A short-term analysis of the modification process of the plaque microbial community before and after treatment in children with S-ECC / 口腔疾病防治

Objective @# To explore from the perspective of microorganisms the changes in plaque microbial community of children with severe early childhood caries (S-ECC) before and 3 months after dental treatment. Meanwhile to show the effect of treatment on the maintenance of long- term caries-free state. @*Methods@# S-ECC children completed dental treatment under general anesthesia. We collected plaque from caries-free dental surfaces before treatment (caries, C) and at the postoperative follow-up review time points of 7 days (C-7D), 1 month (C-1 M), and 3 months (C-3 M). We included caries-free children (caries free, CF) as the control group to analyze the dynamic modification process of the plaque microbial community in the short-term pre- and postdental treatment.@*Results@#Species clustering analysis showed that the compositions of the microbial communities of the S-ECC and CF groups were highly similar. The α diversity index was not statistically significant (P>0.05). From the analysis of the relative abundance, Leptotrichia spp. and Aggregatibacter spp. decreased after treatment compared with before treatment (P<0.05). Streptococcus sanguinis in the C-7D group increased compared with that in the C group and gradually decreased within 3 months. Veillonella spp., Actinomyces spp., Allprevotella spp., Capnocytophaga spp., and Streptococcus mutans differed between the C and CF groups (P<0.05), Streptococcus mutans did not differ significantly between the C-7D and C-1 M groups and the CF group after treatment, while C-3 M showed an increase compared with the CF group (P<0.01). @*Conclusion@#The rapid change in the structure of the flora of children with S-ECC after treatment. The plaque microbial community structure in a caries-free state gradually starts to be established 1-3 months after treatment. There is a "core microbiota" in the oral plaque community that jointly maintains microecological stability. Veillonella spp., Allprevotella spp. and Streptococcus mutans have potential as possible microbial markers.

Clinical assessment of occlusion and temporomandibular joint after placement of preformed metal crowns for primary molars / 口腔疾病防治

Objective @#To explore the effect on children's occlusion and temporomandibular joint (TMJ) after placement of preformed metal crowns and provide a reference for the restoration of defective primary molars. @*Methods @#A total of 39 children who underwent all primary molar metal crown restorations under general anesthesia were enrolled. The participants underwent occlusal contact area, percentage of total occlusal force, asymmetric ratio of occlusal force and occlusal contact time examinations with the T-scan computerized occlusal analysis system. Vertical dimension of occlusion (VDO) was measured using a dental vertical dimension gauge. TMJ dysfunction signs were recorded using the modified clinical dysfunction index (Di), and TMJ dysfunction symptoms were recorded using questionnaires. All data were collected at pretreatment, 1-week, 1-month, 3-month, and 6-month follow-up visits. @*Results@#The occlusal contact area at the 3-month and 6-month follow-up visits returned to the occlusal contact area of pretreatment, and the difference was statistically significant (P>0.05). Compared with pretreatment, the percentage of total occlusal force at the 3-month and 6-month follow-up visits increased significantly, and the difference was statistically significant (P<0.05). The asymmetric ratio of occlusal force and the occlusal contact time were significantly decreased at the 6-month follow-up visit (P<0.05). The vertical dimension of occlusion recovered after one month of treatment (P>0.05). The final statistical analysis of the TMJ assessment showed that there was no significant difference in the clinical disorder index and TMJ dysfunction symptoms before and after treatment (P>0.05). @*Conclusions @# After undergoing all primary molar metal crown restorations, occlusal re-equilibrations were attained after approximately one month. The percentage of total occlusal force and occlusal stability were significantly increased after six months of treatment, without significant temporomandibular joint dysfunction.

Serum levels of iron, zinc, copper and vitamin D in severe early childhood caries / 口腔疾病防治

Objective @#The serum levels of iron, zinc, copper and vitamin D in severe early childhood caries (S-ECC) patients were investigated and analyzed to provide reference for primary prevention and diagnosis of S-ECC children.@*Methods @#A total of 184 children were enrolled in the Children Health Department of Xinjiang Medical University Health Management Center from June 2018 to June 2019. They were divided into the caries-free (CF) group (n=89) and S-ECC group (n=95). The contents of iron, zinc, copper and vitamin D were detected.@* Results@# The serum iron content of the CF group and S-ECC group was (8.36 ± 0.42) mmol/L and (8.13 ± 0.44) mmol/L, respectively, and the difference was statistically significant (t=3.50, P < 0.001); the serum content of zinc was (83.18 ± 7.28) μmol/L and (79.23 ± 6.38) μmol/L, respectively, and the difference was statistically significant (t=3.92, P < 0.001); the serum content of 25-hydroxyvitamin D was (86.72 ± 15.83) nmol/L and (77.75 ± 11.38) nmol/L, respectively, and the difference was statistically significant (t=4.42, P < 0.001). The serum copper content of CF group and S-ECC group was (20.18 ± 4.84) μmol/L and (19.49 ± 4.62) μmol/L, but the difference was not statistically significant (t=0.97, P=0.33).@*Conclusion@#The contents of iron, zinc and vitamin D in the serum of S-ECC patients are low, suggesting that iron, zinc and vitamin D supplementation should be emphasized in the prevention and treatment of S-ECC.

Investigation of postoperative complications in children after dental therapy under general anesthesia / 华西口腔医学杂志

OBJECTIVE@#This study aimed to evaluate the postoperative complications undergoing dental general anesthesia in children and analyze the prevalence and related factors.@*METHODS@#This prospective study involved 292 systematically healthy children (36 to 71 months old) who received extensive dental treatment under general anesthesia. Data about patients' histories, characteristics, dental and anesthesia procedure were collected. Parents or caregivers were interviewed face to face preoperation and 72 h postoperation. Data were analyzed using logistic regression.@*RESULTS@#Approximately 93.5% of the enrolled children reported one or more complications. The most prevalent complication was postoperative pain, followed by weariness, agitation, problem in eating, drowsiness, oral bleeding, cough, fever, etc. The length of operative time and femininity were the risks of the postoperative pain. Nutrition status was the factor probably in association with fever.@*CONCLUSIONS@#The children receive longer operative time and girls show to be more susceptible to the postoperative pain. High nutrition status could be the protective factor of postoperative fever.

Estudio de los Valores de Hemograma en Niños con Caries Temprana de la Infancia Severa / Study of Hemogram Values in Children with Severe Early Childhood Caries

RESUMEN: La caries temprana de la infancia severa (CTI-S) es una enfermedad crónica que afecta a niños menores de 6 años, produce dolor, infección y destrucción de los tejidos dentales. El dolor que experimentan los niños con CTI-S puede llevar a hábitos alimenticios alterados que pueden causar deficiencias nutricionales. El objetivo fue evaluar los valores de hemograma en niños con CTI-S y compararlos con los valores normales de referencia para la edad. Se realizó un estudio retrospectivo observacional. Se analizaron las fichas y hemogramas de 47 niños con CTI-S, clasificados como ASA 1, atendidos bajo anestesia general en el Hospital de la Fuerza Aérea de Chile. Se tomaron en cuenta los valores del hemograma en relación a: Hematocrito, Hemoglobina y VCM. Se realizaron test descriptivos para las variables en estudio y se utilizó el testt para comparar los valores de hemograma con los valores normales de referencia. Se encontró una disminución de los valores de hematocrito en 4 pacientes (8,5 %) y una disminución del valor de VCM en 17 pacientes (36,7 %). Se encontraron diferencias significativas al comparar los promedios obtenidos en relación a hematocrito, VCM y hemoglobina en niños con CTI-S con el promedio de referencia (p <0,001). De acuerdo con los resultados obtenidos en este estudio, podemos concluir que los niños con caries temprana de la infancia severa, tienen alteraciones en los valores promedio de hemograma en relación a hematocrito, hemoglobina y VCM.

ABSTRACT: Severe early childhood caries (S-ECC) is a multifactorial chronic disease that affects children under 6 years of age, produces pain, infection and destruction of the dental tissues. The pain experienced by children with SECC may lead to altered eating habits that may cause nutritional deficiencies. The aim of this study was to evaluate the hemogram values in children with severe early childhood caries, and compare them with age population reference values. An observational retrospective study was carried out. We analyzed the medical records and their respective hemograms of 47 children with S-ECC, classified as ASA1, attended at the Chilean Air Force Hospital under general anesthesia. The hemogram values were taken into account in relation to: hematocrit, hemoglobin and mean corpuscular volume (MCV). Descriptive tests were carried out for the variables under study and the t-test was used to compare the hemogram values with the normal reference values. A decrease in hematocrit values was found in 4 patients (8.5 %) and a decrease in the value of MCV in 17 patients (36.7 %). Significant differences were found when comparing the averages obtained in relation to hematocrit, hemoglobin and MCV in children with S-ECC with the reference average (p <0.001). According to the results obtained, in this study, we can conclude that children with severe early childhood caries, have alterations in the average of hemogram values in relation to hematocrit, hemoglobin and MCV.

Study on the dental plaque microbial community in preschool children with different caries sensitivity / 口腔疾病防治

Objective@#To study the difference in the flora structure and gene function of dental plaque in caries-free and caries-active preschool children by 16S rRNA sequencing.@*Methods@#After oral examination of 96 preschool children aged 3-6 years, they were divided into 3 groups according to their decayed, missing and filled surface (dmfs) index: group CF with no caries (n=31), group ECC with moderate early childhood caries (n=29) and group SECC with severe early childhood caries (n=36). Dental plaques were collected, and DNA was extracted and then underwent metagenomic sequencing by Illumina HiSeq 2 500. The bacterial community structure was analyzed by Qiime. @*Results @#A total of 12 phyla, 31 classes, 31 orders, 50 families, 92 genera and 1 104 species were found in the dental plaque samples of the three groups, most of which belonged to 9 dominant genera, including Streptococcus, Veillonella, etc. The microbial diversity of the dental plaques in the three groups was similar (P > 0.05). Veillonella, Lactobacillus, Megasphaera, and Scardovia in the SECC group were significantly higher than those in the other two groups. There was a significant correlation between the decayed, missing and filled surface (dmfs) index and the genus. Bifidobacterium, Veillonella, Lactobacillus had a positive correlation with the dmfs index, while Eikenella had a negative correlation with the dmfs index. Indicator species analysis showed that Atopobium, Veillonella, Megasphaera, Scardovia, Lactobacillus and Bifidobacterium had high indicative values in the SECC group. @*Conclusion @# There are significant differences in plaque microbiota among preschool children with different caries sensitivities. Veillonella, Megasphaera, Scardovia, Lactobacillus, Bifidobacterium and Atopobium may be the indicator genera of severe early children caries.

Reflexiones sobre la caries de la infancia temprana severa / Reflections on early childhood caries

Introducción: el incremento de las visitas de infantes en nuestras respectivas consultas (menores de tres años) con caries de la infancia temprana severa (CIT-S) en estos últimos años es el origen del presente artíuculo de análisis. Objetivo: describir las características de la (CIT-S) plantear hipótesis sobre su presentación clínica; así como agrupar y resumir los factores de riesgo de este particular grupo etéreo. Conclusiones: mientras mejor comprendamos todos los factores de riesgo que participan en esta enfermedad tan multifactorial y prevalente en la infancia, mejores pautas podremos ofrecer a los padres de nuestros pacientes, basadas en el riesgo individual del infante

Introduction: increased visits in our private practice of infants (under 3 years) with severe early childhood caries (CIT-S) in the recent years is the source of this analysis article. Aim: describe the characteristics of the early childhood caries, hypothesize about its clinical presentation; as well as group and summarize the risk factors of this particular age group. Conclusions: the better we understand all the risk factors involved in this disease as multifactorial and prevalent in childhood, best guidelines we offer parents of our patients, based on the individual risk of the infant.