ora-dental health parameters, the patients should be carefully followed up because they were categorized in high caries risk groups.

Activity of dental pulp cells in semisolid 3D cultures initiated by transforming growth factor-ß1 and bone morphogenetic protein 2, 4.

The intention of this study was to investigate the effect of modified 3D culture conditions on dental pulp cells (DPCs). DPCs were isolated from extracted primary molar, premolar, and wisdom teeth. Tooth samples were divided into three groups as control group; plated into methyl cellulose medium without any supplementation, growth factor (GF) group; supplemented with bone morphogenetic proteins (BMP2, BMP4), transforming growth factor—β1 (TGF—β1) and growth factor+conditioned medium (GF+CM) group; supplemented with both growth factors and pulp conditioned medium. The DPCs were tested for colony forming ability, proliferation capacity and morphology. The highest colony forming ability was detected in the GF and GF+CM groups of DPCs isolated from wisdom teeth. The proliferation capacity was higher in GF+CM group of DPCs isolated from primary molars, and in GF and GF+CM groups of DPCs isolated from wisdom teeth. Scanning electron microscope (SEM) observation of the wisdom teeth samples showed cell—cell interactions in the GF and GF+CM groups. Our results indicate that growth factors and pulp conditioned medium in methyl cellulose culture created proper environment to follow the behavior of dental cells three—dimensionally.

Factitial (self-induced) gingival disease: four case reports.

Bizarre-appearing gingival recessions that do not correspond to any known gingival disease or oral manifestation of any known systemic disease are called factitial (self-induced) gingival disease. Psychological factors are very important in their etiology. Generally, the lesions occur during the time the child is experiencing stress associated with the frustration of his or her dependency needs. Four cases of self-induced gingival recessions involving children aged 4 to 6 years are presented and investigated from the pedodontic, periodontologic, and psychiatric viewpoints.

Artificially formed caries-like lesions around Class II glass ionomer restorations in primary molars.

The aim of this study was to investigate the microleakage around Class II glass ionomer restorations in primary molars. Two different glass ionomer cements and one amalgam control were assessed in vitro by acidified gel technique. Assessment of caries-like lesions was performed using polarized light microscopy. The traditional glass ionomer (Chemfil II) with dentin conditioner provided the highest protection against caries attack and the amalgam restorations provided the least.

Surface texture and enamel-restoration interface of glass ionomer restorations.

The aim of this study was to investigate the surface texture and enamel-restoration interface of Class II glass ionomer restorations in primary molars. A traditional (Chemfil II), a cermet (Chelon-Silver) cement and two light cured glass ionomer cements (Vitremer and Dyract) were used to restore the Class II cavities of 20 primary molars. The surface changes and enamel-restoration interface of restorative materials were evaluated by SEM, after a 12 month period. Microcracks and pores in surface were observed in all of the four different glass ionomer materials. Although, there was no marginal gap formation for Chemfil II, Chelon-Silver and Dyract samples, in 2 samples of Vitremer group gap formation was found with an ion-exchange layer. Also, in Dyract samples wear of restorations was considerable.

Hyper-IgE syndrome: a case report.

The hyper-IgE syndrome (HIES) is a rare disorder characterized by pruritic dermatitis, recurrent Staphylococcus skin abscesses and extremely elevated levels of IgE in serum. In this report, an eleven-year-old-boy with hyper-IgE syndrome is presented. He had a coarse facial appearance, pruritic dermatitis, recurrent skin abscesses, pulmonary infection, a reduced rate of resorption of the roots of primary teeth and an elevated serum IgE concentration. The colonization of Candida albicans, Kiebsiella pneumoniae, Escherichia coli and Staphylococcus aureus were found as; (1x10(2) CFU), (2.2x10(4) CFU), (2.2x10(4) CFU) and (2.6x10(3) CFU) per ml saliva, respectively. Also the pulp of a deciduous molar was investigated with light and transmission electron microscope (TEM). As conclusion, treatment for this condition is lifelong administration of therapeutic doses of a penicillinase-resistant penicillin, with the addition of other antibiotics or anti-fungal agents as required for specific infections.

The effect of bone marrow transplantation on systemic and oral health in Fanconi's aplastic anemia.

Fanconi's anemia (FA) is an autosomal-recessive disorder characterized by a progressive pancytopenia, diverse congenital abnormalities and increased predisposition to malignancy. Sixteen children with FA, aged between 4 to 16 were divided into two groups according to treatments. Nine children had bone marrow transplantation and seven children were treated with steroid and/or anapolan. The changes in dental caries, caries-associated microflora, salivary status and periodontal health were investigated in children with FA. Data were analyzed by one-way ANOVA. A statistically significant difference was found in hematological findings between children who have received bone marrow transplantation (BMT+) and the others, who have not received (BMT-). There was no significant difference in dental caries experience, salivary flow rate, buffering capacity, mutans streptococci and Lactobacilli levels between the study groups. A statistically significant difference was found in gingival index, plaque index, bleeding on probing, probing depth scores between the patients with FA in BMT(+) and BMT(-) groups (p<.05). In conclusion, besides systemic control, additional preventive measures during their whole life to maintain oral health is necessary in these children.

Acute lymphoblastic leukemia: dental health of children in maintenance therapy.

The dental health of 41 children aged 4-16 years who were in maintenance therapy from acute lymphoblastic leukemia (ALL) was examined in relation to the period of time in maintenance. There was no significant difference in dental experience and salivary flow rate between the control group and patients with leukemia. Performed treatment index (PTI) and required treatment index (RTI) scores reflected that children, who were in maintenance therapy had insufficient dental care and needed more dental treatments. A statistically significant difference in salivary pH was found between the children, who were in maintenance therapy for 12-24 months and less than 12 months and also the control group; but the pH scores of all groups were observed in normal limits.

Effects of folk medicinal plant extract Ankaferd Blood Stopper(®) in vital primary molar pulpotomy.

AIM: To compare the clinical and radiographic success rates of two vital pulpotomy agents: formocresol (FC) and Ankaferd Blood Stopper(®) (ABS), in primary molars during a 12-month follow-up period. STUDY DESIGN: A randomised, single-blind study design was used in a sample of 30 healthy 6-9 year old children with 60 carious primary molars without clinical or radiographic evidence of pulp degeneration. METHODS: The pulpotomy agents were assigned as follows: Group 1 was 1:5 diluted Buckley's formocresol (FC) and Group 2 was ABS. Clinical and radiographic follow-up at 3, 6, and 12 months used the following criteria: pain, swelling, sinus tract, mobility, internal root resorption, and furcation and/or periapical bone destruction. STATISTICS: The data were analysed using Chi-square tests. RESULTS: The clinical and radiographic evaluation at 3 months revealed total success rates of 100% in the FC and ABS groups. Success rates in FC and ABS groups at 6 months were 96.7% and 93.3% respectively. At the 12-month follow-ups, the total success rates in the FC, and ABS groups were 89.3% and 85.7%, respectively. When the groups were compared according to the time intervals, no significant differences were observed between the 3, 6, and 12 month values. The success rates of the materials decreased over time. CONCLUSIONS: FC and ABS were found successful as pulp dressings in primary molars. ABS appears to be an alternative pulpotomy agent but periodical follow-ups must be considered to evaluate long term success rates.

Case Series: root healing with MTA after horizontal fracture.

BACKGROUND: Root fractures in permanent teeth are uncommon injuries and represent complex healing patterns. Fractures occur most often in the middle third of a root and rarely at the apical third. CASE REPORTS: Case 1: A 10- year old boy attended the Dept. Paediatric Dentistry Clinic (Istanbul University) after an accident at school 4 hrs earlier. Clinically there was a swollen upper lip, pain on the periapical region of the tooth and horizontal root fractures in the middle third of both roots of teeth 11 and 21 were noted on periapical radiography. Case 2: An 8-year old boy was involved in a bicycle accident 3 months prior to attending. A maxillary splint was present on incisor 11. Clinically an enamel-dentine crown fracture and radiographically a horizontal mid-third root fracture, were seen. Case 3: An 11-year old boy attended after a bicycle accident 1 month before, involving tooth 21. Clinically there was mobility, slight discolouration and radiographically a horizontal mid-third root. TREATMENT: In all cases only the coronal segment of roots were treated and MTA was placed as a fracture line plug. FOLLOW-UP: At 36 months follow up all teeth were asymptomatic and clinical and radiographic investigation of the teeth revealed excellent healing patterns. CONCLUSION: MTA can be considered as a good choice for a definitive root filling material in horizontal tooth root fractures with excellent biological and physical properties.