Congenital adrenal hyperplasia: A case report with premature teeth exfoliation and bone resorption

Congenital adrenal hyperplasia (CAH) is an inherited autosomal recessive disorder characterized by insufficient production of cortisol. The aim of this case report was to present a child with CAH, premature exfoliation of primary teeth and accelerated eruption of his permanent teeth related to bone resorption. A 4.5-year-old Caucasian boy with CAH and long-term administration of glucocorticoids was referred for dental restoration. Clinical examination revealed primary molars with worn stainless steel crowns, severe attrition of the upper canines, and absence of the upper incisors. Before the completion of treatment, abnormal mobility of the first upper primary molars and the lower incisors was detected, and a few days later the teeth exfoliated prematurely. Histologic examination revealed normal tooth structure. Alkaline phosphatase and blood cells values were normal. Eruption of the permanent dentition was also accelerated. Tooth mobility was noticed in the permanent teeth as soon as they erupted, along with bone destruction. Examination revealed an elevated level of receptor activator of nuclear factor-κB ligand and lower-than-normal osteoprotegerin and vitamin D levels. The patient was treated with vitamin D supplements, and his teeth have been stable ever since. CAH is a serious chronic disorder appearing in children with accelerated dental development and possibly premature loss of primary teeth. Copyright © 2015 by the American Academy of Pediatrics

Fluctuating molar asymmetry in relation to environmental radioactivity

Objective: Fluctuating dental asymmetry is considered a sensitive indicator of environmental stress. We used fluctuating asymmetry of teeth in Greek children to assess the effect of the Chernobyl accident to the Greek population, which received relatively large radiation exposure compared to other European countries. Design: Sixty dental casts were divided into two groups according to date of birth prior to or after the Chernobyl accident. The intercuspal distances of the mandibular first permanent molars were measured with digital calipers. We followed the data analysis procedure proposed by Palmer and Strobeck (2003). Results: Fluctuating asymmetry was found at levels above measurement error in all traits except for the buccal measurement. Overall, there were no significant differences in the fluctuating asymmetry between the two groups, after removal of outliers. Conclusions: These results suggest that environmental radioactivity from the Chernobyl incident did not significantly affect the symmetry of lower permanent molar intercuspal distances in the specific population, even though increased levels of radionuclides have been reported in teeth and other tissues. © 2009 Elsevier Ltd. All rights reserved

Pharmacological management of pain during orthodontic treatment: A meta-analysis

Objectives- To evaluate the effectiveness of non-steroidal anti-inflammatory drugs (NSAIDs) in managing pain arising from orthodontic interventions, such as archwire or separators placement. Data Sources- Medline and Cochrane databases searched in February 2010 and updated in July 2010 using orthodontics and pain as the search terms. Additional studies located from Google Scholar, Clinical Trials and the reference lists of retrieved articles. Study Selection- Randomized controlled trials comparing NSAID to placebo using visual analogue scale (VAS) scores. Data Synthesis- Of the 1127 studies identified through database searches, seven were included for meta-analysis. Treatment effects (Hedges' g using random effects model) and 95% confidence intervals (CI) of the pain VAS scores were evaluated at 2, 6 and 24h after intervention, during chewing and biting activities. Pain level at 2h differed between the ibuprofen and placebo groups during biting (95% CI: -0.178 to -0.046), but not during chewing (95% CI: -0.551 to 0.148). At 6h, the ibuprofen group exhibited lower pain levels during both activities (chewing 95% CI: -0.640 to -0.123, biting 95% CI: -0.857 to -0.172). At 24h, no statistically significant difference could be detected between ibuprofen and placebo (chewing 95% CI: -0.642 to 0.112, biting 95% CI: -0.836 to 0.048). No statistically significant difference was found between ibuprofen and acetaminophen at any time point. Conclusion- Ibuprofen appears to lower orthodontic pain compared to placebo at 2 and 6h after separators or archwire placement, but not at 24h, when pain peaks. © 2012 John Wiley & Sons A/S

Removable partial dentures vs overdentures in children with ectodermal dysplasia: two case reports

Background: Ectodermal dysplasia (ED) represents a disorder group characterised by abnormal development of the ectodermal derivatives. Removable partial dentures (RPD), complete dentures (CD) or overdentures (OD) are most often the treatment of choice for young affected patients. Prosthetic intervention is of utmost importance in the management of ED patients, as it resolves problems associated with functional, aesthetic, and psychological issues, and improves a patient’s quality of life. However, few studies present the principles and guidelines that can assist in the decision-making process of the most appropriate removable prosthesis. The purpose of this study was to suggest a simple treatment decision-making algorithm for selecting an effective and individualised rehabilitative treatment plan, considering different parameters. Case reports: The cases and treatment of two young ED patients are described and each one was treated with either RPDs or ODs. Follow-up: Periodic recalls were employed to manage problems, and monitor the changes associated with occlusion and fit of the prostheses in relation to each patient’s growth. Both patients were followed up for more than 2 years and reported significant improvement in their appearance, masticatory function, and social behaviour as a result of the prosthetic rehabilitation. Conclusion: The main factors guiding the decision process towards the choice of an RPD or an OD are the presence of posterior natural teeth, facial aesthetics, lip support, number and size of existing natural teeth, and the occlusal vertical dimension. © 2015, European Academy of Paediatric Dentistry

Comparative clinical study testing the effectiveness of school based oral health education using experiential learning or traditional lecturing in 10year-old children

Background: School based oral health education through traditional lecturing has been found successful only in improving oral health knowledge, while has low effectiveness in oral hygiene and gingival health. The aim of this study was to evaluate the effectiveness of experiential learning (EL) oral health education to traditional lecturing (TL), on enhancing oral health knowledge, attitude and behavior as well as oral hygiene, gingival health and caries of 10-year-old children. Methods: Eighty-four children were recruited for the EL and 100 for the TL group from 3 locations in Greece. Data regarding oral health knowledge, attitude and behavior were collected via questionnaires. Data regarding dental plaque, gingivitis and caries were collected by clinical examination. The evaluation using questionnaires and clinical examination was assessed at baseline and 6 and 18months afterwards. Two calibrated pediatric dentists examined the students using a periodontal probe and artificial light. Modified hygiene index (HI) was used for dental plaque recording, the simplified gingival index (GI-S) was used for gingivitis and DMFT, based on BASCD criteria, for dental caries. Based on a dedicated manual, the teacher applied in the classroom the oral health educational program using EL. Results: EL group had statistically significant better hygiene than the TL at 6months (p < 0.05). Within the same group, both groups had enhanced oral health knowledge at 6 and 18months (p < 0.05) and improved oral health behavior (p > 0.05) and attitude (p > 0.05) at 6months in comparison to baseline. Conclusion: EL program was found more successful than TL in oral hygiene improvement. Both oral health education programs improved the oral health knowledge, attitude and behavior of children. © 2015 Angelopoulou et al.; licensee BioMed Central

Understanding the ionic activity and conductivity value differences between random copolymer electrolytes and block copolymer electrolytes of the same chemistry

Herein, a systematic study where the macromolecular architectures of poly(styrene-block-2-vinyl pyridine) block copolymer electrolytes (BCE) are varied and their activity coefficients and ionic conductivities are compared and rationalized versus a random copolymer electrolyte (RCE) of the same repeat unit chemistry. By performing quartz crystal microbalance, ion-sorption, and ionic conductivity measurements of the thin film copolymer electrolytes, it is found that the RCE has higher ionic activity coefficients. This observation is ascribed to the fact that the ionic groups in the RCE are more spaced out, reducing the overall chain charge density. However, the ionic conductivity of the BCE is 50% higher and 17% higher after the conductivity is normalized by their ion exchange capacity values on a volumetric basis. This is attributed to the presence of percolated pathways in the BCE. To complement the experimental findings, molecular dynamics (MD) simulations showed that the BCE has larger water cluster sizes, rotational dynamics, and diffusion coefficients, which are contributing factors to the higher ionic conductivity of the BCE variant. The findings herein motivate the design of new polymer electrolyte chemistries that exploit the advantages of both RCEs and BCEs. © The Royal Society of Chemistry