Tooth development included in the multifocal jaw lesions of Langerhans cell histiocytosis

Many cases demonstrating the oral manifestations of Langerhans cell histiocytosis (LCH) have been reported; however, tooth development in jaw lesions has rarely been mentioned. This paper reports the case of a 3-year-old Japanese girl with LCH suffering from multiple osteolytic lesions of the skull and jaw bones. She was referred to our paediatric clinic because of swelling of the mucogingival folds in the upper and lower primary molar regions. The patient responded well to steroid therapy and the osteolytic lesions resolved. There was an accompanying development of permanent tooth germs included in the lesions. Langerhans cell histiocytosis in children usually has a long-term clinical course and paediatric dentists should be involved with oral health care for affected patients.     

Comparison of palatal sensitivity after treatment of cleft palate by a supraperiosteal or mucoperiosteal flap

We compared palatal sensitivity after push-back palatoplasty in patients operated on with a conventional mucoperiosteal flap and with a supraperiosteal flap. We studied 37 patients, whose mean age was 18 years (range 11-28), with unilateral cleft lip, alveolus, and palate who required palatoplasty at our clinic; 18 patients had a supraperiosteal, and 19 a mucoperiosteal flap. Thresholds of palatal sensitivity were measured with Semmes-Weinstein monofilaments. The mean values of thresholds of palatal sensitivity in patients who had a push-back palatoplasty were higher than those in a normal control group. The mean values for patients who had a supraperiosteal flap were significantly lower than those who had a mucoperiosteal flap.     

Comparison of United States and Korean dental hygiene students using the Hiroshima university-dental behavioural inventory(HU-DBI)

OBJECTIVE: To compare cross-national differences of dental health behaviour among dental hygiene students. DESIGN: Cross-cultural differences. Setting: United States (USA) and Korea. SUBJECTS AND METHODS: One hundred and twenty-six dental hygiene students in USA and 246 in Korea were surveyed using the Hiroshima University-Dental Behavioural Inventory (HU-DBI) (in English and Korean versions respectively). RESULTS: There were considerable differences in oral health behaviour between USA and Korean dental hygiene students. Of great significance were findings that while only a small proportion of the USA students (1%) reported gum bleeding when they brushed their teeth, 37% of the Korean students did so (P<0.001). Furthermore, only 19% of the Korean students had been told by their dentist that they were performing a high level of plaque control, contrasted with 76% of the USA students. Logistic regression model showed that it was possible to distinguish USA students from Korean peers with a probability of more than 90% by using the HU-DBI. CONCLUSIONS: There were considerable differences in dental health attitudes/behaviour among dental hygiene students in the two countries. The variation in the favourable attitudes/behaviour toward oral health appeared to reflect the students' clinical training experience in Korea.     

Impacted supernumerary tooth developed under palatal polyp

We present a rare case of an infant's palatal polyp associated with an impacted supernumerary tooth. We have previously reported three cases of palatal polyps in infants [1]. In one case, after surgical removal of the palatal polyp at the age of 1 year and 8 months, the lesion subsequently began swelling. A periapical radiograph at the age of 2 years and 9 months revealed a small calcified mass in the maxillary left incisor region. The swelling was kept under observation, the calcified mass developed gradually and was removed surgically at the age of 5 years and 5 months. The removed calcified mass was clinically diagnosed as an impacted supernumerary tooth and this was confirmed histologically. Histological findings did not indicate any relationship between the palatal polyp and the impacted supernumerary tooth.     

Comparison of health behaviour and oral/medical conditions in non-insulin-dependent (type II) diabetics and non-diabetics

One hundred and two dentate patients with type II diabetes mellitus and 98 non-diabetic subjects were examined for oral conditions and metabolic state. Self-reported health behaviour was analysed. From factor analysis four factors emerged: general health behaviour (GHB), perceived fatigue (PF), diet control (DC) and regular diet (RD). In diabetics PF, DC and RD were significantly higher than that in non-diabetics. Patients with diabetes were more likely to control their disease through a programme of decreased kilojoule intake leading to weight management. However, they tended to tire. The mean gingivitis index was significantly higher (p<0.01) among diabetics (2.39) than among nondiabetics (1.99). The number of missing teeth was significantly higher (p<0.01) for diabetics (6.7) when compared with non-diabetics (4.3). On the other hand, aetiological factors (plaque, calculus) and the level of dental health behaviour as expressed in the HU-DBI scores were similar. Probing pocket depth did not differ statistically between groups. The increasing number of missing teeth in diabetics may primarily result from severe periodontitis with tooth mobility or deep pockets. Findings in this study suggest that the difference in the severity of periodontitis between diabetics and non-diabetics was significant although aetiological factors and the level of dental health behaviour were similar.     

Service-mix in general dental practice in Japan: A survey in a suburban area

Overseas investigations have reported the amount and variety of dental services provided. An understanding of the current service-mix in private general practice is important in the anticipation of the future practice of dentistry. The main purpose of this study was to describe the service-mix of private general practitioners in Japan, which was recorded using the Australian Dental Association Dental Procedure Code. Some comparisons with previous studies were offered. The youngest age group and adolescents formed only a small percentage of the total patients, while the greatest percentage of patients occurred in the 45–64 year age group. The services provided were mainly restorative, diagnostic, advanced restorative and endodontic services. Preventive services represented a minority of dental activity, especially for young patients. Periodontic and orthodontic services were also remarkable for their low percentage in all age groups. In comparison with an Australian study, the percentage of preventive services was considerably lower. Movement toward a preventive emphasis in Japanese dentistry requires a change in the clinical model, de-emphasizing biomedical and aetiological approaches and placing greater emphasis on the patient and factors affecting dental practice.     

In vivo and in vitro study of the effects of chlorpromazine on tooth mineralization in rats and mice

The effects of chlorpromazine (CPZ) on tooth mineralization were examined using incisor dentine in adult rats and cultured tooth germs of mandibular first molars dissected from mouse embryos. CPZ (10, 50 and 250 mg/kg, s.c.) substantially inhibited dentine mineralization as evaluated by contact microradiographs. Plasma calcium and phosphorus concentrations were not decreased by CPZ (10 and 50 mg/kg). Physicochemical effects were not involved in the action of CPZ on the mineralization. In vitro experiments showed that CPZ (1 and 10 μM) inhibited mineralization and alkaline phosphatase (ALP) activity in the tooth germs. As CPZ has the properties of a calmodulin antagonist, the calmodulin antagonists W-7 and W-5 were also examined. Both inhibited mineralization and ALP activity in tooth germs; W-5 had less effect than W-7. These in vivo and in vitro findings suggest that CPZ inhibited cell-mediated mineralization in dentine without affecting the calciumdashregulating system and physicochemical mineral deposition. In addition, calmodulin could be involved in cell-mediated mineralization.     

Conscious survey of dental patients. 1. Questionnaire related to general dentistry (in the case of the new patients of the Nippon Dental University Hospital)

Increased information on dentistry in the mass media in recent years may have caused changes in patients' attitudes toward dental care. To better understand patient' attitudes, we conducted a questionnaire survey of patients on the first visit to our hospital. Of 384 responses, 196 were eligible for statistical analysis. The following findings were obtained. 1. Among the motives for visiting a dental clinic, "Manifestation of pain or symptoms" was given by majority (85.7%) of respondents, followed by "detection of abnormality" (20.4%). The percentage of patients wanting treatment of "any part suggested by the dentist" was highest (35.7%), followed by those expecting "treatment including cleaning" (30.1%). The above results indicate that patients still tend to visit a clinical after subjective symptoms appear and leave the content of treatment to the dentist. However, an increasing number of patients appear to be concerned with their oral condition and visit a clinic before manifestation of symptoms. 2. Among factors in selecting their dentist, "expertise" obtained the highest percentage, 87.2%, followed by "providing prompt treatment" (38.8%) and "trying to avoid pain" (32.1%), in that order. Dissatisfaction with dentists was described as "no explanation of treatment" in 57.1%, "lack of sympathetic attitude" in 38.3% and "easily resorts to tooth extraction" in 35.4%. These results suggest that patients expect good human relations with their dentists, sufficient explanations of treatments and sympathetic consideration, as well as expertise. 3. The majority of patients (85.7%) hoped to receive instructions on oral hygiene and to be increased interest in information above prophylaxis. Meeting their needs will remain a future issue for dentists.