Acquired immune deficiency syndrome (AIDS): disease characteristics and oral manifestations

This article has reviewed the disease process and oral manifestations of AIDS. Specifically, dentists should review the medical history and perform an overall health assessment for all dental patients before treatment is rendered. Attention should be directed to the prodromal signs and symptoms of AIDS. If dental treatment of a patient with AIDS is required, strict infection control guidelines are mandatory.     

3例艾滋病患者的口腔表征和诊断

对3例艾滋病患者的口腔表征进行分析,并对艾滋病的诊断进行探讨,以提高口腔医务工作者对艾滋病的警惕性,做到早发现、早诊断、早治疗,以控制疾病的进一步传播及加强医务工作人员的自身防护。     

Carisolv化学机械去龋技术治疗乳牙龋病效果的系统评价

目的:评价Carisolv化学机械去龋技术治疗乳牙龋病的临床疗效。方法:计算机检索Co-chrane图书馆(2009年第2期)、PubMed(1966~2009)、MEDLINE(1966~2009)、Embase(1966~2009)、CBM(1978~2009)、CNKI(1989~2009)、VIP(1989~2009),同时采用手工检索相关资料,纳入Carisolv化学机械去龋技术与传统机械去龋比较治疗乳牙龋病的临床随机对照试验。按Cochrane系统评价方法评价纳入研究的质量,对同质研究采用RevMan 5.0软件进行Meta分析。结果:共纳入5个随机对照试验,合计162例病人,272个乳牙。结果显示:与传统手用去龋器械比较,Carisolv化学机械去龋技术去龋时疼痛程度较轻,对龋损去除效果、去龋时间、病人接受程度及术后并发症发生率的影响,两种方法差异无统计学意义。与传统机用器械的比较,Carisolv与高速涡轮机联合去龋法对龋损去除效果的差异无统计学意义;但Carisolv的去龋时间较长[WDM=3.09,95%CI(2.38,3.80)];而疼痛程度[RR=0.62,95%CI(0.42,0.90)]及病人接受度,Carisolv优于高速涡轮机联合去龋法。与慢速涡轮机联合去龋法的比较,Carisolv15 min内的龋损去净效率低[RR=0.61,95%CI(0.47,0.78)];去龋时间较长[WDM=6.69,95%CI(5.77,7.61)];但是,对于去龋的疼痛程度和病人的接受程度,两种方法差异无统计学意义。机用器械组中仅有1个研究进行了术后半年的随访,结果显示两种去龋方法术后并发症的发生率差异没有统计学意义。结论:Carisolv化学机械去龋技术治疗乳牙龋病能够有效去除龋损组织,但其去龋时间较长且去龋效率低于传统机用器械。Carisolv去龋引起的疼痛程度及病人的接受程度优于传统高速机用去龋器械,但无异于手用或慢速机用器械。由于本系统评价纳入研究的数量和质量有限,上述结论尚需开展更多大样本、设计良好、指标全面的临床随机对照试验来进一步验证。     

Multiple supernumerary teeth (MSNT) and Ehlers-Danlos syndrome (EDS): a case report

Familial occurrence of supernumerary teeth is reported in a father and his son. While the lather had only one supernumerary tooth in the maxillary premolar region, his son had 8 unerupted supernumerary teeth. In addition, both patients had joint hypermobility and stretchable skin, typical of EDS syndrome type III. To the best of our knowledge, the association of supernumerary teeth with Ehlers-Danlos syndrome has never been previously reported. Single supernumerary teeth (SSNT) are most commonly found in the maxillary anterior region, whereas multiple supernumerary teeth prevail in the mandibular premolar region. We suggest that the aetiology of multiple supernumerary teeth may be different from that of single supernumerary teeth.     

Immunoglobulin A deficiency and oral health status: a case–control study

Introduction: Immunoglobulin A (IgA) is important for mucosal health. Selective IgA deficiency (IgAD) is the most common primary immunodeficiency but its effect on oral health is unclear. The aim of this study was to investigate dental, periodontal and oral mucosal health in IgAD individuals.
Material and methods: In total, 32 adult IgAD subjects were compared with 63 randomly selected individuals. Participants answered questionnaires regarding general and oral health and underwent oral examination, including examination using the periodontal screening and recording (PSR) system and dental examination using the DMF system.
Results: The IgAD individuals had significantly more often undergone tonsillectomy (44% versus 24%, p= 0.046 ) and adenoidectomy (31% versus 8%, p= 0.003 ) compared with the controls. Furthermore, the IgAD subjects reported having pharyngitis, stomatitis and herpes labialis significantly more often. There was no significant difference in periodontal health ( mean PSR index ; 1.87 versus 1.77) or dental health ( mean DMFS ; 51.3 versus 53.7 ) between the two cohorts. A positive correlation between Helicobacter pylori infection and severity of periodontitis was found ( p= 0.036).
Conclusion: IgAD predisposes to oral mucosal infections but does not influence periodontal or dental health. This is the first controlled study to include detailed clinical history and investigations, together with full oral and dental examination, in adults with IgAD.     

Treatment of traumatized primary teeth: a conservative approach

This retrospective study examined some different types of treatment to primary teeth. The aim of this study was to assess the treatment of traumatized primary teeth and the importance of a long-term follow up. Brazilian children in the age group of 1-4 years from a baby clinic took part in the study. Three hundred and fifteen patients suffered some type of traumatic injury, a total of 338 affected teeth. Data were registered in specific records and submitted to statistic analysis. The most prevalent type of treatment was monitor only (85%) followed by tooth extraction and endodontic procedure. Invasive treatments were performed in case of severe traumas, usually 6 months after the injury. We verified that a careful follow up might be the preferential choice to the treatment of traumatic primary teeth even in some severe cases.     

The oral manifestations of Maroteaux-Lamy syndrome (mucopolysaccharidosis VI): a case report

Maroteaux-Lamy syndrome is one of the genetic disorders involving disturbances in mucopolysaccharide metabolism resulting in increased storage of acid mucopolysaccharide in various tissues. The basic defect in Maroteaux-Lamy syndrome is a deficiency of arylsulfatase B, which leads to accumulation of dermatan sulfate in tissues and their urinary excretion. The deposition of mucopolysaccharides leads to a progressive disorder involving multiple organs that often results in death in the second decade of life. This disease, which has several oral and dental manifestations, is first diagnosed on the basis of clinical findings. A large head, short neck, corneal opacity, open mouth associated with an enlarged tongue, enlargement of skull, and a long antero-posterior dimension are the main characteristic features. Dental complications can be severe and include unerupted dentition, dentigerous cystlike follicles, malocclusions, condylar defects, and gingival hyperplasia. An 11-year-old boy with Maroteaux-Lamy syndrome (mucopolysaccharidosis type VI) is described in this article, with special emphasis on the oral manifestations.     

A 2-year follow-up of primary molars, pulpotomized with a gentle technique and capped with calcium hydroxide

abstract — The prognosis for pulpotomy of primary molars with calcium hydroxide as wound dressing was evaluated clinically and radiographically. Thirty-three primary mandibular molars were amputated under the following conditions: (1) chronic coronal pulpitis, (2) the amputation was done with diamond instruments and a high-speed machine under aseptic conditions, and (3) application of calcium hydroxide in contact with the wound surface. After 1 year the treatment was regarded as successful for 22 of the teeth (67%); II teeth showed internal dentin resorption. After 2 years the frequency of success, allowing for drop-out, was 5996. Internal dentin resorption was seen in 14 root canals; in 10 of them within the first 6 months. A histologic study of nine root pulps with internal dentin resorption revealed an extra-pulpal blood clot on the wound surface in five.     

Replantation of avulsed primary incisors: a critical review of a controversial treatment

Compared with the abundant literature on the replantation of avulsed permanent teeth, the literature on replantation of avulsed primary teeth is significantly more limited. A search of PubMed, using the terms: primary teeth, primary incisors, avulsion, exarticulation, replantation and reposition, and search in the reference list of the relevant articles, revealed 16 case reports of replantation of 31 primary incisors in 24 children. This article is a critical review of the arguments against replantation that have been presented in textbooks, review articles, and clinical guidelines.     

Dental caries indices for primary teeth: the need to comply with international recommendations

This paper illustrates inconsistent use of abbreviations in indices employed to assess caries prevalence and incidence in the primary dentition. Possible consequences of this practice are discussed and it is suggested that authors, editoris and referees for dental journals should accept and adhere to internationally agreed upon definitions of these indices. As long as there is disagreement on the use of the dmf and def indices these initials should be defined under "methods".     

Riga-Fedes syndrome: Natal or neonatal teeth associated with tongue ulceration. Case report

A case of natal teeth associated with traumatic ulceration to the ventral surface of the tongue (Riga-Fedes syndrome) in a four week old boy is presented. On radiographic examination, two teeth, present at birth, were found to be early erupted deciduous lower central incisors. A family history of natal teeth, all involving both lower deciduous central incisors associated with trauma to the tongue during suckling, was elicited. The ulceration healed over a period of four weeks using an innovative conservative treatment regime, involving the use of Stomahesive Wafer. Four months later the only sign of any previous pathosis was a fibrous scar on the ventral surface of the tongue.     

AIDS and the oral cavity. Epidemiology and clinical oral manifestations of human immune deficiency virus infection: a review

Since the first patients with acquired immune deficiency syndrome (AIDS) were seen in 1981, the disease has been recognized as an epidemic, now considered a major health threat. This article reviews, on the basis of the literature and personal observations of 120 human immune deficiency virus (HIV) infected patients, some aspects of the HIV (HTLV III/LAV) infection with emphasis on epidemiology and clinical aspects. The clinical oral manifestations include 5 groups of lesions: fungal infections, bacterial infections, viral infections, neoplasms and lesions of unknown etiology. In total, these 5 groups comprise 34 different lesions of the oral cavity.     

Trauma in primary teeth and its effect on the development of permanent successors: a controlled study

Objective: This controlled study investigated the occurrence of sequelae to permanent successors (SPS) following traumatic dental injury in primary teeth (TDIp). Additionally, this study evaluated whether TDIp is a risk factor for SPS, with a focus on an association between SPS and the child's age and type of trauma. Materials and methods: The trauma group (TG) consisted of permanent teeth, whose antecessors had suffered TDIp, in a population of children with complete eruption of permanent teeth. The control group (CG) consisted of permanent teeth from the same individuals, whose antecessors had not suffered TDIp. There were 214 cases of TDIp with their respective permanent teeth. In the CG 247 permanent teeth, whose antecessor had not suffered TDIp, were included. Data concerning such teeth and when TDIp occurred (in terms of the child’s age) and types of SPS were collected. The chi-square test, regression logistic with generalized estimating equations (GEE) test, and risk analyses were applied to investigate the associations. Results: Overall, 29% of the permanent teeth in the TG presented SPS. This was compared to the development disturbances in the CG, which was 7%. The TG demonstrated the highest risk for SPS (OR, 5.388; p?=?.0001). The discolouration of enamel (37%) was the most common type of SPS found. SPS was more prone to occur in permanent teeth whose antecessors had been intruded (39%; p?<?.001). TDIp when the child was 1-year old was associated with SPS (p?<?.001). Moreover, children who had TDIp had a 4.1 times higher risk of presenting SPS. Conclusions: TDIp is a risk factor for the development of SPS. All types of TDIp caused SPS in this research. Additionally, the younger ages at the time of the injury and intrusions were related to SPS.     

Pathophysiology of primary burning mouth syndrome with special focus on taste dysfunction: a review

Primary burning mouth syndrome (BMS) is a chronic oral condition characterized by burning pain often accompanied with taste dysfunction and xerostomia. The most compelling evidence concerning BMS pathophysiology comes from studies on the somatosensory system using neurophysiologic or psychophysical methods such as blink reflex, thermal quantitative sensory testing, as well as functional brain imaging. They have provided convincing evidence for neuropathic involvement at several levels of the somatosensory system in BMS pain pathophysiology. The number of taste function studies trying to substantiate the subjective taste disturbances or studies on salivary factors in BMS is much more limited, and most of them suffer from definitional and methodological problems. This review aims to critically evaluate the existing literature on the pathophysiology of BMS, paying special attention to the correctness of case selection and the methodology used in published studies, and to summarize the current state of knowledge. Based on the recognition of several gaps in the current understanding of the pathophysiology of BMS especially as regards taste and pain system interactions, the review ends with future scenarios for research in this area.     

Two years'' effect on the primary dentition of mouthrinsing with a 0.2% neutral NaF solution

The benefits to the primary teeth from a school-based fluoride mouthrinsing program are presented. Children in grades 1--4, residents of a fluoride-deficient community in New York, rinsed an average of 49 times during 2 school years using a 0.2% neutral NaF solution. Rinsing was done under the supervision of homeroom teachers. Differences in caries prevalence of 20.0% (dfs/child) or 23.8% (dfs/100s) were found in children who participated in the rinsing program for 2 years compared with baseline caries scores of children who never rinsed. Surface specific differences in caries prevalence after 2 years were: 27.5% for proximal surfaces, 24.1% for buccolingual surfaces, and 12.4% for occlusal surfaces.     

Caries progression in primary molars: 24-month results from a minimal treatment programme

Abstract A 2-stage topical treatment regimen (AgF followed by SnF₂) was used in an attempt to limit caries progression in the primary molars of children participating in a minimal treatment programme. The children lived in an isolated community in western New South Wales (fluoride in water < 0.2 parts/10⁶) and were from a low socioeconomic background. The progression, over a 24-month period, of 281 established lesions in the approximal and occlusal surfaces of primary molars in 54 subjects (mean age 7.0 years) was determined from bilewing radiographs. Of the lesions studied, the majority (69%) were in dentine at baseline. At 24 months, 74% of the approximal surface lesions and 90% of the occlusal surface lesions that were in enamel at baseline remained unchanged. The greatest change occurred in the approximal surface lesions that were within 1 mm of the pulp at baseline. Only 35% of the lesions required any treatment other than topical metal fluoride therapy during the 24-month period.