Influence of orthodontic treatment in the primary dentition upon development of the dentition and craniofacial growth

The aim of the present study was to compare the sensitivity, specificity and usefulness of the DIG-ELISA, DOT-ELISA and Indirect ELISA tests for determining the seroprevalence of fasciolosis in cattle under tropical conditions in Mexico. To standardize the tests, positive and negative sera to F. hepatica from 88 Holstein Freisian adult cows located in an enzootic area of fascioliosis and 88 crossbred adult cattle from a fluke-free area were used. For the epidemiological study, 85 crossbred cattle between 1 to 7 years of age were used. Animals were bled every two months, from March 1995 to September 1996 and the sera obtained were stored at -70 degrees C, until used. Indirect ELISA showed a sensitivity of 96.5% and a specificity of 98.8%, DIG-ELISA 97.5% and 80.0% and DOT-ELISA 93.1% and 95.4%, respectively. During 1995, Indirect ELISA yielded the highest levels of IgG anti-F. hepatica antibodies. However, in 1996, after animal treatment with triclabendazole, DIG-ELISA tended to show higher percentages of antibody-positive animals, but it was not significantly different (p>0.05) from the other tests. Comparisons made in parallel to the faecal sedimentation test demonstrated that all serological tests detected higher percentages of positive animals. Only one serum out of ten (10%) of Paramphistomum spp. cross-reacted with the DOT-ELISA test, but no cross-reaction was observed with sera from animals with other parasites. All ELISA tests were highly sensitive and specific; they may be recommended for use in seroepidemiological surveys for F. hepatica.     

Replacements of restorations in the primary and young permanent dentition

The present study focused on the type of restorative material used and the reasons for replacements of restorations in the primary and the young permanent dentition. All patients with restorations and who were 8 and 19 years of age in 1995 and were regularly treated at 11 Public Dental Health clinics in J?nk?ping County, Sweden, participated in the study. Data were extracted from the records for all types of restorations in canines and molars for the preceeding of 5 years for the 8-year-olds (i.e. from 3 to 8 years of age; n = 546) and for approximal restorations in premolars and molars for the preceeding 13 years for the 19-year-olds (i.e. from 6 to 19 years of age; n = 606). In all, 6012 restorations were evaluated. The two most common restorative materials used in the primary dentition were compomer and glass ionomer cement and in the young permanent dentition composite and amalgam. In the primary dentition, 29% of the restorations had been replaced and 4% of the teeth with restorations had been extracted. Thus, 33% of the restorations in the primary dentition failed. The corresponding figure for the young permanent dentition was 13%. The most common reason for replacements in the permanent dentition was secondary caries. That restorations often fail because of caries and that the development of secondary caries is not prevented by replacement of an old restoration indicate that more attention should be paid to preventive dental care for patients with restorations in the primary as well as in the young permanent dentition.     

Enamel pearls in the primary dentition: report of two cases

Concentrations of the polyamines, putrescine, spermidine and spermine were investigated in rat brains, in which chemical kindling or single convulsion had been induced by intraperitoneal injection of pentylenetetrazol (PTZ). A single injection of 60 mg/kg of PTZ produced tonic-clonic convulsion and increased the putrescine concentration 8 h after the injection. At lower doses of PTZ (10 and 30 mg/kg), neither marked behavioral seizure nor significant change in any polyamine concentration was observed. On the other hand, repeated injections of 30 mg/kg of PTZ eventually resulted in intense motor seizures (PTZ kindling) and increased the concentrations of all three polyamines. The most marked increase was detected in putrescine 1-48 h after the intense seizures. The increase in putrescine was clearly higher in PTZ kindling than in single convulsion. These results suggest that increases in polyamine concentrations are involved in neuronal excitability in the epileptic brain.     

Splint therapy for skeletal Class III malocclusion in the primary dentition

The objective of this study was to evaluate the effect of referral bias in a clinical audit of lymphoma in a university hospital. We compared demographic and clinical characteristics as well as survival for Jerusalem residents (local) and referred (distant) patients diagnosed from 1987 to 1992 and treated in our institution. Referred patients were younger (p < 0.0001), and less likely to be immigrants (p < 0.0001), than local patients. Aggressive non-Hodgkin's lymphomas (NHL) were more common in the referred population (p = 0.015). Survival for Hodgkin's disease was consistently better for local patients, but for patients with NHL the findings were reversed. In this study referred patients differed in their clinical and sociodemographic characteristics but did not consistently exhibit a worse outcome than that of local patients. The unpredictable nature of referral bias may be due to better functional status or resources among referred patients, or to selective referral for procedures such as bone marrow transplantation. While reports on the natural history of disease from tertiary institutions may be biased by referral patterns, the direction of the bias is not uniform.     

Characteristics of protrusive and lateral excursions of the mandible in children with the primary dentition

Collection of patient-centred health status is a method for quantifying patient outcome in the context of clinical trials for the treatment of coronary artery disease (CAD). Traditional clinical trial end-points, such as morbidity and mortality, fail to adequately measure the health-related outcomes of disease states for which death is a rare occurrence. Health-related quality of life (QOL) and functional status surveys allow measurement of the general, and/or disease-specific, health-related limitations experienced by patients. Measures of patient preference, in turn, quantify the effects these health-related limitations have on the overall value patients ascribe to their current health state. Together, these outcomes measures may provide a more accurate appraisal of the benefit conferred by treatment. Currently, selection of the appropriate outcomes measures and methodological approaches for a clinical trial is complicated by the lack of consensus on a single quality of life measure for use with patients with (CAD). This article outlines the use of QOL measures in anti-anginal trials done to date and summarises the approaches currently available for assessing QOL, including the differences between psychometric and preference-based techniques, and general and disease-specific health measures. In conclusion, a framework is provided for selecting the appropriate instruments and methodology in the context of the clinical trial.     

Viscous glass-ionomer cements: a new alternative to amalgam in the primary dentition?

Glass-ionomer cements offer advantages in the treatment of the primary dentition. New, colored, highly viscous glass-ionomer cements hold the promise of better abrasion properties. Owing to their high viscosity, their handling characteristics are similar to those of amalgam. Examination of their properties demonstrated increased resistance to abrasion in comparison to amalgam, although no improvement in fatigue or flexural resistance was found. Clinical experience extending over 2.5 years confirmed these results.     

Plaque removal efficacy of a newly developed powered toothbrush in the primary dentition of pre-school children

A cross-over, single-blind clinical study was performed to compare a powered and a manual toothbrush for their ability to remove plaque from the teeth of pre-school children. Seventy-three randomly selected 4- to 6-year-old children from two kindergarten classes in Erfurt, Germany participated in the study. A new powered children's toothbrush (Rowenta) and a currently marketed manual children's toothbrush (Elmex) were used for an assessment period of two weeks each. Then the groups were crossed over to use the alternate toothbrush for another two weeks. Whole mouth, gingival margin and interproximal plaque area levels were determined using the Rustogi et al. plaque index. Statistical analysis of the data showed significantly effective (p < 0.05) plaque removal with both toothbrushes, immediately after toothbrushing and at one and two weeks, compared to the respective baseline scores. The statistical analysis also demonstrated that the powered toothbrush was significantly (p < 0.05) better on percent plaque reduction on all tooth areas compared to the manual toothbrush, except at two weeks with the interproximal assessment.     

Bone grafting at the stage of mixed and permanent dentition in patients with clefts of the lip and primary palate

Secondary bone grafting of a residual alveolar cleft has become a well established procedure. However, little attention has been paid to the benefits of these bone grafts in patients with clefts of the lip and alveolus only. This retrospective and comparative study includes 21 patients who had received a secondary or a late secondary bone grafting procedure from tibia and whose mean clinical and radiographic follow-up after the bone graft was 5.5 years. Eighteen patients treated without bone grafting served as controls. Length and width of cleft, presence or absence of permanent lateral incisor, size of nasal floor bony defect, and interdental alveolar bony height in the cleft area were investigated. The results showed that bone grafting was indicated particularly in wide clefts with missing lateral incisors. Eruption of a tooth close to the cleft was facilitated and the bony support for teeth neighboring the cleft was improved. In some cases, additional support of the alar base of the nose was achieved and closure of an oronasal fistula facilitated. A further advantage of bone grafting of clefts of the primary palate was that it might make it possible to insert a titanium implant carrying an artificial tooth in the cleft area.     

Anatomical variations in the dentition of the domestic cat

Skulls (n = 155) of adult domestic cats were examined macroscopically and anatomical variations were documented. The maxillary second premolar tooth was absent in 7.9% of cases, and was found to have a single root in 27.7%, partly fused roots in 55.1% and two fully formed roots in 9.2% of cases. The maxillary first molar tooth was absent in 2.3% of cases; a single root was present in 35.0%, a partly fused root in 34.7%, and two roots in 28.0% of cases. Supernumerary roots were found on the maxillary third premolar teeth in 10.3% of cases. Other variations were found to be extremely rare.     

Prevalence of malocclusion in the primary and early mixed dentition in a group of Egyptian children with complete unilateral cleft lip and palate

This study was carried out to investigate the prevalence of malocclusion in the primary and early mixed dentition for a group of Egyptian children with complete unilateral cleft lip and palate following surgical rep. air of the anomaly. The material consisted of 35 children (20 males and 15 females) with complete unilateral cleft lip and palate aged 3 to 7 years who were compared with 60 non-cleft Egyptian children (37 males and 23 female) of the same age.     

Phenotypic features of dentition in diastrophic dysplasia

BACKGROUND: Studies of hypertension, diabetes, and diet have indicated a relationship between social support and adherence to treatment regimens. Estimates of nonadherence following abnormal Pap test results range as high as 40%. In this study, the relationship between social support and adherence behavior was examined in a population of low-income, public-health-department patients with abnormal Pap smears. METHODS: Medical record reviews ascertained adherence behavior and interviews determined receipt of social support for 498 women. RESULTS: Related to adherence were: receipt of any social support; receipt of each of three types of support (informational, emotional, and tangible support); amount of support received; satisfaction with support; and source of support. Reported need for support was not related to adherence behavior. Receipt of social support was more strongly related to adherence when the woman's emotional response to the notification of the abnormal Pap smear was greater, and when acculturation was higher (among Latinas). Knowledge of the results of the Pap test was found to be an intervening variable between receipt of informational support and adherence. Knowledge of the purpose of the Pap smear was found to be independently related to adherence. Among black women, emotional support was most strongly related to adherence, while among Latinas, tangible support was most strongly related to adherence. In a multivariate model, Pap-test knowledge and the interaction between emotional response and receipt of any social support were significantly related to adherence. CONCLUSIONS: Findings suggest that supportive interventions, including provision of medical information, emotional support, child care, and transportation, could help to reduce nonadherence.     

Molar polymorphisms and the timing of dentition mineralization

The chronological age, skeletal age, and morphological age at the time of mineralization of 14 stages of the permanent teeth of 121 boys and 111 girls of the serial experimental sample of the Burlington Growth Centre were contrasted according to whether or not the children had 4- or 5-cusped mandibular permanent first molars, and whether or not they had agenesis of one or more third molars. In the boys with 4-cusped mandibular first molars, the mineralization of the teeth occurred at significantly earlier chronological and skeletal ages when they were significantly shorter in stature. Tooth mineralization was not consistently earlier in the girls with 4-cusped molars, but these girls tended to be taller and heavier than those with 5-cusped molars. In contrast, in both sexes with agenesis of third molars, the mineralization of the teeth was significantly delayed according to chronological, skeletal and morphological evaluation. The change in timing of mineralization was greatest for the second premolars and second molars, and least for the first molars.     

Identification of caries risk children and prevention of caries in pre-school children

A special model for dental care in pre-school children was used in a small clinic in the county of Blekinge in southern Sweden. The model is based on screening of caries risk performed by a dental assistant before the caries attack. Any single risk factor or risk behavior in pre-school children was considered. The aim was to 1) evaluate the dental assistant's selection of caries risk children up to the age of three years, 2) compare dental health variables in 4 yr olds in the test clinic with those for the whole county in 1994 and 3) compare time spent by the dentist and the dental assistant in the test clinic and in the whole county per child up to the age of four. 102 children participated. One specially trained dental assistant screened all children using background factors combined with clinical examinations at ages 1, 2 and 3. Eighty-two children participated each year from one year. A systematized form for questioning the parents was used. Individual caries prevention was given including fluoride and antimicrobial treatments as well as fissure sealants in primary molars at caries risk. The proportion of children with caries lesions at four years and a caries risk assessment up to the age of two was 1.0 (sensitivity). The proportion of children with no caries lesions at four years and no caries risk assessment at year two was 0.7 (specificity). The most frequent risk factors found at 2 yrs were frequency order: lack of oral hygiene (visible plaque), deep fissures in molars and frequent intakes of sweet drinks. The proportion of children with no caries lesions at 4 yrs of age in the test clinic was 92.9% compared to a county mean of 76.4%. In the group of children where a risk assessment was made each year from one year the proportion of caries free children was 96.3%. The total time spent per child in the test clinic was 22 minutes more than the county mean. However, dentist's time, excluding assistance, was 28 minutes less in the test clinic. The results suggest that the model used for caries prevention in pre-school children is cost-effective, and that dental health can be remarkably improved.     

Trans-surgical restoration of extensive Class IV defects in the anterior dentition

Direct bonding is the most commonly utilized treatment for conservative aesthetic restoration of the anterior dentition. Class IV defects require special attention due to their high incidence, particularly in young patients. One of the major challenges for the clinician in treating defects in this category is selecting the appropriate restorative composite resin material that emulates the physical and optical characteristics of dentin and enamel and conceal the fracture line at the tooth/composite interface. Class IV defects with margins violating the biologic width present another concern, since this violation often impedes the attainment of the correct anatomic contours. The learning objective of this article is to describe a technique for achieving a correct integration of the periodontium, the tooth structure, and the restorative composite resin material to achieve a high level of aesthetic excellence.     

Progression of HIV in haemophilia

A series of permeability thresholds to Ca2+ metabolites and macromolecules, occurring at different times when cells are attacked by complement, has been established by imaging HeLa cells transiently expressing a recombinant cytosolic fusion protein of firefly luciferase and aequorin (luciferase-aequorin) to measure changes in ATP and cytosolic free Ca2+. Nuclear fluorescence of propidium was used as a measure of permeability to small molecules, and luciferase activity imaged to assess lysis. The rise in cytosolic free Ca2+ observed after C9 attack preceded by at least 60 s both the increase in propidium fluorescence, measured in single cells, and the decrease in ATP monitored by luciferase light emission. These effects were dependent on the concentration of C9. At concentrations of C9 up to 4 micrograms/ml no loss of luciferase-aequorin protein was detected at the end of the experiment. Thus the membrane integrity of the cells remained intact, even though the cells were permeable to propidium. These results confirmed our earlier observations that propidium permeability in cells attacked by complement was not a reliable measure of cell death. They also show that it is vital to take account of cellular heterogeneity if the mechanisms by which cells respond to membrane pore former attack are to be correctly interpreted.     

Modalities of fluoride prescription in the caries prevention

Three periods of child dental development carry a high risk of caries: the second year of life, the age of 6 years and adolescence (14-15 years). Besides education on oral hygiene and appropriate diet, fluoride is a major tool of caries prevention. However, it must be considered as a medication and its use must always take into account age and its different possible sources in order to avoid excessive administration.