The <Emphasis Type="Italic">Candida</Emphasis> species that are important for the development of atrophic glossitis in xerostomia patients

Background

The purpose of this study was to clarify the species of Candida that are important for the development of atrophic glossitis in xerostomia patients.

Methods

A total of 231 patients with subjective dry mouth were enrolled in the present study. Logistic regression analysis was performed to clarify the contribution of each Candida species and other variables to the development of atrophic glossitis. The dependent variable was the absence/presence of atrophic glossitis. The Candida colony-forming units (CFU) of C. albicans, C. glabrata, C. tropicalis, and C. krusei, as well as age, gender, resting (RSFR) and stimulated (SSFR) whole salivary flow rate, and denture-wearing status, were treated as explanatory variables.

Results

Logistic regression analysis showed that two factors were closely associated with the presence of atrophic glossitis: an increase in C. albicans CFU and a decrease in the SSFR.

Conclusions

C. albicans, but not non-albicans Candida, was associated with atrophic glossitis in xerostomia patients who had no systemic predisposing factors, indicating that C. albicans remains a treatment target for Candida-related atrophic glossitis.

     

Prevention in kindergartens with 500 ppm fluoride toothpaste—a randomized clinical trial

Objectives

The aim of the study was to evaluate the effect of an intensified preventive programme in kindergartens.

Materials and methods

Two thousand two hundred twenty-eight 2- to 4-year-old children attending kindergartens in two counties in northern Hesse were randomly allocated to two groups. Children in the test group participated in daily tooth brushing with 500 ppm fluoride toothpaste, which was supervised by specially trained dental nurses. Children in the control group received tooth brushing instructions three to four times a year. Caries experience was recorded using WHO criteria. The basic survey was performed from October 2006 to April 2007, with the final examinations between March and July 2009. The statistical evaluation was performed by means of the software package SPSS 17.0. To compare the mean Δdmf values of the test and control groups, Mann-Whitney U tests were performed.

Results

Two thousand one hundred twelve children (test group, 1096; control group, 1048) participated in the final examinations. The caries increment of the test group (Δdmf-s?=?1.55) was 24 % lower than the increment of the control group (Δdmf-s?=?2.02, p?=?0.043). Based on Δdmf-t values, the corresponding figures were 0.79 for the test group and 1 for the control group (p?=?0.44). High increment values (Δdmf-s >7) were observed in the control group twice as often as in the test group.

Conclusion

The results show that an intensified preventive programme in kindergartens, based on supervised daily tooth brushing, has a positive effect on the dental health of preschool children.

Clinical relevance

It is sufficient to offer such programmes in socially deprived areas.

     

Comparison of efficacy of tray-delivered carbamide and hydrogen peroxide for at-home bleaching: a systematic review and meta-analysis

Objectives

The aim of the study was to compare the color change produced by tray-delivered carbamide peroxide [CP] versus hydrogen peroxide products [HP] for at-home bleaching through a systematic review and meta-analysis.

Materials and methods

MEDLINE via PubMeb, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature database (LILACS), Brazilian Library in Dentistry (BBO), and Cochrane Library and Grey literature were searched without restrictions. The abstracts of the International Association for Dental Research (IADR) and unpublished and ongoing trial registries were also searched. Dissertations and theses were explored using the ProQuest Dissertations and Periodicos Capes Theses databases. We included randomized clinical trials that compared tray-delivered CP versus HP for at-home dental bleaching. The color change in shade guide units (SGU) and ΔE were the primary outcomes, and tooth sensitivity and gingival irritation were the secondary outcomes. The risk of bias tool of the Cochrane Collaboration was used for quality assessment.

Data

After duplicate removal, 1379 articles were identified. However, only eight studies were considered to be at “low” risk of bias in the key domains of the risk bias tool and they were included in the analysis. For ΔE, the standardized mean difference was ?0.45 (95 % CI ?0.69 to ?0.21), which favored tray-delivered CP products (p?<?0.001). The color change in ΔSGU (p?=?0.70), tooth sensitivity (p?=?0.83), and gingival irritation (p?=?0.62) were not significantly different between groups.

Conclusions

Tray-delivered CP gels showed a slightly better whitening efficacy than HP-based products in terms of ΔE, but they were similar in terms of ΔSGU. Both whitening systems demonstrated equal level of gingival irritation and tooth sensitivity.

Clinical significance

Tray-delivered CP gels have a slightly better whitening efficacy than HP-based products in terms of ΔE. This should be interpreted with caution as the data of ΔSGU did not show statistical difference between the products.

     

<Emphasis Type="Bold">S</Emphasis>hort fibre-reinforced composite for extensive direct restorations: a laboratory and computational assessment

Objectives

The objective of the study was to evaluate the effectiveness of a short fibre-reinforced composite (FRC) applied in combination with a conventional filler composite (CFC) on the fatigue resistance, fracture strength, failure mode and stress distribution, for restorations of premolars under two loading angles.

Material and methods

Thirty-two inferior premolars received extensive cavities with removal of the lingual cusp. Teeth were restored directly using ‘FRC (EverX Posterior, GC) + CFC (G-aenial, GC)’ or ‘CFC only’ and received two fatigue/fracture loadings at two different angles (0°/45°) (n = 8). Data were submitted to two-way ANOVA (α = 5 %) and Tukey test. Failure mode was analysed using SEM. Four 3D finite element (FE) models were constructed and static, linear and elastic analyses were performed. Maximum principal and von Mises stresses were evaluated.

Results

All specimens survived the mechanical fatigue simulation. No statistical difference in fracture resistance was recorded between FRC + CFC and CFC only, considering both loading angles (p = 0.115). However, the 0° loading showed a statistical significant higher strength than the 45° loading (p = 0.000). Failure mode analysis revealed more repairable fractures upon 0° loading, versus more root fractures (unrepairable) upon 45° loading. FE revealed a higher amount of stress upon 45° loading, with tensile stress being imposed to the lingual cervical area.

Conclusion

The fracture strength was not increased using the FRC. Loading at a 45° decreased significantly the fracture resistance.

Clinical relevance

The restoration of extensive cavities in posterior tooth is a challenge for the clinicians and the choice of the material that increases the fracture strength of tooth-restoration complex is required.

     

Internal derangement in the temporomandibular joint of juveniles with clinical signs of TMD

Aim

The aim of this study was to investigate possible correlation of specific skeletal or dental class in children and adolescents with clinical signs of temporomandibular dysfunction (TMD) with the severity of internal derangement (ID) of the temporomandibular joint.

Materials and methods

Based on MRI images, the ID of 232 juvenile temporomandibular joints in 116 patients were retrospectively recorded. The distribution of the ID stages within the skeletal and dental classes was compared by means of the χ ² test.

Results

Excluding the comparison between skeletal Class I (S I) and skeletal Class II (S II; p < 0.05), no statistically significant differences in the distribution of the ID stages were found between the skeletal classes (p > 0.05). No statistically significant differences were found when comparing the distribution of the ID stages between the dental classes (p > 0.05).

Conclusion

According to these findings, there is no skeletal or dental class that is related to higher degrees of internal derangement in the TMJs of children and adolescents presenting clinical signs of TMD. Therefore, it is not possible to draw conclusions about the severity of the ID in relation to the dental and skeletal class in symptomatic juvenile TMJs.

     

Occurrence of oral <Emphasis Type="Italic">Candida</Emphasis> colonization and its risk factors among patients with malignancies in China

Objectives

Oral colonization of Candida could lead to later development of oropharyngeal candidiasis or candidemia among the immunocompromised patients. This study aims to describe the occurrence and risk factors of oral Candida colonization in patients with malignancies.

Materials and methods

From October 2012 to March 2013, 78 patients with pulmonary cancer (group I), 101 patients with gastrointestinal tract tumor (group II), 79 patients with hematopoietic system malignant tumor (group III), and 101 healthy controls were consecutively recruited in a hospital in Beijing, China. The oral rinse samples were taken and Candida species were identified; the enzymes activities were tested.

Results

In total, 110 and 27 Candida strains were isolated from 91 patients and 26 controls, respectively. The oral colonization rate with Candida albicans in group III (12.7 %) was significant lower than that in group I (30.8 %), group II (33.7 %), and control group (25.7 %). The oral colonization rates with non-albicans Candida species in group I, group II, and group III were 15.4, 10.9, and 12.7 %, respectively, while only one non-albicans Candida strain was identified in control group. The non-albicans Candida species exhibited a lower virulence than C. albicans. Age was an independent risk factor for Candida colonization in patients with pulmonary cancer and digestive tract malignant tumor, “Teeth brush <1 time/day” was an independent risk factor for Candida colonization in patients with hematopoietic system tumor.

Conclusions

The differences of risk factors for oral Candida colonization in patients with different cancers require different strategies for the prevention and control of Candida infection.

Clinical relevance

Old aged patients with pulmonary cancer and digestive tract malignant tumor are high-risk population for Candida colonization. Increasing frequency of teeth brush might be helpful for preventing Candida colonization.

     

Comparison of digital dental images yielded by digital dental casts,cone-beam computed tomography,and multislice computed tomography for measurement of dental area

Objectives

We investigated and compared the errors generated by multislice computed tomography (MSCT), cone-beam computed tomography (CBCT), and digital dental casts when used to provide digital data about dental structures.

Methods

Ten A20 skull models were scanned with MSCT and CBCT, and dental plaster cast models were optically scanned in three dimensions. The maxillary dental area was then compared. The distance between the three-dimensional scan data of the skull and each set of digital dental data were measured. Reference data were then overlapped with the experimental digital model using surface-based registration. The distance of errors was measured with the shortest distance measurement function. The distances between each experimental digital model and the reference scan data were measured, and error values were determined for all maxillary teeth and each tooth surface area. Errors were measured for all teeth from the central incisors to the second molar on both the left and right sides. Errors were measured from the mesial, distal, and labial surfaces and the tooth cusp tip area for each tooth.

Results

The digital dental casts had the smallest error (p < 0.001). The error in the digital dental casts (mean ± standard deviation) was 0.10 ± 0.12 mm. The CBCT error was 0.34 ± 0.38 mm, which was significantly greater than the MSCT error (0.19 ± 0.16 mm) (p < 0.001).

Conclusions

We recommend the use of digital dental casts with digital dental imaging for three-dimensional measurement of the dental area because this technique had the smallest errors.

     

Knowledge,perceptions, and clinical experiences on molar incisor hypomineralization among dental care providers in Hong Kong

Background

Molar incisor hypomineralization (MIH) is an alarming problem with considerable challenges in management. This study aimed to evaluate and compare the knowledge, perceptions, and clinical experiences of molar incisor hypomineralization (MIH) between general dental practitioners (GDPs) and paediatric dentists (PDs) in Hong Kong.

Methods

A cross-sectional survey of 557 randomly selected GDPs (approximately 25% of all registered dentists) and all registered PDs (n?=?31) were invited. They were asked to complete a 4-section questionnaire adapted and modified from a study by Gambetta-Tessini and co-workers on sociodemographic profiles, knowledge, experience, and perceptions regarding MIH. Data were analyzed with chi-square, Fisher’s exact, and multiple factor ANCOVA tests.

Results

The overall response rate was 43.37% (255/588). Majority (74.1%) of the respondents encountered MIH in their practices. A significantly higher mean knowledge score (46.33?±?7.1) was observed among PDs than GDPs (43.09?±?7.0) (P?<?0.01) and among PDs who are 40?years old or younger (P?<?0.001). Differences in treatment of MIH were also observed between PDs and GDPs (P?<?0.05). Paediatric dentists were more confident in diagnosing and treating MIH (P?<?0.001). Most respondents (87.8%) expressed a need for continuing education on MIH.

Conclusion

Continuing education on MIH is needed to assure that the highest quality of evidence-based care is given to patients with MIH. Dissemination of latest best evidence on MIH, especially to GDPs, will assure that the condition is accurately diagnosed and well managed.

     

Comparative cone-beam computed tomography evaluation of the osseous morphology of the temporomandibular joint in temporomandibular dysfunction patients and asymptomatic individuals

Objective

We examined the bone components of the temporomandibular joint (TMJ) in asymptomatic individuals and patients with temporomandibular dysfunction (TMD) using cone-beam computed tomography (CBCT).

Methods

Two hundred asymptomatic individuals and 200 patients with TMD were included in this study. Condyle position, eminence height, eminence inclination, condyle shape, and fossa shape were assessed on CBCT images of the 800 temporomandibular joints.

Results

The eminence inclination (P?<?0.05), eminence height (P?<?0.0001), mediolateral width of condyle (P?<?0.0001), and anterior joint space (P?<?0.0001) were significantly greater in male subjects compared with female subjects in both the asymptomatic group and TMD group. Comparisons of the asymptomatic group and TMD group revealed significant differences in the anterior joint space (P?<?0.0001), ratio of anterior joint space to posterior joint space (P?<?0.001), posterior joint space (P?<?0.05), eminence inclination (P?<?0.05), eminence height (P?<?0.05), condyle shape (P?<?0.0001), and fossa shape (P?<?0.05).

Conclusions

The present analyses suggest that a steeper articular eminence inclination may be risk factor for TMD. The presence of TMD was associated with the condyle position in the TMJ.

     

Phosphorylated epidermal growth factor receptor expression and <Emphasis Type="Italic">KRAS</Emphasis> mutation status in salivary gland carcinomas

Objectives

Salivary gland carcinomas (e.g., adenoidcystic carcinoma or mucoepidermoid carcinoma) are rare and often unresectable head and neck tumors. They are also weakly affected by most chemotherapeutic drugs, which emphasize the need for further studies on this topic. In clinical practice, various drugs target the well-characterized EGFR pathway in many epithelial tumors. There is limited reliable data on phophorylated EGFR expression, such as activated conformation, in salivary gland tumors.

Materials and methods

This study investigates the pEGFR expression in salivary gland carcinomas (n = 43). Three different carcinoma varieties, that represent >50 % of all salivary gland tumors, were included: adenoidcystic carcinoma (n = 23), mucoepidermoid carcinoma (n = 17), and adenocarcinoma NOS (not otherwise specified) (n = 3). The specimens were investigated by immunohistochemistry. Additionally, mutations of KRAS oncogene were screened with gene sequencing. The findings were correlated with clinical data by using SPSS.

Results

In 34 out of 43 specimens (79 %), a positive staining for pEGFR was found. Sex, tumor entity, tumor site, and grading had no significant correlation with pEGFR expression. A weak correlation was found for tumor size and pEGFR expression. Significant correlations were found for pEGFR expression with patient’s age and lymph node metastasis (pN). No specimen showed a KRAS mutation in codon 12 or 13.

Conclusion

Salivary gland carcinomas show a high expression of pEGFR. This high expression correlates with lymph node metastasis, which supports the hypothesis that a high pEGFR expression facilitates lymphogenous metastasis. Due to this pEGFR expression, status may be a negative predictive factor in salivary gland carcinoma diagnostics. Patients with pN-positive salivary gland cancer may benefit from EGFR-inhibiting drugs.

Clinical relevance

The EGFR pathway may be a potential target for chemotherapy of advanced unresectable salivary gland carcinomas.

     

Comparison of Efficacy of Transalveolar Screws and Conventional Dental Wiring Using Erich Arch Bar for Maxillomandibular Fixation in Mandibular Fractures

Introduction

Maxillomandibular fixation is required in nearly all cases of facial fractures which can be achieved by conventional dental wiring techniques or newer methods using transalveolar screws.

Material and Methods

A prospective randomized clinical study divided into two groups with thirty adult patients each with mandibular fractures was undertaken comparing the Maxillomandibular fixation technique using transalveolar screws and Erichs arch bar. Total time taken, rate of glove perforation, intraoperative and postoperative complications were noted in both the groups.

Results

The time taken for maxillomandibular fixation in minutes and rate of glove perforation was found to be statistically significantly less for transalveolar group compared to arch bar group (p < 0.05). However, there was no significant difference found in the oral hygiene and gingival status using the Glass index and Gingival index. The rate of screw breakage (04.67%), wire breakage (05.12%), non-vitality due to iatrogenic dental damage (01.66%), soft tissue injury and tooth loss were some of the noted complications during the study.

Conclusion

We found that transalveolar group offered advantages like less time taken with a definite decreased risk of percutaneous injury, while the iatrogenic complications like dental damage can be reduced by taking adequate precautions.

     

Clinical evaluation comparing the fit of all-ceramic crowns obtained from silicone and digital intraoral impressions

Objectives

The aim of this study is to compare the fit of all-ceramic crowns fabricated from conventional silicone impressions with the fit of all-ceramic crowns fabricated from intraoral digital impressions.

Methods

Twenty patients with 26 posterior teeth with a prosthetic demand were selected for the study. Two crowns (Straumann-Zerion) were made for each preparation. One crown was fabricated from an intraoral digital impression system (IDI group; Cadent-iTero), and the other crown was fabricated from a conventional one-step silicone impression (CI group; Express Penta Putty and Body Light). To replicate the interface between the crown and the preparation, each crown was cemented on its corresponding clinical preparation with ultra-flow silicone (Express Ultra Light Body). Each crown was embedded in resin to stabilize the registered interface, cut in 2-mm-thick slices in a buco-lingual orientation. Internal misfit was measured in microns using stereomicroscopy with a magnification of ×40. Measurements were taken at different landmarks: margin, chamfer angle, axial, crest, and occlusal fosse. After checking for normality, data was analyzed using paired Student’s t test (α?=?0.05).

Results

Fit values were significantly affected by the impression technique (p?=?0.000). Mean internal misfit and mean marginal misfit were 111.40 μm (SD?=?54.04)/80.29 μm (SD?=?26.24) for the crowns of the IDI group and 173.00 μm (SD?=?92.65)/133.51 μm (SD?=?48.78) for the CI group.

Conclusion

All-ceramic crowns fabricated from intraoral digital impressions with parallel confocal technology demonstrated a clinically acceptable internal and marginal fit as conventional impression.

Clinical significance

Intraoral digital impressions as initial step to the digital workflow could further improve the marginal adaptation of all ceramic single crowns.

Trial registration

http://www.isrctn.com/ISRCTN16111844

     

Smoking status,dental visits and receipt of tobacco counseling in dental office among mobile and trailer home adolescents

Background

Mobile and trailer home (MTHs) residents are an understudied group. In this study we determined the cigarette smoking status, dental visits in the past 12 months, and receipt of tobacco counseling in adolescents living in MTHs compared to adolescents living in other types of housing.

Methods

For this secondary data analysis study, we used data of adolescents aged 10 to 19 years (n?=?74,890) from the 2012 Florida Youth Tobacco Survey (FYTS). Weighted multiple logistic regression model was conducted to understand the differences between adolescents living in MTHs compared to those living in other types of housing.

Results

Approximately 6 % of the sample reported living in MTHs. The regression model showed that older (p?<?0.0001), female (p?=?0.0091), and middle school (p?<?0.0001) adolescents were more likely, and those who identified as Asians (p?=?0.0006), Black/African Americans (p?<?0.0001), and Hispanics (p?<?0.0001) were less likely to be living in MTHs compared to their counterparts. Current established smokers (p?<?0.0001) and non-established smokers (p?<?0.0001) were more likely to report living in MTHs compared to non-smokers. Those reporting to have not visited a dental office (p?<?0.0001) were more likely to be living in MTHs. Those who visited a dental office but not received any tobacco counseling (p?<?0.0001) were less likely to be living in MTHs compared to their counterparts.

Conclusions

Current cigarette smokers and those not visiting a dental office were more likely to be MTH adolescents. Adolescents reporting to have received tobacco counseling in a dental office were more likely to be living in MTHs.

     

Differences between osteoradionecrosis and medication-related osteonecrosis of the jaw

Purpose

The appearance of osteoradionecrosis (ORN) and medication-related osteonecrosis of the jaw (MRONJ) is similar, but clinically important differences between ORN and MRONJ exist. The aim of this study was to compare the clinical data between ORN and MRONJ and to reveal the critical differences between these diseases.

Methods

We retrospectively reviewed the epidemiological data, clinical findings, and treatment in 27 ORN and 61 MRONJ patients. Radiographic signs before the initiation of treatment were also assessed.

Results

The median age (P?=?0.0474) and the ratio of female to male patients (P?<?0.0001) were significantly higher in MRONJ patients. There were significantly more MRONJ patients who reported a history of pain when compared with ORN patients (P?=?0.0263). As an aetiological factor, tooth extraction was significantly more relevant to MRONJ than ORN (P?=?0.0352). When assessing the radiographic signs on computed tomographic images, periosteal reaction was found only in MRONJ patients (P?=?0.0158). Minimal debridement was performed significantly more frequently for MRONJ (P?=?0.0093), and by contrast, surgical resection was performed more frequently for ORN (P?=?0.0002).

Conclusions

Understanding the clinical and underlying pathological differences between ORN and MRONJ probably contributes to the selection of appropriate treatment for each patient.

     

Prevalence of <Emphasis Type="Italic">Candida albicans</Emphasis> and <Emphasis Type="Italic">Candida dubliniensis</Emphasis> in caries-free and caries-active children in relation to the oral microbiota—a clinical study

Objectives

The correlation between caries and the oral prevalence of Candida spp. in children is contradictory in literature. Thereby, authors focused on Candida albicans as the most isolated Candida species from the oral cavity. Therefore, the aim of the present study was to compare caries-free and caries-bearing children regarding their oral carriage of Candida spp.

Material and methods

Twenty-six caries-free (CF group) and 26 caries-active children (CA group) were included into this study. Three different types of specimens were assessed, saliva and plaque, and in the case of caries, infected dentine samples were microbiologically analyzed for aerobic and anaerobic microorganisms and their counts. Special attention was given to the differentiation between C. albicans and Candida dubliniensis. Additionally, different biochemical tests, VITEK 2 (VITEK®2, bioMérieux, Marcy-l’Etoile, France) and 16S and 18S ribosomal DNA (rDNA) sequencing, were applied for identification.

Results

The detection of C. albicans did not differ between the CF and CA groups. C. dubliniensis was never detected in any specimen of the CF group, but occurred in one quarter of the CA group (27 % in plaque, 23 % in saliva), thus leading to a statistically significant difference between the two groups (p < 0.05). In six of these cases, C. dubliniensis was detected concomitantly in saliva and plaque and once only in plaque. CA group harbored statistically more Streptococcus mutans than the control group revealing a correlation between S. mutans and C. dubliniensis regarding the caries group.

Conclusions

This is the first study reporting a frequent detection of C. dubliniensis in caries-active children, which could have been underestimated so far due to difficulties in differentiation between this yeast species and C. albicans.

Clinical relevance

Microbiological diagnostic—especially of oral Candida species—is an important determinant for identifying etiological factors of dental caries in children.

     

The impact of the new scene drug “crystal meth” on oral health: a case–control study

Objective

The use of methamphetamine (MA), a highly addictive stimulant, is rapidly increasing, with MA being widely abused as the scene drug “Crystal Meth” (CM). CM has been associated with severe oral health effects, resulting in so-called “Meth mouth”. This term appeared for the first time in 2005 in the literature and describes the final complex of symptoms including rampant caries, periodontal diseases and excessive tooth wear. The aim of this study was to investigate the effects of chronic CM abuse on teeth and intraoral tissue with respect to potential symptoms of Meth mouth.

Materials and methods

In cooperation with two centres for addiction medicine, we performed clinical intraoral investigations in 100 chronic CM users and 100 matched-pair controls. We undertook a caries and periodontal examination by using the clinical parameters DMF-T/DMF-S, bleeding on probing index (BOP) and periodontal screening index (PSI) and tested individual oral hygiene by using approximal space plaque index (API). All clinical data were analysed by the t test for independent samples.

Results

We found significantly larger numbers of caries (p < 0.001) and higher levels of gingival bleeding (p < 0.001) and periodontal disease (p < 0.001) among CM users. Oral hygiene was significantly lower in CM users (p < 0.024).

Conclusion

Chronic CM use can lead to extensive potential damage within the intraoral cavity. When CM is used over a long period of time and in the absence of treatment, clinical symptoms in terms of Meth mouth syndrome cannot be excluded.

Clinical relevance

Based on our results, we recommend a specific prevention and therapeutic concept including educational campaigns for MA users and specialized dental care for CM patients.

     

Influence of metabolic-linked early life factors on the eruption timing of the first primary tooth

Aim

Early eruption of permanent teeth has been associated with childhood obesity and diabetes mellitus, suggesting links between tooth eruption and metabolic conditions. This longitudinal study aimed to identify pre-, peri- and postnatal factors with metabolic consequences during infancy that may affect the eruption timing of the first primary tooth (ETFT) in children from an ethnically heterogeneous population residing within the same community.

Material and methods

Participants were recruited (n = 1033) through the GUSTO (Growing Up in Singapore Towards healthy Outcomes) birth cohort (n = 1237). Oral examinations were performed at 3-month intervals from 6 to 18 months of age. Crude and adjusted analyses, with generalized linear modelling, were conducted to link ETFT to potential determinants occurring during pregnancy, delivery/birth and early infancy.

Results

Overall mean eruption age of the first primary tooth was 8.5 (SD 2.6) months. Earlier tooth eruption was significantly associated with infant’s rate of weight gain during the first 3 months of life and increased maternal childbearing age. Compared to their Chinese counterparts, Malay and Indian children experienced significantly delayed tooth eruption by 1.2 and 1.7 months, respectively.

Conclusions

Infant weight gain from birth to 3 months, ethnicity and maternal childbearing age were significant determinants of first tooth eruption timing. Early life influences can affect primary tooth development, possibly via metabolic pathways.

Clinical relevance

Timing of tooth eruption is linked to general growth and metabolic function. Therefore, it has potential in forecasting oral and systemic conditions such as caries and obesity.

     

Prevention of post-operative bleeding in hemostatic compromised patients using native porcine collagen fleeces—retrospective study of a consecutive case series

Introduction

Various anticoagulant therapy regimes bear the risk of postsurgical bleeding events after dental extractions. Local hemostyptic measures, e.g., collagen fleeces, are applied by surgeons to prevent such bleedings. No standard protocol in prevention of bleeding events has met general acceptance among surgeons yet.

Purpose

The purpose of this retrospective study was to determine if post-operative bleeding can be prevented by suturing native collagen fleeces into extraction wounds immediately after teeth removal, regardless what anticoagulant regime is performed.

Methods

A total of 741 extraction units were removed from 200 consecutive in-ward patients with or without alternation of different anticoagulant therapy regimes. Anti-vitamin K agents were the most prescribed drugs (n?=?104, 52 %), followed by Acetylsalicylate (ASS) (n?=?78, 39 %). Nineteen (9.5 %) patients received a dual anti-platelet therapy. Out of 104 patients receiving an anti-vitamin K agent (phenprocoumon), 84 patients were bridged, 20 patients continued to their anticoagulant therapy without alterations. Following careful tooth extraction, extraction sockets were filled using a native type I and III porcine collagen sponge (Collacone, Botiss Biomaterials, Berlin), supported by single and mattress sutures for local hemostasis. Post-operative bleeding events were rated according to their clinical relevance.

Results

In the post-operative phase, 8 out of 200 consecutively treated patients experienced a post-operative bleeding event. All of them had been designated for a long-term anti-vitamin K therapy (p?≤?0.05), and extractions were performed under a heparin bridging regime (n?=?6) or an uninterrupted anti-vitamin K agent therapy (n?=?2). No bleeding events occurred in patients with ASS 100 therapy or low-dose LMWH therapy (p?≤?0.05), or in patients with dual anti-platelet therapy (0 out of 24). None of the bleeding events put patients’ health at risk or required systemic intervention.

Conclusion

Sufficiently performed local hemostyptic measures, like the application of collagen fleeces in combination with atraumatic surgery, bears a great potential for preventing heavy bleeding events in hemostatic compromised patients, regardless of their anticoagulant therapy.

     

An Assessment of the Incidence of Prolonged Postoperative Bleeding After Dental Extraction Among Patients on Uninterrupted Low Dose Aspirin Therapy and to Evaluate the Need to Stop Such Medication Prior to Dental Extractions

Purpose

To propose that low dose aspirin therapy need not be withdrawn for routine dental extraction procedure.

Aim

This study was designed to evaluate the post operative bleeding in patients on low dose aspirin therapy by dividing them into two groups: one with withdrawing and the other without withdrawing the regime before dental extraction.

Materials and Methods

This study included 80 patients on low dose aspirin therapy. They were divided into two groups of 40 patients each; Group I (control group) included patients on who were asked to stop the medication 5 days prior to dental extraction; Group II (test group) included patients who were asked not to stop the medication prior to dental extraction. Strict atraumatic extractions were performed by a single surgeon. Data were analyzed using the independent “t” test @ 80 % power.

Results

The mean pre-operative bleeding time in the control group was 87.75 s and the test group was 95.75 s which was statistically significant (p < 0.05). The mean pre-operative clotting time in the control group was 228.63 s and the test group was 246.25 s which was also statistically significant (p < 0.05). No patients in either group had any episode of prolonged postoperative bleeding following extraction from the surgical site and no local haemostatic measures had to be used except for one patient in Group II.

Conclusion

Authors conclude from this study that dental extraction procedures in patients on low-dose therapy can be safely carried out without stopping the antiplatelet therapy.

     

Was molar incisor hypomineralisation (MIH) present in archaeological case series?

Objective

With respect to the unknown aetiology of molar incisor hypomineralisation (MIH), it is unclear whether this phenomenon was overlooked in the last century as a result of a high number of caries in children or if this developmental disorder was not present until then. Therefore, this study determined the presence of MIH in historical dentitions and teeth.

Materials and methods

Dental remains from late medieval (n = 191, twelfth–sixteenth century, Regensburg, Germany), post-medieval (n = 33, sixteenth–eighteenth century, Passau, Germany) and modern age archaeological skeletal series (n = 99, nineteenth–twentieth century, Altdorf, Germany) were examined for MIH. In addition, linear enamel hypoplasia (LEH), diffuse opacities, hypoplasia and Turner’s teeth were documented.

Results

MIH-related demarcated opacities or enamel breakdowns were found in only 15 (0.4 %) of the 3891 examined permanent teeth. Ten cases (3.1 %) from a total of 323 dentitions were classified as having MIH. In contrast, 98 individuals (30.3 %) showed LEH. Other enamel disorders were recorded in 64 individuals (19.8 %).

Conclusion

With respect to the low number of affected dentitions and teeth, MIH most likely did not exist or was at least rarely present in the investigated archaeological case series.

Clinical relevance

This study supports the hypothesis that MIH may be linked to contemporary living conditions or other health-related factors.