Mouthwashes: Alternatives and Future Directions

This narrative review summarises "alternative" or "natural" over-the-counter (OTC) mouthwashes not covered elsewhere in this supplement and newly emerging products, as potential mouthwashes of the future. The "natural" mouthwashes reviewed include saltwater, baking soda, coconut oil, charcoal, propolis, seaweeds, and probiotics. Other than essential oils, it is apparent that their clinical effectiveness is still under debate, but there is some evidence to suggest that propolis reduces plaque and gingivitis. This review also covers the host immune response, via novel anti-inmmunomodulant mouthwashes, such as erythropoietin to reduce inflammation with oral mucositis (OM) after radiotherapy. The emerging concept of nanoparticle-containing mouthwashes, such as iron oxide, is further discussed for OM, this agent having the potential for more targeted delivery of chemical antimicrobials. Unfortunately, there are impacts on the environment of widening mouthwash use with more new products, including increased use of packaging, antimicrobial resistance, and possible detrimental effects on marine life. Further, there are roadblocks, relating to regularly approvals and side effects, that still need to be overcome for any OTC deivered immunomodulant or nanoformulation mouthwashes. . Despite these caveats, there are many new mouthwashes under development, which could help manage major oral diseases such as caries, gingivitis, and periodontal disease

Six-month recall dental appointments, for all children, are (un)justifiable

Each child is an individual with specific needs, which necessitates a different plan of management based on the type of oral disease or disability present. This raises a question as to whether the customary fixed sixmonth recall visits for children commonly advocated by dental professionals need to be altered/adjusted so as to reflect the individual's oral health needs more closely, in order to optimize their clinical and costeffectiveness. This paper provides a comprehensive review of the evidence to either justify or refute the sixmonth recall dental appointments for all children. Based on the available evidence, we conclude that the judgment about appropriate intervals should be made by the dental practitioner on an individual risk basis as insufficient evidence exists to either justify, or refute the six-month recall dental appointments.link_to_subscribed_fulltex

Radiographic localization of supernumerary teeth in maxilla

This journal supplement is Special Issue: Abstracts of the 23rd Congress of the International Association of Paediatric Dentistry, 2011Poster Session P29 - Dental Trauma 4/TMJ/Xrays/Education: abstract no. P29-526BACKGROUND: Localization of supernumerary teeth is essential for diagnosis and treatment planning, and several techniques have been reported in the literature. Nevertheless, vertical tube shift (VTS) and horizontal tube shift (HTS) techniques are commonly used for localization of supernumerary teeth. AIM: This study sought to evaluate the reliability of two different localization techniques (VTS and HTS) for supernumerary teeth. DESIGN: Seventy five patients were randomly selected from the records of paediatric patients at the Prince Philip Dental Hospital. Only non-syndromic patients with single supernumerary teeth, and complete clinical and radiographic (PAN, AO, PA and CBCT) records were included. Ten examiners independently rated 75 pairs of radiographs for each technique. Descriptive statistics were computed using chi-squire teat and kappa statistics was employed to assess the intra- and inter- observer reliability. RESULTS: Data from 750 pairs were available for analysis. The overall sensitivity for VTS and HTS was 73% and 72.9% respectively with slight inter- and good intra- examiner reliability. Statistically significant differences were not evident between the two techniques for localizing supernumerary teeth. CONCLUSION: Based on the findings of this study, an approximate 27% failure rate was evident for both VTS and HTS techniques.link_to_OA_fulltextThe 23rd Congress of the International Association of Paediatric Dentistry, Athens, Greece, 15-18 June 2011. In International Journal of Paediatric Dentistry, 2011, v. 21 suppl. s1, p. 245, abstract no. P29-52

Management of dental traumatic injuries to permanent dentition-an informed approach

This journal supplement is Special Issue: Abstracts of the 23rd Congress of the International Association of Paediatric Dentistry, 2011Poster Session P18 - Jens O. Andreasen Awards: abstract no. P18-327INTRODUCTION: Fractured, displaced, or avulsed teeth are the most commonly occurring dental traumatic injuries (DTIs) in children. These injuries cause pain, impair masticatory function, speech, and compromise esthetics, thus affecting the child’s overall quality of life. The child’s age, severity of injury, and appropriate treatment and follow up, using the recommended guidelines and procedures, are critical for successful treatment. CASE REPORT: A 9-year-old Chinese boy presented with avulsion and intrusion injuries to his permanent maxillary central incisors, 90-minutes following a fall at school. His medical history was noncontributory. Tooth 21 was re-implanted, and teeth 21 and 11 were treated endodontically with calcium hydroxide placed in the root canal. Consequently, tooth 21 exhibited external root resorption, and after 21 months only the cervical third of the root had remained. In the presence of the patients existing malocclusion teeth 11 and 21 were extracted as part of a multidisciplinary treatment plan with the option of using the lateral incisors to replace the central incisors and canines to replace the laterals. COMMENTS: Despite the availability of several management options, there appears to be no guaranteed outcome for DTIs. Each child is an individual with specific treatment needs, which necessitates a different treatment plan based on the type of traumatic injury encountered. This case highlights, that the treatment outcome patterns of DTIs are unpredictable and, a multi-disciplinary informed approach, as in this case, may result to a more predictable outcome.link_to_OA_fulltextThe 23rd Congress of the International Association of Paediatric Dentistry, Athens, Greece, 15-18 June 2011. In International Journal of Paediatric Dentistry, 2011, v. 21 suppl. s1, p. 177, abstract no. P18-32

Remineralizing action of CPP-ACP reagents on artificial carious lesions

This journal supplement is Special Issue: Abstracts of the 23rd Congress of the International Association of Paediatric Dentistry, 2011Oral Session O10 - Cariology 3: abstract no. O10-90AIM: To evaluate the efficacy of CPP-ACP containing pastes; Clinpro® (500 ppm tri-calcium phosphate +950 ppm sodium fluoride) and Tooth Mousse Plus® (10% CPP-ACP + 900 ppm sodium fluoride) in remineralizing artificial enamel carious lesions. DESIGN: Fifty extracted human third molars were cleaned of soft tissue debris and inspected for any cracks, caries or hypoplasia. The teeth were painted with an acid resistant nail varnish leaving a 1 mm window on the buccal and lingual surfaces and then immersed in a demineralizing solution for 96 h, to produce artificial carious lesions 90–180 lm deep. Subsequently, the teeth were sectioned longitudinally through the lesion to produce sections that were approximately 100–150 lm thick. The tooth specimens were randomly divided into four groups (n = 29) and treated with a non-fluoridated or fluoridated paste (for 1 min), Clinpro® or TM Plus® pastes (for 3 min) in a 10 day pH cycling model. Lesion depth (LD) and mineral content (Vmax) for each specimen were evaluated using polarized light microscopy (PLM) and microradiography (MRG) before and after the pH cycle. Paired t-test, ANOVA and Student-Newman–Keuls tests were employed to make comparisons within, and between the different treatment groups. RESULTS: Significant differences were evident when comparisons were made between the pre- and post-treatment specimens within each group. When multiple comparisons were made, specimens treated with Clinpro® exhibited the greatest reduction in LD and increase in Vmax as compared to the other treatment groups. CONCLUSION: A three minute application of Clinpro® exhibited a higher efficacy in remineralizing artificial enamel carious lesions than TM Plus®.link_to_OA_fulltextThe 23rd Congress of the International Association of Paediatric Dentistry, Athens, Greece, 15-18 June 2011. In International Journal of Paediatric Dentistry, 2011, v. 21 suppl. s1, p. 31, abstract no: O10-9

Novel complex disease allele mutations in cleidocranial dysplasia patients

This study reports a novel identical complex disease allele harboring two non-synonymous mutations that were identified in two southern Chinese individuals of the same family with cleidocranial dysplasia (CCD). Blood samples were obtained from the proband, his parents, plus 100 matched control subjects. Exons 0 to 7 of the RUNX2 gene were amplified using specific primers and sequenced. Multiple sequence alignment and protein structure modeling was performed using ClustalW2 and MODBASE software while PolyPhen-2 and MutationTaster applications were employed to predict the disease-causing potential of the identified mutations. A complex disease allele in two affected individuals harboring two non-synonymous mutations in a cis-position on exons 4 (D273N) and 5 (P299L) were identified. The identified mutations were in the conserved region and changed the protein structure

Heterozygous Variants in <i>FREM2</i> Are Associated with Mesiodens, Supernumerary Teeth, Oral Exostoses, and Odontomas

Background: Supernumerary teeth refer to extra teeth that exceed the usual number of dentitions. A mesiodens is a particular form of supernumerary tooth, which is located in the premaxilla region. The objective of the study was to investigate the genetic etiology of extra tooth phenotypes, including mesiodens and isolated supernumerary teeth. Methods: Oral and radiographic examinations and whole-exome sequencing were performed on every patient in our cohort of 122 patients, including 27 patients with isolated supernumerary teeth and 94 patients with mesiodens. A patient who had multiple supernumerary teeth also had odontomas. Results: We identified a novel (c.8498A>G; p.Asn2833Ser) and six recurrent (c.1603C>T; p.Arg535Cys, c.5852G>A; p.Arg1951His, c.6949A>T; p.Thr2317Ser; c.1549G>A; p.Val517Met, c.1921A>G; p.Thr641Ala, and c.850G>C; p.Val284Leu) heterozygous missense variants in FREM2 in eight patients with extra tooth phenotypes. Conclusions: Biallelic variants in FREM2 are implicated in autosomal recessive Fraser syndrome with or without dental anomalies. Here, we report for the first time that heterozygous carriers of FREM2 variants have phenotypes including oral exostoses, mesiodens, and isolated supernumerary teeth