Prevalence of tooth loss, bleeding on probing and malocclusion as oral disease indicators in Costa Rican male adolescents: a cross sectional study / Prevalencia de la pérdida de piezas dentales, del sangrado al sondeo y la maloclusión como indicadores de enfermedades orales en adolescentes varones costarricenses: un estudio transversal

The evidence to characterize oral health during adolescence in Costa Rica is limited. This lack of adequate research makes it difficult to develop appropriate health policies for this subgroup of the population. This is particularly important because adolescence is the period during which good health habits must take root in order to foster good physical and cognitive development. This study aims to determine the prevalence of tooth loss, bleeding on probing and malocclusion in Costa Rican male adolescents at the ''Colegio Técnico Profesional San Agustín'' (St. Augustine's Technical High School) located in the province of Cartago. Data was collected from 428 male adolescents aged 12-22 years in a cross-sectional study during 2019. Prevalence of tooth loss was calculated as the number of individuals having lost at least one tooth. The average number of teeth lost by individuals was also recorded. The bleeding on probing was an indicator used as a proxy parameter for monitoring periodontal health where the presence of bleeding on probing and calculus was also recorded. Malocclusion was measured using the Dental Aesthetic Index (DAI). The results showed that the prevalence of tooth loss, bleeding on probing and malocclusion was of 19%, 70.0% and 98%, respectively. It was also found that 81% of the participants had all their teeth, 11% had lost 1 tooth, 8% had lost more than one tooth of which 0.5% had lost more than 5 teeth. Considering a general classification of periodontal problems based on bleeding on probing and presence of calculus, the prevalence of periodontal problems increases to 92%. Regarding the DAI, the category identifying a very severe malocclusion was the most prevalent in the sample (88%). It is alarming the high prevalence of tooth loss, bleeding on probing, and malocclusions in a sample of Costa Rican male adolescents, compared to similar studies in other countries. The overarching conclusion of this study is that oral diseases represent an important health problem that urgently need proper public health action.

La evidencia para caracterizar la salud bucal durante la adolescencia en Costa Rica es limitada. Esta falta de investigación adecuada dificulta el desarrollo de políticas de salud convenientes para este subgrupo de la población. Esto es particularmente importante porque la adolescencia es el período durante el cual se deben arraigar buenos hábitos de salud para fomentar un buen desarrollo físico y cognitivo. Este estudio tiene como objetivo determinar la prevalencia de pérdida de piezas dentales, sangrado al sondeo y maloclusión en adolescentes varones costarricenses del Colegio Técnico Profesional San Agustín ubicado en la provincia de Cartago. Se recopilaron datos de 428 adolescentes varones de 12 a 22 años en un estudio transversal durante 2019. La prevalencia de pérdida de piezas dentales se calculó como el número de individuos que habían perdido al menos una pieza dental. También se registró el número promedio de dientes perdidos por individuos. El sangrado al sondeo fue un indicador utilizado como parámetro para el seguimiento de la salud periodontal donde también se registró la presencia de sangrado al sondeo y cálculo dental. La maloclusión se midió utilizando el Índice Estético Dental (DAI, por sus siglas en inglés). Los resultados mostraron que la prevalencia de pérdida de piezas dentales, sangrado al sondeo y maloclusión fue del 19%, 70,0% y 98%, respectivamente. También se encontró que el 81% de los participantes tenían todos sus dientes, el 11% había perdido 1 pieza dental, el 8% había perdido más de una pieza dental, de los cuales el 0,5% había perdido más de 5 piezas dentales. Considerando una clasificación general de problemas periodontales basada en sangrado al sondeo y presencia de cálculo, la prevalencia de problemas periodontales aumenta al 92%. En cuanto al DAI, la categoría que identifica una maloclusión muy severa fue la más prevalente en la muestra (88%). Es alarmante la alta prevalencia de pérdida de piezas dentales, sangrado al sondeo y maloclusiones en una muestra de adolescentes varones costarricenses, en comparación con estudios similares en otros países. La conclusión general de este estudio es que las enfermedades bucodentales representan un importante problema de salud que necesita urgentemente una acción adecuada de salud pública.

Systematic review of clinical effects of enamel matrix derivative as adjunctive therapy for gingival recession / 口腔疾病防治

Objective @#To evaluate the clinical effect of enamel matrix derivative(EMD) assisted with connective tissue graft(CTG) in the treatment of gingival recession.@*Methods @#Search The Cochrane Library, PubMed, EMbase, Web of Science, Wanfang Public Database,VIP database and CNKI to search for randomized controlled trials of EMD in the treatment of gingival recession. The search period is from the establishment of the databases to October 3, 2022. The test group was treated with EMD+CTG, while the control group was treated with CTG alone. Meta-analyses were performed using Review Manager 5.4.1 and Stat12.0.@*Results@# Meta analysis results showed that only 12 months after treatment, there was a statistically significant difference in the PD and CAL outcome indicators between the EMD assisted treatment group and the control group [MDPD=-0.10, 95% CI (-0.19, -0.01), P = 0.03], [MDCAL=-0.38, 95% CI(-0.71, -0.04), P = 0.03]. There was no significant difference between the test group and the control group in other indicators.@*Conclusion @#EMD assisted CTG in the treatment of gingival recession may be beneficial to the reduction of PD and CAL.

Peri-implant clinicoradiographic status among betel-quid chewers and controls

Abstract The aim of the present case-control observational study was to evaluate the peri-implant clinicoradiographic status among betel-quid chewers and controls. Self-reported betel-quid chewers and controls were included. Participants were categorized into 3 groups: Group-1: Individuals chewing betel-quid with tobacco; Group-2: Individuals chewing betel-quid without tobacco; and Group-3: Controls (individuals not using tobacco in any form). Demographic data was collected using a questionnaire. Periodontal and peri-implant clinicoradiologic parameters (plaque and gingival indices [PI and GI], probing depth [PD] and crestal bone loss/marginal bone loss [CBL/MBL]) were assessed. Clinical attachment loss (AL) around teeth was also assessed. Group comparisons were done using the one-way analysis of variance and Bonferroni Post-hoc adjustment tests. Correlation of periodontal and peri-implant inflammatory parameters with the duration of betel-quid chewing habit and duration of placement in the mouth were assessed using logistic regression analysis. P<0.05 was considered statistically significant. Thirty, 30 and 30 patients were included in groups 1, 2 and 3, respectively. Full-mouth PI (P<0.01), GI (P<0.01), clinical AL (P<0.01), PD (P<0.01) and mesial and distal MBL (P<0.01) were higher in groups 1 and 2 than Group-3. Peri-implant mPI (P<0.01), mGI (P<0.01), PD (P<0.01) and MBL/CBL (P<0.01) were significantly higher in groups 1 and 2 than Group-3 with no significant difference in groups 1 and 2. Betel-quid chewing habit either with or without tobacco is a risk-factor of peri-implant soft-tissue inflammation and CBL.

Resumo O objetivo do presente estudo observacional de casos-controles foi avaliar o estado clínico-radiográfico periimplantar dos usuários de bétele. Foram incluídos usuários que relataram utlizar a substância bétele como tabaco de mascar. Os participantes foram categorizados em 3 grupos: Grupo-1: Indivíduos que mascam bétele com tabaco; Grupo-2: Indivíduos que mascam bétele sem tabaco; e Grupo-3: Controle (indivíduos que não usam tabaco sob qualquer forma). Os dados demográficos foram recolhidos utilizando um questionário. Foram avaliados parâmetros clínico-radiográfico e periimplantares (índices placa e gengivais [IP e IG], profundidade de sondagem [PS] e perda de crista óssea/ perda óssea marginal [PCO/POM]). Também foi avaliada a perda inserção clínica (IC) em torno dos dentes. As comparações de grupo foram feitas utilizando a análise de variância unidireccional e os testes de ajustamento post-hoc de Bonferroni. A correlação dos parâmetros inflamatórios periodontais e periimplantares com a duração do hábito de mastigação da bétele e duração da colocação na boca foi avaliada utilizando a análise de regressão logística. P<0,05 foi considerado estatisticamente significativo. Foram utilizados 30 pacientes em cada grupo. O IP de boca inteira (P<0,01), IG (P<0,01), IC clínica (P<0,01), PS (P<0,01) e POM mesial e distal (P<0,01) foram mais elevados nos grupos 1 e 2 do que no grupo 3. O mPI peri-implantar (P<0,01), '(P<0,01), PD (P<0,01) e POM/PCO (P<0,01) foram significativamente mais elevados nos grupos 1 e 2 do que no grupo 3, sem diferença significativa nos grupos 1 e 2. O hábito de mastigar a substância bétele com ou sem tabaco é um fator de risco de inflamação dos tecidos moles periimplantares e PCO.

Condición Periodontal de los Dientes Temporales Adyacentes a la Hendidura Alveolar en Pacientes con Labio y Paladar Hendido Unilateral No Sindrómico, Hospital Nacional de Niños "Dr. Carlos Sáenz Herrera", Caja Costarricense de Seguro Social

RESUMEN: Los dientes adyacentes a la hendidura alveolar, en pacientes con labio y paladar hendido, presentan mayor incidencia de problemas periodontales, según la literatura. El objetivo de este trabajo fue evaluar si los dientes temporales adyacentes a la hendidura alveolar presentan mayor incidencia de problemas periodontales en niños con labio y paladar hendido unilateral completo no sindrómico, nacidos en 2010 y 2011, atendidos en el Hospital Nacional de Niños "Dr. Carlos Sáenz Herrera", Caja Costarricense de Seguro Social. Este estudio prospectivo, transversal, descriptivo, e intervencional evaluó variables epidemiológicas, clínicas y radiográficas (placa bacteriana, profundidad de bolsa, nivel de inserción, recesión gingival, sangrado, encía queratinizada e insertada, cálculo y movilidad dental, tipo de hendidura alveolar). Se utilizó técnicas de análisis estadísticos descriptivas (distribución de frecuencias, cruce de variables y construcción de intervalos de confianza). El análisis de datos y procesamiento estadístico se realizó en SPSS versión 17.0 y en Excel. El grupo constó de 17 pacientes, con edad promedio de 5 años. Se encontró 47 % de placa dental y 0 % de cálculo dental. La profundidad de bolsa y el sangrado fueron estadísticamente mayores para los dientes dentro de la hendidura alveolar. Los dientes adyacentes a la hendidura presentaron menor cantidad de encía queratinizada e insertada. Referente a la movilidad dental no existe diferencia estadísticamente significativa. Solo un diente presentó recesión gingival. La hendidura alveolar completa predominó radiográficamente. Los dientes cercanos a la hendidura alveolar tienen mayor predisposición a problemas periodontales, por lo que es relevante el seguimiento regular de la salud periodontal.

ABSTRACT: The teeth adjacent to the alveolar cleft, in patients with cleft lip and palate, present a higher incidence of periodontal problems, according to the literature. The purpose of this study was to evaluate whether the temporary teeth adjacent to the alveolar cleft present a higher incidence of periodontal problems in children with non-syndromic complete unilateral cleft lip and palate, born in 2010 and 2011, treated at the Hospital Nacional de Niños "Dr. Carlos Sáenz Herrera", Caja Costarricense de Seguro Social. This prospective, cross-sectional, descriptive, and interventional study evaluated epidemiological, clinical and radiographic variables (bacterial plaque, pocket depth, insertion level, gingival recession, bleeding, keratinized and inserted gingiva, dental calculus and mobility, type of alveolar cleft). It used descriptive statistical analysis techniques frequency distribution, crossing of variables and construction of confidence intervals. Data analysis and statistical processing was performed in SPSS version 17.0 and in Excel. The group consisted of 17 patients, with an average age of 5 years. 47 % dental plaque and 0 % dental calculus were found. Pocket depth and bleeding were statistically higher for teeth in the alveolar cleft. The teeth adjacent to the cleft had less keratinized and inserted gingiva. Regarding dental mobility, there is no statistically significant difference. Only one tooth had gingival recession. The complete alveolar cleft predominated radiographically. Teeth close to the alveolar cleft have a greater predisposition to periodontal problems, so regular monitoring of periodontal health is relevant.

Lacrimal duct probing combined with tobramycin eye drops in the treatment of congenital dacryocystitis / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To explore the clinical efficacy of probing lacrimal passage combined with tobramycin eye drops in the treatment of congenital dacryocystitis. <p>METHODS: A total of 228 children(250 eyes)aged from 6mo-3a with congenital dacryocystitis treated in our hospital from January 2017 to June 2019 were included. They were assigned into three groups by age: 133 patients(149 eyes)aged from 6mo-1a(Group A), 62 patients(64 eyes)aged from 1-2a(Group B), and 33 patients(37 eyes)aged from 2-3a(Group C). All patients received lacrimal duct probing in surface anesthesia combined with postoperative tobramycin eye drops. <p>RESULTS: The probing cure rates of congenital dacryocystitis among there groups were 97.3%(Group A), 92.2%(Group B)and 83.8%(Group C), respectively. No adverse events reported. Through comparison of these three groups, the cure rate of children from 6mo-1a was the highest. The difference was statistically significant(<i>P</i>=0.009).<p>CONCLUSION: Lacrimal duct probing is effective in the treatment of congenital dacryocystitis, and it is safe and reliable to combine tobramycin eye drops(TOBREX)after surgery. The best time for treatment is 6mo-1a. The operation is simple, less complication, with high clinical value.

Clinical efficacy evaluation of minimally invasive periodontal therapy assisted by endoscopy / 口腔疾病防治

Objective @# To investigate the clinical effect of periodontal endoscope-assisted scaling and root planing (SRP) in treating advanced periodontitis. @*Methods@# Nineteen cases of grade Ⅲ and Ⅳ periodontitis selected from June 2017 to January 2019 in the Nanjing Stomatological Hospital, Medical School of Nanjing University were divided into the periodontal endoscope and control groups. In the periodontal endoscope group, SRP was performed under a periodontal microscope in one treatment after initial supragingival scaling; in the control group, SRP was performed under regular conditions, and additional SRP was conducted in positive bleeding on probing sites twice every other week as needed. Periodontal status, including probing depth (PD), bleeding on probing (BOP) and attachment loss (AL), was recorded by a Florida probe.@*Results@# For sites of 4<PD ≤ 6 mm, there was no significant difference in PD- and BOP-positive rates or AL between the two groups at baseline. The PD- and BOP-positive rates and AL in the endoscope group and control group decreased significantly from baseline at 3 and 6 months. PD in the endoscope group was smaller than that in the control group at 3 months (P < 0.05). There was no significant difference between the two groups at 6 months (P >0.05). There was no significant difference in the BOP positive rate or AL change between the two groups at 3 months and 6 months (P > 0.05). For sites with PD > 6 mm, at baseline, the positive rates of PD, BOP and AL in the endoscope group were more serious than those in the control group, and the differences were statistically significant. The PD- and BOP-positive rates and AL in the endoscope group and control group decreased significantly from baseline at 3 and 6 months. However, PD in the endoscope group became shallower than that in the control group (P < 0.05) after 3 and 6 months. There was no significant difference in the BOP positive rate or AL between the two groups (P>0.05). @*Conclusion @#When compared to regular SRP, periodontal microscope-assisted SRP achieves better improvement in PD and is more beneficial for reducing the BOP and AL of deeper sites.

Analysis of the neonatal dacryocystitis treated by lacrimal passage probing in ambulatory surgery mode during the prevalence of COVID-19 / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To analyze the clinical efficacy of neonatal dacryocystitis treated by the lacrimal passage probing(LPB)in ambulatory surgery mode during the prevalence of the COVID-19, and to provide a theoretical basis for the development and promotion of daytime operation mode of LPB in neonatal dacryocystitis.<p>METHODS: The information of 215 cases with neonatal dacryocystitis treated by LPB with ambulatory surgery mode was analyzed retrospectively, including the cure rate, the incidence of complications and adverse reactions, as well as the reasons for not arriving at the hospital after appointment.<p>RESULTS: All patients accomplish LPB surgery and daytime operation management successfully. The success rate of LPB for neonatal dacryocystitis with ambulatory surgery mode was 99.6%, with few postoperative complications and adverse reactions. The reason why the children did not arrive at the hospital after appointment was mainly due to the sickness being catching a cold, pneumonia, diarrhea and other diseases, otherwise, they had to cancel or postponed the appointment.<p>CONCLUSION: In the course of the prevalence of the COVID-19, LPB in the treatment of neonatal dacryocystitis in ambulatory surgery mode is safe, effective and feasible. It can reduce hospitalization expenses, shorten hospitalization time, and is more conducive to the prevention and control of COVID-19, which is worthy of popularization and application.

The level of antimicrobial peptides in gingival crevicular fluid and its correlation with periodontal clinical indexes in elderly patients with type 2 diabetic periodontitis / 口腔疾病防治

Objective@#To investigate the changes and significance of human beta-defensin-2 (HBD-2) and LL-37 in the gingival crevicular fluid of patients with periodontitis and type 2 diabetes mellitus (T2DM).@*Methods@#This study was conducted among 45- to 85-year-old patients in the Department of Stomatology and Internal Medicine of Shenzhen Center for Chronic Disease Control, including a healthy control group of 22 people, a systemically healthy control group of 19 people with periodontitis, a T2DM periodontal health group of 15 people, and a T2DM group of 21 people with periodontitis. The Florida periodontal probe was used for periodontal examination, and the clinical indexes, including probing depth (PD), clinical attachment level (CAL) and probing on bleeding (BOP), were recorded. The concentrations of HBD-2 and Ll-37 in gingival crevicular fluid were determined by ELISA. The differences in HBD-2, LL-37 and periodontal clinical indexes between the groups were compared, and correlation analysis was conducted.@*Results@#The PD values in T2DM with the periodontitis group were higher than those of the systemically healthy controls with periodontitis group (P < 0.05); the levels of HBD-2 and LL-37 in gingival crevicular fluid in systemically healthy controls with periodontitis group were significantly higher than those in the healthy control group (P < 0.05), the level of HBD-2 in gingival crevicular fluid in systemically healthy controls with periodontitis group was significantly higher than that in T2DM with periodontitis group (P < 0.05); and the antimicrobial peptides HBD-2 and LL-37 in gingival crevicular fluid were significantly positively correlated with the PD and CAL in systemically healthy controls with periodontitis group (P < 0.05), and there was no significant correlation between the antimicrobial peptides HBD-2, LL-37 in gingival crevicular fluid and PD, CAL in T2DM with periodontitis group (P > 0.05).@*Conclusion@#The levels of antimicrobial peptides HBD-2 and LL-37 in gingival crevicular fluid of middle-aged and elderly patients with T2DM periodontitis were lower, and there was no significant correlation with PD and CAL in periodontal clinical indicators.

Application of Tobramycin eye drops combined with irrigation and probing of lacrimal passage in the treatment of infant dacryocystitis / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To observe the application effect of tobramycin eye drops combined with irrigation and probing of lacrimal passage in the treatment of infant dacryocystitis. <p>METHODS: Totally 158 infants(174 eyes)with dacryocystitis treated in the hospital between January 2018 and December 2019 were enrolled. They were randomly divided into observation group(79 cases, 85 eyes)and control group(79 cases, 89 eyes)according to the order of treatment. The observation group was treated with tobramycin eye drops combined with irrigation and probing of lacrimal passage, while the control group was treated with irrigation and probing of lacrimal passage alone. The therapeutic effects of two groups were evaluated. The number of successful probing, incidences of complications, changes in inflammatory factors \〖interleukin 6(IL-6), tumor necrosis factor-α(TNF-α), high-sensitivity C-reactive protein(hs-CRP)\〗 before and after treatment and satisfaction of family members were compared between two groups. <p>RESULTS: The total response rate and the success rate of one-time probing in the observation group were significantly higher than those in the control group(91.8% <i>vs</i> 76.4%, 94.1% <i>vs</i> 80.9%, <i>P</i><0.05). After treatment, the observation group had significantly lower levels of IL-6, TNF-α and hs-CRP than the control group(<i>P</i><0.05). The incidence rate of complications in the observation group was significantly lower than that in the control group(4.7% <i>vs</i> 14.6%, <i>P</i><0.05). Family members of the observation group had significantly higher satisfaction than those of the control group(96.2% <i>vs</i> 82.3%, <i>P</i><0.05). <p>CONCLUSION: Tobramycin eye drops combined with irrigation and probing of lacrimal passage can effectively strengthen the curative effect on infant dacryocystitis, improve the success rate of one-time treatment, control local infectious inflammation, and reduce the incidence of postoperative complications. Besides, family members are highly satisfied.

Avaliação e Treinamento das Técnicas Básicas e Iniciais para a Locomoção com A Bengala em Ambientes Escolares1 / Evaluation and Training of Basic and Initial Techniques for Probing Cane Use in School Environments1

RESUMO: Este estudo teve como objetivo avaliar um programa de treinamento das técnicas básicas com a bengala em ambiente escolar. Uma estudante com 13 anos de idade, com cegueira congênita, matriculada no 6º ano/ 5ª série do Ensino Fundamental, participou do estudo. Os instrumentos utilizados foram os protocolos de avaliação das técnicas básicas de orientação e mobilidade. As avaliações ocorreram em três ambientes: corredores, sala de aula e pátio, e o design quase experimental foi composto por pré-teste, intervenção e pós-teste. A análise foi quantitativa para os desempenhos da estudante e, na intervenção, qualitativa para a escolha das estratégias de ensino. Os resultados do pré-teste apontaram que a estudante não teve dificuldades em executar os comportamentos básicos das técnicas propostas, porém deixou de realizar aqueles que são específicos, que foram o foco do treinamento. As estratégias de ensino foram explicações, instruções e apresentação de modelos cinestésicos. Os resultados do pós-teste apontaram que a estudante conseguiu executar a maioria dos comportamentos de todas as técnicas em todos os ambientes. Conclui-se que o programa de treinamento teve sucesso devido: ao tipo de estudo quase experimental, que possibilitou objetivamente a avaliação dos comportamentos; às fichas de registro e de filmagem, que garantiram o controle do processo de ensino; às estratégias de ensino empregadas; ao ensino e ao treinamento focado no ambiente natural da aluna cega. Dois pontos foram identificados como necessários para melhora do uso das técnicas: o tipo de vestimenta, os acessórios, os calçados da aluna e o tempo de treinamento.

ABSTRACT: The aim of this study was to evaluate a program for training basic probing cane techniques in the school environment. A 13-year-old female student with congenital blindness enrolled in the 1st grade of Middle School participated in the study. The instruments used were the evaluation protocols of the basic orientation and mobility techniques. The evaluation took place in three environments: corridors, classroom and schoolyard, and the quasi-experimental design consisted of pretest, intervention and posttest. The analysis was quantitative for the student's performance and, in the intervention, it was qualitative for the choice of the teaching strategies. The results of the pretest indicated that the student had no difficulty in performing the basic behaviors of the proposed techniques, but failed to perform those that are specific, which were the focus of the training. The teaching strategies were explanations, instructions and presentation of kinesthetic models. Posttest results pointed out that the student was able to perform most behaviors of all techniques in all environments. It was concluded that the training program was successful due to: the quasi-experimental study type that objectively allowed the evaluation of behaviors; registration and filming forms, which ensured control of the teaching process; the teaching strategies employed; teaching and training focused on the blind student's natural environment. Two points were identified as necessary to improve the use of the techniques: the type of clothing, the accessories, the student's shoes and the training time.

Application of three-dimensional printed digital surgical guide in the anterior maxillary dental implant / 中国组织工程研究

BACKGROUND: Conventional implantation at anterior aesthetic region is difficult to achieve ideal three-dimensional position, and needs high implantation accuracy. OBJECTIVE: To evaluate the clinical application effect of three-dimensional printed digital guide technology in anterior dental implant. METHODS: Eighty-six cases of dental implants were divided into two groups. Control group (n=43, 52 implants) received conventional dental implantation. Trial group (n=43, 52 implants) received implantation under three-dimensional printed digital guides. The accuracy of the three-dimensional position of the implants was measured. The modified plaque index, modified bleeding index, probing depth and the satisfaction of patients with implant denture were measured at 6 months after implantation. RESULTS AND CONCLUSION: (1) The errors of vertical and horizontal directions at the top and the root after implantation in the trial group were significantly fewer than those in the control group (P < 0.05). (2) The modified plaque index, modified bleeding index, and probing depth in the trial group were significantly lower than those in the control group (P < 0.05). (3) The satisfaction of patients in the trial group was 98% (42/43), which was higher than 86% (37/43) in the control group. (4) In summary, three-dimensional printed digital guide plate used in dental implant dentures can improve the three-dimensional position accuracy after implantation and improve the postoperative clinical effect.

Congenital nasolacrimal duct obstruction agent through failure to treat clinical analysis for the first time / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To report the data of 28 cases of congenital nasolacrimal duct obstruction who failed in the first probing of lacrimal passage in our hospital, summarize the strategy of retreatment. <p>METHODS: Retrospective study, selected 591 cases of children with 28 cases in our hospital from Feb. 1, 2013 to Dec. 31, 2017, all were for the first time of probing of lacrimal passage through failure of children with congenital nasolacrimal duct obstruction(not including traumatic and lacrimal duct abnormalities), collect the case history, the nasal situation, the age of the first time to probing of lacrimal passages, information such as case data before and after treatment.<p>RESULTS:In 28 cases, 15 cases with probing of lacrimal passage joint tube insertion second time, take the tube after cured, 10 cases treated with inferior turbinate, again with probing of lacrimal passage joint tube insertion, take the tube after cured, 2 cases of children with acute dacryocystitis often strikes, under general anesthesia with transnasal endoscopic dacryocystorhinostomy, 1 cases of children with bony nasolacrimal duct obstruction and strictures, with tears spill without overflow pus, pay a follow-up visit, sinus fully developed after the age of 13 under transnasal endoscopic dacryocystorhinostomy.<p>CONCLUSION: Congenital nasolacrimal duct obstruction of lacrimal duct exploration for the first time failed again take personalized ladder solution treatment, reasonable treatment of the disease.

The treatment of the congenital nasolacrimal duct obstruction / 国际眼科杂志(Guoji Yanke Zazhi)

@#Congenital nasolacrimal duct obstruction(CNLDO)has an incidence rate of 5.7% and there are many clinical treatments for the disease. But these treatments have been taken very randomly. Therefore, it is still a controversial topic on how to choose the best treatment. This paper will discuss the treatments of CNLDO so as to know the characteristics of each treatment for better clinical services.

Investigation of dental caries and periodontal conditions in maintenance hemodialysis patients / 口腔疾病防治

Objective@#To compare the prevalence of dental caries and periodontal disease in patients with end-stage renal disease treated with maintenance hemodialysis with that in healthy controls and to investigate the relationship between end-stage renal disease, dental caries and periodontal disease.@*Methods @#A total of 82 maintenance hemodialysis patients who met the inclusion criteria were selected as the case group, and 86 healthy persons who underwent oral examination in the physical examination center were selected as the control group. Dental caries and periodontal conditions were examined in the two groups. The dental caries examination was conducted by determining the number of decayed-missing-filled teeth, which was recorded as recommended by the World Health Organization. The periodontal condition parameters included the plaque index, calculus index, bleeding on probing, periodontal pocket depth and clinical attachment loss.@*Results@#The prevalence of dental caries in the case group and healthy control group was 87.8% and 81.4%, respectively, and there was no statistically significant difference between the two groups (P > 0.05). The periodontal indexes, including the plaque index, calculus index, probe bleeding index, periodontal pocket depth and clinical attachment level, in the case group were significantly higher than those in the control group (P < 0.05), and the prevalence of periodontitis in the case group was significantly higher than that in the control group (97.6% vs 88.4%, P < 0.05).@*Conclusion@#The dental caries conditions were comparable between the case group and the control group, but the prevalence and severity of periodontitis were significantly higher in the case group than in the control group.

Investigation on the influence of periodontal disease in gestation on small for gestational age / 口腔疾病防治

Objective @#The purpose of this study was to investigate the relevant social and environmental factors affecting the occurrence of periodontal diseases during pregnancy in pregnant women and to analyze the influence of the periodontal status of women in the second trimester of pregnancy on small for gestational age (SGA) delivery.@*Methods@# A total of 215 pregnant women were enrolled in this study in the Department of Periodontology of the West China Hospital of Stomatology of Sichuan University from May 2015 to May 2018. Periodontal parameters, such as bleeding on probing (BOP), probing depth (PD) and clinical attachment loss (CAL), were recorded at 16-24 weeks of gestational age. Subjects were divided into the periodontitis (n=32) group, gingivitis (n=171) group and periodontally healthy (n=12) group according to their periodontal conditions. With the patient′s informed consent, the patient decided whether to receive periodontal treatment. Basic and socioeconomic information was collected through questionnaires. After delivery, subjects were divided into the SGA group and non-SGA group according to their birth results. The periodontal clinical indicators, questionnaire results and delivery results were compared among the groups.@*Results @#The mean PD (P=0.005, r=-0.192) and BOP% (P=0.003, r=-0.199) were negatively correlated with economic income. The family income in the periodontitis group was significantly lower than that in the healthy group and the gingivitis group (P < 0.05). The flossing use rate was significantly higher in the healthy group than that in the gingivitis group (P < 0.05). A total of 106 pregnant women received scaling and root planing, while 109 patients only received oral hygiene instruction. After delivery, SGA occurred in 23 cases (10.7%), and there were no significant difference in SGA incidence among the three groups (P > 0.05). PD ≥ 5 mm% and PD ≥ 4 mm% (P < 0.05) were significantly higher in the SGA group than in the non-SGA group. There was no significant difference in SGA incidence between the treated group and the untreated group (P > 0.05).@*Conclusion@#Family income and dental flossing use have an impact on the incidence of periodontal diseases during pregnancy. The severity of periodontitis in pregnant women is correlated with the incidence of SGA.

Clinical application of molar uprighting for impacted mandibular second molars / 口腔疾病防治

Objective @#To investigate the effect of the clinical application of molar uprighting in the treatment of impacted mandibular second molars.@*Methods@# A total of 16 cases of impacted mandibular second molars were chosen, and the impacted molars were treated with straight wire appliances and molar uprighting. Before and after treatment, the vertical angle of the molar, the height of the distal buccal tip, the height of the distal buccal tip of the anchorage molar, the depth of the periodontal pocket and the height of the alveolar bone were measured. Moreover, the treatment cycles of the third molar extraction group, the premolar group and the nonextraction group were compared.@*Results @#All impacted molars responded well to treatment. The vertical time of impacted molars was (1.34 ± 0.45) months, (2.20 ± 0.57) months, and (2.30 ± 0.45) months in the third molar extraction group, the premolar extraction group and the nonextraction group, respectively. The treatment time of the third molar extraction group was shorter than that of the other two groups, and the difference was statistically significant (P < 0.05). After treatment, the inclination of impacted second molars increased by (25.94 ± 8.85)°, the elongated distal buccal tip was depressed by (1.00 ± 1.48) mm, the depth of the proximal and middle periodontal pocket of impacted molars decreased by (1.21 ± 1.03) mm, and the height of the alveolar bone of the proximal and middle adjacent surfaces of impacted second molars increased by (4.57 ± 1.45) mm; these differences were statistically significant (P < 0.05). There was no significant difference in the height of the distal buccal tip of the first molar before and after treatment (P > 0.05).@*Conclusion @#Molar uprighting is an efficient, reliable, and convenient method that can shorten the treatment period. Extraction of crowded third molars is beneficial for the vertical and periodontal health of impacted second molars.

Result of Probing for Congenital Nasolacrimal Duct Obstruction in Children Less than 1 Year Versus Children Greater than 1 Year

Congenital obstruction of nasolacrimal duct is a very common cause of epiphora in new born children.Controversy exists regarding the natural course and management of children with congenital nasolacrimalduct obstruction. The present study was undertaken on 80 children of congenital nasolacrimal duct obstructionwith no previous intervention. They were divided into two groups of 40 each. Group 1 had children aged lessthan 1 year and Group 2 comprised of children older than 1 year. Probing was done under general anesthesia.The mean age of the patients in Group 1was 8.35±2.65 months and that of the children in Group 2 was27.5±11.98 months. The overall success rate of probing was 78.75%. Success rates in Group 1 and Group2 were 85% and 72.5%, respectively. The difference between the two groups was statistically insignificant.However, there was a significant difference in the success rate of probing depending on the type of obstruction(p<0.05). Membranous obstruction of NLD was associated with increased success rates of probing ascompared to firm obstruction of NLD (p=0.001230, Yates corrected Chi square =0.0009578). Probing is asafe option of treating congenital nasolacrimal duct obstruction. Probing is beneficial in older children althoughthe success rate of probing tends to decline with increasing age. Firm anatomical obstruction in nasolacrimalduct is associated with a decline in the success rate of probing.

Clinical Outcome and Factors Predictive of Outcome of Nasolacrimal Duct Probing for Congenital Nasolacrimal Duct Obstruction in Younger and Older Children Performed at a Regional Institute of Ophthalmology in Western India

2-6 % of full term newborn children manifest symptoms of congenital nasolacrimal duct obstruction. The most frequent presentation is tearing associated with mattering of the eyelashes and recurrent infection. We designed a study to compare the success rate of nasolacrimal duct probing for congenital nasolacrimal duct obstruction in younger and older children seen at our western regional institute of ophthalmology. Probing under general anaesthesia was done in a cohort of children presenting with congenital nasolacrimal duct obstruction . The demography ,clinical presentation, management and outcome of the cases were documented. Factors associated with success of the procedure were documented. Aim: The aim of the study was to document the clinical outcome and factors predictive of success of nasolacrimal duct probing for congenital nasolacrimal duct obstruction in younger and older children seen at our Western Regional Institute of Ophthalmology in India. Methods: The study was carried out at our Western Regional Institute of Ophthalmology. The study period was July 2018 to May 2019 . The study was a prospective interventional outcome study in an institutional cohort. Probing was reserved for patients with recurrent infection or acute dacryocystitis in children between 6 months to 9 months of age . Initial probing was the treatment of choice for children between one year and three years as well as older children above three years upto twelve years. Probing was performed under general anaesthesia. Patients were followed at 1 week, 3 weeks, 3 months and 6 months after the procedure. Outcome was defined as resolution of symptoms and signs of nasolacrimal duct obstruction as observed by the ophthalmologist as well as reported by the parents within 3 weeks of the procedure and continued remission for 6 months post procedure. Probing was done twice before the procedure was declared a failure. Statistical Analysis: Student t test and chi square test was used for statistical analysis . p<0.05 was taken as significant. The Fischer exact test was used to calculate the chi square value. Results: 25 eyes of 18 children with congenital nasolacrimal duct obstruction were subjected to probing during the time of the study. The age range was six months to eleven years. The overall success rate was 16/25(64%). The success rate for children less than or equal to three years was 8/9 (89%).The success rate in the age group three years to less than or equal to seven years was 7/12 (58.3%) . The success rate dropped to 25% (1/4) for children more than seven years of age. The success rate of nasolacrimal duct probing was observed to reduce with increasing age of the child. Persistent dacryocystitis, firm obstruction on nasolacrimal duct probing and repeat probing were statistically significantly associated with the outcome of probing. The children with any of the above factors had a lower success rate of nasolacrimal duct probing. Conclusion: The results of our study are comparable to other studies reporting outcome and predictive factors of nasolacrimal duct probing in younger and older children with congenital nasolacrimal duct obstruction. Children less than or equal to three years of age with congenital nasolacrimal duct obstruction could be successfully managed with nasolacrimal duct probing with great outcomes. Older children too had a reasonable outcome and age did not appear to be a significant factor affecting outcome. A firm obstruction on probing, persistent dacryocystitis and repeat procedure are significantly associated with the outcome of nasolacrimal duct probing. Conclusion: Children less than or equal to three years of age with congenital nasolacrimal duct obstruction can be successfully managed with nasolacrimal duct probing with great outcomes. Older children too had a reasonable outcome and age did not appear to be a significant factor affecting outcome. Thus in the light of the fact that probing is a safe and effective procedure , it appears logical to give a trial of initial nasolacrimal duct probing even to children older than three years. A firm obstruction on probing, persistent dacryocystitis and repeat procedure are significantly associated with the outcome of nasolacrimal duct probing.

Nasal endoscopic features and outcomes of nasal endoscopy guided bicanalicular intubation for complex persistent congenital nasolacrimal duct obstructions

Purpose: To study the clinical presentation, nasal endoscopic features, and outcomes of nasal endoscopy guided (NEG) bicanalicular intubation (BCI) in children with complex persistent congenital nasolacrimal duct obstruction (pCNLDO). Methods: A prospective, interventional study including eligible children (age ? 12 years) having complex pCNLDO. The demographics, number of previous probings, nasal endoscopy findings, and outcomes; were noted in all children who underwent NEG-BCI with Crawford's stents. Matting of eyelashes (MoE, upper, and lower eyelid), tear-film height (TFH), and fluorescein dye disappearance test (FDDT) was assessed pre and postoperatively. The minimum stent in-situ period was 12 weeks, and the minimum follow-up was 6 months (after stent removal). Results: Total 32 children (36 eyes) including 18 females (56.25%) were studied. At a mean age of 4.9 years, all children had epiphora and discharge with MoE (both upper and lower), raised TFH and positive FDDT. Previously, all children underwent conventional probing (s)- once in 12 (33.3%), twice in 18 (50%) and thrice in 6 (16.7%) eyes. The general ophthalmologists performed the majority (n = 21, 58.33%) of those. The BCI was performed under GA in all eyes, and at a mean follow-up of 8.5 months, the “complete” success was noted in 29 eyes (80.5%), 'partial' success in 4 (11.1%) and failure in 3 (8.3%). The stent prolapse was seen in three. Conclusion: NEG-BCI may provide a satisfactory resolution to complex pCNLDO after single or multiple failed probings. NEG provides confident and efficient management of coexistent intranasal complexities related to the inferior turbinate and meatus.

Periodontal Response of Teeth to Orthodontic Tooth Movement- A Comparative Study

The force of orthodontic treatment, is basically categorized as controlled trauma,[1] that can damage the pulp because of the absence of collateral blood supply in the pulp tissues makes pulp as the most sensitive tissues of the whole body. The problem is not the accumulations, but there is a likelihood of conversion of the supra gingival plaque accumulations into sub gingival plaque while tipping or intrusion tooth movements that favors the change of gingivitis into periodontitis. The present study was conducted with the aim to determine the periodontal response to orthodontic tooth movement. Methods: The present prospective observational study was conducted in the department for a period of 1 year. Before the start of treatment, clinical attachment and probing depth was measured. These parameters were also measured after active tooth movement and tooth retention. Difference in clinical attachment was noted before and at the end of the treatment. All the data was arranged in a tabulated form and analyzed using SPSS software. The data was expressed as mean +/- standard deviation. Results: The mean age of the subjects was 28.75+/-3.64 years. There were 66.7% (n=20) males and 33.3% (n=10) females. The baseline probing depth amongst control teeth was 4.4+/-0.5 and after tooth movement was 3.7+/-0.5 and after retention was 3.6+/-0.05. The mean difference in clinical attachment loss after tooth movement on mesial and distal side was -0.5+/-1.7 and - 0.6+/-0.9 respectively. The mean difference in clinical attachment loss after tooth retention on mesial and distal side was -0.7+/-1.4 and -0.8+/-1.1 respectively. Conclusion: Orthodontic movement of teeth may be detrimental for the periodontal health when realignment of the teeth have been considered.