Oral health behavior at age of 11–12 years predicting educational plans at age of 15–16 years

Objective. The aim was to determine if oral health-related behavior at the age of 11–12 years predicts adolescents' educational plans at the age of 15–16 years when adjusting for gender and parents' occupational level. Materials and methods. The study population consisted of all fifth and sixth graders starting in the 2001–2002 school year in Pori, Finland (n = 1691); of these, 1467 returned properly filled questionnaires on behavior (toothbrushing and consumptions of xylitol products, candies, soft drinks and sports drinks) in 2001 and on educational plans in 2005. Parents' occupational levels were reported in 2001 by one of the parents of 1352 of these children. Associations between adolescents' educational plans and their behavior, gender and parents' occupation were evaluated using logistic regression model. Results. Children's oral health-related behavior at age 11–12, gender and parent's occupational level predicted their educational plans at age 15–16. Association between educational plans and behavior, especially cumulative health behavior, remained statistically significant when controlling for gender and parent's occupation: OR = 1.4 for difference of one good habit, and OR = 5.3 for difference of five good habits. Conclusions. Since difference in oral health-related behavior can be seen already in primary school, even when controlling for parents' occupational level, polarization of adolescents may begin already in primary school stage or even earlier.     

Orbital bone fractures: 10 years’ experience at the Rome trauma centre: retrospective analysis of 543 patients

Orbital fractures are among the most frequent facial traumas. This study retrospectively analysed patients treated in Umberto I Hospital Trauma-Centre, Sapienza University of Rome from 1 January 2010 to 31 December 2020. The inclusion criteria were as follows: diagnosis of pure/impure orbital bone fracture, complete clinical and radiological records, and a minimum 12-month follow up. Gender, age, aetiology, fracture type, treatment, and associated complications were analysed using IBM SPSS Statistics, and p values of <0.05 were considered significant. In total, 1393 patients presented with orbital trauma, 543 of whom met the inclusion criteria and underwent surgery (394 males (72.6%) and 149 females (27.4%); mean (range) age 39.2 (7–90) years). Assault (n = 165, 30.4%) was the most common cause of trauma, followed by road traffic accidents and sports-related incidents. Diplopia was the major symptom at diagnosis (n = 183, 33.6%). Open reduction and internal fixation via a sub-eyelid approach was the preferred treatment, achieving a significant reduction in the functional changes induced by fracture (p < 0.05). Our data will aid future studies of maxillofacial traumatology and suggest that education and prevention measures could reduce the incidence of this type of trauma.     

Diabetes and Tooth Loss: An analysis of data from the National Health and Nutrition Examination Survey, 2003–2004

BackgroundThe authors conducted an analysis of data from the National Health and Nutrition Examination Survey (NHANES) to understand the association between diabetes and tooth loss in the United States.MethodsThe authors analyzed the oral examination and self-reported diabetes data obtained from the NHANES 2003–2004 cycle and included 2,508 participants representing a civilian, noninstitutionalized U.S. population 50 years and older. The authors calculated the prevalence of edentulism and the number of missing teeth among dentate people, and they used multiple regression analyses to assess the association between diabetes and tooth loss.ResultsThe prevalence of edentulism was 28 percent and 14 percent among people with and without diabetes, respectively. The multiple logistic regression analysis revealed that people with diabetes were more likely to be edentulous than were those without diabetes (adjusted odds ratio = 2.25; 95 percent confidence interval, 1.19–4.21). Among dentate adults, those with diabetes had a higher number of missing teeth than did adults without diabetes (mean [standard error {SE}] = 9.8 [0.67]), mean [SE] = 6.7 [0.29]); P < .01).ConclusionsThese study results revealed that adults with diabetes are at higher risk of experiencing tooth loss and edentulism than are adults without diabetes. One of every five cases of edentulism in the United States is linked to diabetes.Practical ImplicationsAlthough the association between diabetes and periodontal disease is well established, health care professionals also need to recognize the risk of tooth loss and its effect on quality of life among people with diabetes.     

The monitoring of deep caries lesions after incomplete dentine caries removal: results after 14–18 months

This paper aims to assess radiographic changes after incomplete carious dentine removal and tooth sealing. Thirty-two teeth with deep caries lesions were studied. The treatment consisted of incomplete excavation, application of a Ca(OH)₂ layer, sealing temporarily for a 6- to 7-month period and then restoration. Standardised bitewing radiographs were taken immediately after the temporary sealing and at 6- to 7- and 14- to 18-month intervals. The digitised images were analysed blind by image subtraction. The quantitative analyses subtractions were performed in the radiolucent zone (RZ) beneath the restoration and in two adjacent control areas (CA). Two cases were lost during the 6- to 7-month period (one pulp necrosis and one pulp exposure during removal of the provisional sealing). No difference (p>0.05) was observed in the radiographic density of the CA and the RZ in the two experimental periods. The mean and standard deviation (grey tonalities scale) were 129.42±5.83 and 127.65±4.67 (control areas) and 132.96±7.41 and 132.90±5.99 (RZ) for the first and second experimental periods, respectively. The radiographic density of the CA differed from the RZ (Tukey test, p<0.001). Interference in environmental conditions by partial dentine caries removal and tooth sealing arrests lesion progression, suggesting that complete dentine caries removal is not essential to control caries progression.     

Clinical evaluation of chemomechanical and mechanical caries removal: status of the restorations at 3, 6, 9 and 12 months

In this study, the clinical efficacy of Carisolv™ system and the hand excavation method in the removal of occlusal dentine caries of primary molar teeth was evaluated. Both Carisolv system and hand excavation method were applied for the removal of caries on different teeth of the same children. After the removal of the caries, Dyract AP materials were used to restore the teeth. The clinical follow-up was made every 3 months within a year. The clinical evaluations of restorations were carried out in accordance with US Public Health Service (USPHS) criteria. To determine whether there was any statistical difference between the groups, chi-square analysis was used. During both excavation methods, pain occurrence and the need for anesthesia and the time spent were all recorded. The time spent for the removal of caries in Carisolv system and in hand excavation method was 9.03±4.14 min (mean±SD) and 7.34±3.41 min (mean±SD), respectively (P>0.05). At the end of 1 year, differences between Carisolv and hand excavation groups in terms of marginal adaptation and secondary caries were found to be statistically insignificant (P>0.05). During the removal of caries, certain children complained about pain both in Carisolv system and hand excavation method (7.1 and 35.7%, respectively). As a result, it can be argued that Carisolv system is effective in the removal of caries and causes minimum level pain occurrence. Compared to hand excavation, Carisolv system seems to be a promising restorative approach to remove occlusal caries in primary molar teeth. Studies of longer duration are needed to confirm these findings.     

Adenoid cystic carcinoma of the maxillary sinus: a clinical–pathological report of 10 years of experience from a single institution

Adenoid cystic carcinoma (ACC) is the most common malignant salivary gland tumour of the maxillary sinus. The present study describes 24 cases seen over a period of 10 years at the Brazilian National Cancer Institute. Socio-demographic, clinical, pathological, and follow-up data were retrieved from the medical files for the period 1997–2006. The mean age of the patients was 51.1 years. Twenty-one (87.5%) presented advanced tumours. The main signs and symptoms found were a tumour mass (87.5%), pain (50%), nasal obstruction (25%), and epistaxis (20.8%). Most cases (62.5%) were treated with surgery and radiation therapy. Follow-up data showed two patients (8.3%) with residual disease, local recurrences in four (16.7%) patients, and distant metastasis in five (20.8%). The overall 5- and 10-year survival rates were 72.61% and 62.11%, respectively. Maxillary sinus ACC has an aggressive but indolent behaviour, typically presenting at an advanced T stage that reflects a poor prognosis for patients.     

Parental influence and the development of dental caries in children aged 0–6 years: A systematic review of the literature

ObjectiveA well established body of research documents the role of individual factors, such as biology and diet, in the aetiology of early childhood caries (ECC). Recently empirical attention has shifted to the relationships between broader ecological influences (e.g., education, ethnicity and income) and ECC; however, how such determinants interplay in the aetiology of ECC remains unclear. An intermediary mechanism that warrants greater empirical attention is parental influences. This oversight is interesting given the primacy of the parent in governing the child's proximate environment and the likelihood of the child endorsing adaptive or maladaptive health attitudes, beliefs and behaviours. The objective of this paper was to conduct a systematic review of the evidence for parental influences on the development of caries in children aged 0–6 years.DataAll studies testing associations between dental caries and socio-demographic factors, feeding practices, parent attributes, behaviours, oral health, attitudes, knowledge and beliefs in children aged 0–6 years, published between 2006 and 2011.SourceMedline, ISI, Cochrane, Scopus, Global Health and CINAHL databases.Study selectionFifty-five studies were included from an initial identification of 1805 studies.ConclusionsTo date, most research has focused on the association between caries and socio-demographic and feeding factors with few studies exploring parents’ attributes, attitudes, knowledge and beliefs, and none exploring possible pathways between the multiple layers of influences potentially accounting for how determinants of ECC operate and traverse individual, familial, community, and socio-cultural contexts. Collaboration between Psychologists and Dentists may accelerate the identification and understanding of mechanisms that underlie risk associated with ECC.     

Sealing occlusal caries lesions in adults referred for restorative treatment: 2–3 years of follow-up

The aim of this study was to assess the possibility to arrest occlusal caries lesions in adults by sealant as well as to assess the presence of radiographic progression, arrest, and regression of the sealed lesions. Seventy-two occlusal caries lesions in 52 adult patients referred to restorative treatment by senior lecturers at School of Dentistry, Copenhagen, Denmark were included. In case the patient had more than one occlusal caries lesion, randomization between sealing and restoration was made; otherwise, the lesion was sealed. In total, 60 resin sealants and 12 composite restorations were made. Follow-up period was 25–38 months (mean = 33 months). Data were analyzed using non-parametric statistics including kappa statistics. After 2–3 years, the dropout rate was 15%; two patients did not show up for control and nine previously sealed lesions were restored by the patients' general practitioners. All 12 restorations and 39 of the remaining 49 sealants were well functioning, seven (14%) sealants were repaired/replaced due to failure, and three (6%) sealed lesions were restored due to caries progression (p > 0.05). The radiographic assessment showed caries progression beneath five (10%) sealants, caries regression beneath one (2%) sealant, and unchanged depth beneath 43 (88%) sealants and all restorations (p > 0.05). The majority of the referred lesions were successfully arrested by sealants, indicating the possibility for extending the criteria for sealing occlusal caries lesions in adults. However, a longer observation period is needed for final conclusion. Extending the criteria of therapeutic sealing of occlusal caries lesions in adults will lead to increased dental health.     

Determinants for craniofacial pains in children 6–8 years of age: the PANIC study

Objective: Determinants for orofacial pain, headache, morning headache and painful signs of temporomandibular disorders (TMD) were investigated in prepubertal children.

Material and methods: The participants were a population sample of 439 children aged 6–8 years. Craniofacial pains, eating meals and snacks, sleep bruxism, sleep quality, sleep-disordered breathing (SDB), psychological well-being, parental education and household income were assessed by questionnaires filled out by the parents. Sleep duration was assessed using a combined heart rate and movement sensor and clinical signs of TMD and dental occlusion by a dentist. The determinants of pain conditions were analyzed using logistic regression.

Results: Of all 439 children, 26% had experienced orofacial pain and 31% headache during the past 3 months, 17% had suffered morning headache weekly and 13% had painful signs of TMD in a clinical examination. Restless sleep was associated with increased risk of orofacial pain, the painful signs of TMD and restless sleep with increased risk of headache and restless sleep, sleep bruxism and skipping meals with increased risk of morning headache after adjustment for other independent determinants of these pain conditions. Headache was associated with increased risk for painful signs of TMD.

Conclusions: Craniofacial pains are common among prepubertal children. Prepubertal children with sleep bruxism, restless sleep and skipping meals have increased likelihood of craniofacial pains.     

The prevention of dental caries and periodontal disease from the cradle to the grave: what is the best available evidence?

Increasing weight is being given to applying an evidence-based approach to clinical practice. There is evidence to support a range of preventive measures which the profession and patients can apply to maximize the control of caries and periodontal disease. This paper examines the strength of evidence to support the advice and procedures that may be used by dental professionals to provide an effective preventive programme of advice and procedures for patients of all ages. A hierarchy of evidence is used ranging from Cochrane Reviews at the top, observational studies in the middle, and opinion at the bottom. Whilst the evidence to support preventive advice and procedures in children and adolescents is relatively strong, few studies have been conducted in adults and the elderly.     

Prevalence and incidence of oromandibular dystonia: an oral and maxillofacial surgery service–based study

Objectives

Oromandibular dystonia is a focal dystonia characterized by sustained or intermittent contractions of the masticatory and/or tongue muscles. This epidemiological study aimed to estimate the prevalence and incidence of oromandibular dystonia in Kyoto (population: 1,465,701).

Materials and methods

The population sample was citizens of Kyoto who visited our department between 2015 and 2019 and were differentially diagnosed by an oromandibular dystonia specialist having idiopathic (primary) and acquired (secondary) oromandibular dystonia. A total of 144 patients (100 women and 44 men; mean age, 57.5 years) were analyzed for clinical features, and the prevalence (prevalence date, January 1, 2020) and annual incidence were estimated.

Results

The male-to-female ratio was 1:2.3 (p<0.001). Age at onset was significantly (p<0.01) earlier in men (47.5 years) than that in women (56.9 years). The crude prevalence of oromandibular dystonia was estimated at 9.8 per 100,000 persons (95% confidence interval: 8.3–11.6) (idiopathic dystonia, 5.7 [4.6–7.1]; tardive dystonia, 3.4 [2.5–4.5]) and incidence at 2.0 (1.3–2.8) per 100,000 person-years (idiopathic dystonia, 1.2 [0.68–1.9], tardive dystonia, 0.68 [0.32–1.3]). The prevalence was 13.0 (10.5–15.8) in women and 6.3 (4.6–8.5) in men. All age groups showed female predominance. The highest prevalence was 23.6 (14.4–36.5) in women aged 60–69 years.

Conclusions

As this is an oral and maxillofacial surgery service–based study, the actual prevalence of oromandibular dystonia may be even higher.

Clinical relevance

It was suggested that oromandibular dystonia might be more common than cervical dystonia or blepharospasm.

     

Comparison of incidence of complications and aesthetic performance for posterior metal-free polymer crowns and metal–ceramic crowns: Results from a randomized clinical trial

Objectives

The purpose of this randomized clinical study was to evaluate the clinical performance of posterior, metal-free polymer crowns after follow-up for up to six years, and to compare it with the performance of metal–ceramic crowns.

Methods

Eighty single crowns, manufactured from a polymer composite resin, were set on posterior teeth. Half of these received a glass–fibre framework (group 1) whereas half were prepared without framework stabilization (group 2). As the control group, 40 conventional metal–ceramic crowns were inserted. Primary endpoints were incidence of complications, investigated on a time-to-event basis, plaque status, and aesthetic performance.

Results

Thirty clinically relevant complications occurred after a median time of 2.3 years. Median follow-up time was four years. The most frequent complications were delamination (n = 24) and root-canal treatment (n = 4) of the crowns; the incidence of complications was not significantly different among crown materials (p = 0.60). Twenty crowns had to be replaced (six polymer crowns in group 1, nine polymer crowns in group 2, four crowns in the control group, and one tooth (in group 1) had to be extracted). Mean plaque and gingival indexes for the test groups did not differ from those for the control group.

Conclusions

Within a median follow-up period of four years, the clinical performance of posterior polymer crowns with and without a glass–fibre framework was not significantly different from that of metal–ceramic crowns, although the number of catastrophic failures of composite crowns was higher than that of the metal–ceramic crowns.

Clinical significance

On the basis of the study results, posterior polymer crowns may be an alternative to metal–ceramic crowns, although additional research is needed before they can be recommended, without reservation, as permanent restorations.     

National Study of Adult Oral Health 2017–18: participation and representativeness

The National Study of Adult Oral Health (NSAOH) 2017–18 collected information from a sample of the Australian population aged 15 years and over. The Study comprised an interview questionnaire, completed by telephone or online, and an oral epidemiological examination among dentate participants. Participation in the Study was voluntary and therefore relied on the goodwill of selected participants. This paper provides a summary of participation rates for the Interview and Examination phases of the study. The potential for biased population estimates due to variation in participation rates is explored. The weighting procedure implemented to ensure the sample is representative of the target population is described and a comparison of the estimated population distributions derived from the weighted sample and the actual population distributions is provided for a range of socioeconomic characteristics. In summary, it can be concluded that estimates derived from the weighted Interview and Examination samples are valid estimates of the Australian population aged 15 years and over.