Tooth eruption sequence and dental crowding: a case-control study.

UNLABELLED: When cases of dental crowding are identified and diagnosed promptly, interceptive orthodontics is particularly successful. AIM: To assess the differences in the eruption sequence of the mandibular canine and first premolar teeth in children with and without dental crowding. MATERIALS AND METHODS: Children who attended the Shiraz Dental School's orthodontic clinic (Iran) from September to December 2012 were enrolled in this case-control study. Tooth size arch length discrepancy (TSALD) of all 8-10 year olds was calculated from patients' dental models. Thirty-six children were randomly selected from those with TSALD of equal or less than 4mm (those with crowding). Each selected case was matched for sex and age with another child (as control) with TSALD>-4mm attending the same clinic, in the same time period. The existing panoramic radiographs were traced and the eruption percentages were measured for mandibular canine and first premolar teeth. The mean difference between canine and first premolar eruption percentages was compared between the case and control groups using the SPSS (version PASW 18) software and a paired sample t-test. RESULTS: Canine and first premolar eruption percentages in the case group were 65.82±13.00 and 78.92±10.15 percent, respectively. The mean eruption percentages for canines and first premolars of the control group were 74.12±14.55 and 75.47±11.60 percent, respectively. There was a significant difference in pre-eruptive positions of canine and first premolar teeth in those with moderate to severe crowding when compared to the control group (p<0.001). CONCLUSION: These findings may improve the early diagnosis of children with high risk of developing moderate to severe crowding during mixed dentition

Socioeconomic gradients in general and oral health of primary school children in Shiraz, Iran

BACKGROUND: Health status is largely determined by socio-economic status. The general health of individuals at higher social hierarchy is better than people in lower levels. Likewise, people with higher socio-economic status have better oral health than lower socio-economic groups. There has not been much work regarding the influence of socio-economic status on the health conditions of children in developing countries, particularly in Iran. The aim of this study was to compare the oral and general health conditions of primary school children of three different socio-economic areas in the city of Shiraz, Iran. METHODS: This cross-sectional study was conducted on 335, 8- to 11-year-old primary schoolchildren in Shiraz. The children were selected by a three-stage cluster sampling method from three socio-economically different areas. Tools and methods used by the United Kingdom's Medical Research Council were used to obtain anthropometric variables as indicators of general health. The Decay, Missing, Filled Teeth (DMFT) Index for permanent teeth, dmft Index for primary teeth, the Modified Developmental Defects of Enamel (DDE) Index, the Gingival Index (GI) and the Debris Index-Simplified (DI-S) were used for oral health assessment.  RESULTS: Height (P<0.001), weight (P<0.001), and BMI (P=0.001) significantly increased as the socio-economic status of area increased. GI score (P<0.001), DI-S score (P<0.001), number of permanent teeth with DDE (P=0.008), and number of DDE lesions in permanent teeth (P=0.008) significantly decreased as the socio-economic status of area increased. DISCUSSION: Findings of this study generally confirmed that social gradients exist in both general and oral health status of the primary schoolchildren of Shiraz. The influence of socio-economic status on health condition means children have different life chances based on their socio-economic conditions. These findings emphasize the significance of interventions for tackling socio-economic inequalities in order to improve the health status of children in lower socio-economic areas

Association of characteristics of delivery and medical conditions during the first month of life with developmental defects of enamel.

BACKGROUND: Developmental defects of enamel (DDE) may be influenced by health problems and illness in children. The aim of the study was to identify the main characteristics of birth (delivery) and adverse medical conditions during the first month of life that may be related to DDE in permanent teeth. METHODS: 1000 schoolchildren between the ages of 9 and 11 years were selected for this cross-sectional study by multistage randomization from four educational zones in Shiraz in 2013. Intraoral examination was used to diagnose DDE according to World Health Organization screening guidelines and the Modified DDE Index. The data on seven birth factors as well as health and nutritional conditions during the first month of life were collected by a questionnaire completed by the parents, and were analyzed with the chi-squared test, Spearman's correlation and binary logistic regression. RESULTS: 469 (48.2%) out of 974 schoolchildren had at least one permanent tooth with DDE. The defects were significantly related with Apgar score at birth <7 (p = 0.003) and illness during the first month (p = 0.035). The frequency of DDE was significantly lower in the third child in families compared to the first and second child (p = 0.005). However, DDE showed no significant relationship with gestational age, delivery type, birth weight, gender or type of feeding during early infancy. CONCLUSIONS: Three associated factors were identified (birth Apgar score, illness during the first month of life, birth order) for DDE in permanent teeth. No specific illness was found to be significantly associated with DDE

Designing a customized clinical practice guideline regarding antibiotic prophylaxis for Iranian general dentists.

BACKGROUND: Clinical practice guidelines produced by developed countries seemed to be not completely feasible for developing countries due to their different local context. In this study, we designed a customized guideline about antibiotic prophylaxis before dental procedures for Iranian general dentists. METHODS: This study was conducted of two parts, including a qualitative part and a cross-sectional analytic part. A multidisciplinary team searched for related guidelines and other documents, selected the most updated and high quality ones, customized their recommendations based on available antibiotics in Iran, prepared a draft adapted guideline and summarized its recommendations in 3 flowcharts. An expert panel (20 specialists of four Iranian dental universities) participated in a consensus process, afterwards to determine the relevance and clarity of the flowcharts and their items. Then the Content Validity Indices (CVIs) were calculated and any items with CVI higher than 0.79 remained. RESULTS: The adapted recommendations were summarized in flowcharts A to C. Two separate groups of patients who need antibiotic prophylaxis were presented in flowchart A; including those with high risk for distant-site infection (infective endocarditis and prosthetic joint infection) and those at risk for poor healing and orofacial infection (due to impaired immunologic function). Flowcharts B and C described antibiotic regimen and also the dental procedures where antibiotic prophylaxis was needed for mentioned groups. The content validity indices and the percentages of agreement between the expert panel members were considerably high. CONCLUSIONS: A localized, clear and straight forward guideline that addresses all groups of dental patients who need antibiotic prophylaxis has been produced for Iranian general dentists