The role of Polish school nurses in the oral health promotion for 7-19 year-old children and adolescents.

PURPOSE: The assessment of the role of school nurses in the oral health education and counselling of children and adolescents aged 7-19 years. METHODS: A self-administered questionnaire was used to evaluate nurses' practice in oral health education, previous training in caries prevention, collaboration with a dentist and self-assessment of knowledge. Data were analysed with the Chi square test. RESULTS: The study group consisted of 140 Polish school nurses. Respondents declared the following activities: dietary counselling (99.2%), oral hygiene education (92.8%), NHS-funded supervised fluoride prophylaxis (82.8%), and caries screenings (4.3%). 47.1% participated in training on caries prevention, 25.7% had a collaboration with a dentist. Nurses from schools located in towns less frequently provided oral hygiene education (p < 0.005) and dietary counselling, but more often had a collaboration with a dentist (p < 0.05). The youngest nurses were more confident about their knowledge (p < 0.05). There was an association between participation in training on caries prevention and positive opinion on a school-based fluoride prophylaxis (p < 0.01). Nurses who did not include dental topics in their practice worked mainly with pupils older than 15 years, had shorter experience (p < 0.05), secondary education, worked in urban areas and had no training on dental problems (p < 0.01). CONCLUSION: Polish school nurses have potentially crucial roles in improving the oral health status in pupils through oral hygiene education, dietary counselling and fluoride prophylaxis included in their duties.

Dentin dysplasia type I.

This paper describes a rare case of genetically determined dentin dysplasia type Iin 26-year-old male patient. The paper highlights anatomical and radiologicalaspects of dental abnormalities and emphasizes the significance of the educationof both general practitioners and paediatricians as regards referring patients withdiagnosed dentin dysplasia for a multi-specialty therapy.

Dens invagination and root dilaceration in double multilobed mesiodentes in 14-year-old patient with anorexia nervosa.

This paper describes a rare case of erupted double supernumerary teeth with unusual morphology in a 14-year-old patient with an eating disorder. The coexistence of dental morphological anomalies: multilobed mesiodens, multiple dens in dente of different types and root dilaceration have not been previously reported. The paper highlights anatomical and radiological aspects of dental abnormalities and clinical implications of delayed treatment.

Status of occlusal surfaces of first permanent molars in 6-8-year-old children evaluated by the CAST and DMF indices.

AIM: The aim of this study was to evaluate the status of occlusal surfaces of first permanent molars in 6- to 8-year-old children using the Caries Assessment Spectrum and Treatment (CAST) index and to assess how it correlates with DMF in the surveyed population. MATERIALS AND METHODS: A total of 1931 occlusal surfaces of first permanent molars in 6-8-year-old children from Bialystok District, Poland, were assessed using the DMF and the CAST indices. The prevalence and experience of different caries stages were evaluated. Data were statistically analysed with the Kruskal-Wallis test, the Dwass-Steele-Critchow-Fligner post-hoc test and the cross-tabulation. The intra-examiner reliability was evaluated. Results Caries prevalence on occlusal surfaces of the first permanent molars measured by DMF was 13.3% and by CAST -37.6%. The mean DMF was 0.33 and the mean D -0.07. For CAST, the mean values of early (codes 3-4) and advanced caries stages (codes 5-6) were 0.55 and 0.05, respectively. The DMF index statistically significantly increased with age. In the whole population the mean number of filled teeth was higher than the decayed ones. With reference to the CAST index, children showed increase in enamel lesions with age. The intra-examiner reliability was 0.94 for DMF and 0.88 for CAST. Conclusion The surveyed subjects showed a low prevalence of dental caries measured with DMF and a moderate prevalence when the CAST was used. The CAST index is a promising tool for epidemiological studies on caries. It provides more information on the disease prevalence, experience and severity compared to the DMF index.

Cytotoxicity evaluation of three light-cured dentin adhesive materials on human gingival fibroblasts, ex vivo.

PURPOSE: To evaluate the cytotoxic effects of three current light-cured dentin adhesives, in both uncured and post-cured conditions, on human gingival fibroblasts. MATERIAL AND METHODS: The materials tested were Heliobond, Adper Single Bond 2 and Xeno V, which are characterized by various compositions and application procedures. Each agent, in volumes of 5 and 10 µL, was tested after polymerization, and those unpolymerized were diluted in DMEM to 10-3 and 10-5. The cytotoxicity of the adhesives was assessed on the basis of a test of cell viability in a culture of human gingival fibroblasts, with the use of tetrazolic salt (MTT assay). RESULTS: The results showed that, among the adhesive/bonding systems tested, Xeno V was the least cytotoxic. There were statistically significant differences in cell survival between polymerized Xeno V, Adper Single Bond 2 and Heliobond in the amount of 5 µL as well as between the Xeno V and Adper Single Bond 2 in 10-5 dilutions. The tested adhesives were more toxic in the polymerized form than in the dilutions. Samples of 10 µL resulted in a lower survival percentage of fibroblasts compared to 5 µL. CONCLUSION: All the tested adhesives demonstrated cytopathic effects towards human gingival fibroblasts, but varied in their cytotoxicity. This has clinical implications. Dentists should follow the rules of adhesive application, precisely dose them and not allow direct contact with the gums as, even after polymerization, adhesive agents exhibit potential cytotoxic activity.

New endodontic obturation systems and their interfacial bond strength with intraradicular dentine - ex vivo studies.

PURPOSE: To comparatively evaluate adhesive properties of selected root canal fillings through the measurement of the material-dentine interfacial bond strength. MATERIAL AND METHODS: Fifty extracted single-rooted human teeth with one canal each were prepared using Hero instruments to size 30.04. Teeth were divided into four subgroups depending on the root canal filling material and the method of obturation: Resilon/Epiphany - a thermoplastic method (IA), Resilon/Epiphany - a matching single-point method (IB), gutta-percha/Roeko Seal Automix - a thermoplastic method (IIA) and gutta-percha/Roeko Seal Automix - a matching single-point method (IIB). The obturated roots were cut perpendicular to the long axis to create 1.7 mm thick slices. The bond strength was measured for each test slice with push -out testing machine. RESULTS: The highest push-out bond strength was registered in subgroup IB (3.98 ± 1.33 MPa). Significantly lower bond strength was observed in subgroups IA (0.50 ± 0.24 MPa), IIA (0.33 ± 0.18 MPa) and IIB (0.08 ± 0.03 MPa) (p<0.001). No statistically significant differences in material-dentine interfacial bond strength values were observed between IA and IIA, IA and IIB, IIA and IIB subgroups (p > 0.05). CONCLUSIONS: The push-out bond strength of the material-dentine interface was dependent on the type of material used and the root canal filling technique. The R/E system exhibited better adhesion ability to intraradicular dentine than G/RSA. The highest bond strength was observed for Resilon/Epiphany introduced with the single-cone technique.

Evaluation of the product based on Recaldent technology in the treatment of dentin hypersensitivity.

PURPOSE: The aim of the study was to evaluate the efficiency of GC Tooth Mousse in the treatment of patients with dentin hypersensitivity caused by various factors. MATERIAL AND METHODS: The evaluation was carried out on 101 teeth with dentin hypersensitivity in 13 patients. Patients with gingival recession and exposed dental necks and those with non-carious lesions at the initial stage were selected. The initial examination was to evaluate the intensity of pain inducted by a stream of the air syringe and by probing the tooth surface. It was repeated directly after the preparation application, after 15 minutes, after 1 and 4 weeks. RESULTS: After the medicine application, the number of teeth reacting with strong or extremely strong pain decreased (from almost 80% to 37.62%). The percentage of teeth reacting with mild pain increased by 15% and the number of teeth which did not react to the cold air stream also increased by 27.72%. The values after 15 minutes were similar. A week later, the percentage of teeth with very strong pain was elevated and so was the percentage of medium pain. On the other hand, the number of teeth without pain and with mild pain decreased twice. After one month the percentage distribution was close to the results obtained after 7 days. CONCLUSIONS: 1. GC Tooth Mousse preparation, based on Recaldent technology reveals insufficient effectiveness and short-term therapeutic effect in treating hypersensitivity of dentine. 2. It seems that soothing the pain by GC Tooth Mousse should be regarded rather as an additional remineralizing effect of the medicine.

The effect of glass ionomer cement Fuji IX on the hard tissues of teeth treated by sparing methods (ART and CMCR).

PURPOSE: The aim of the study was to assess the effect of glass ionomer fillings Fuji IX on the mineral content of the hard dental tissues of carious teeth treated by sparing methods. MATERIAL AND METHODS: The study material consisted of 4 deciduous teeth lost due to physiological resorption. The teeth had glass ionomer fillings Fuji IX inserted after treatment of caries by means of sparing methods (ART and CMCR). Chemical analysis of enamel and dentin was performed by means of energy dispersive spectroscopy (EDS) with X-ray analysis QUEST system at a distance of 20 um (point C) and 120 um (point D), respectively. The content of the following elements was evaluated in weight percent: oxygen (O), fluoride (F), sodium (Na), magnesium (Mg), aluminum (Al), silicon (Si), phosphorus (P), calcium (Ca), strontium (Sr). The Ca/P ratio was calculated. T-student test for pairs, with the level of significance p < 0.05, was used for statistical analysis of the results. RESULTS: We found significantly higher levels of fluoride, aluminum and silicon and lower concentrations of calcium and phosphorus in the dentine adjacent to the filling (point C). However, no statistically significant differences were observed in the levels of the elements between these two sites of measurement. CONCLUSIONS: Our results indicate that mineralization of the calcified dentine may involve elements released from glass ionomer cement Fuji IX.

New technology in endodontics--the Resilon-Epiphany system for obturation of root canals.

PURPOSE: Clinical and laboratory assessment of a new root canal filling material--Resilon-Epiphany system. MATERIAL AND METHODS: In 21 patients, 48 root canals were filled using a single-cone method or lateral condensation technique of gutta-percha with addition of Epiphany sealer. Laboratory investigations were performed on 4 extracted one-root human teeth, which were prepared by means of a crown-down technique and obturated with Resilon-Epiphany using System B and Obtura II. Next, the roots were transversely cross-sectioned in the mid-length at a 2 mm distance from the apex and analysed in SEM. RESULTS: After a year, the treatment proved to be clinically and radiologically successful in all the patients. SEM analyses revealed good adhesion of Epiphany sealer to the canal walls with visible tags in dentine tubules. Good adherence was also found of Epiphany to Resilon and Resilon to root dentine, but few gaps were also observed. CONCLUSIONS: Our preliminary positive results require more thorough evaluation, longer observation period and a larger group of patients. However, they allow the assumption that resin-percha will successfully replace gutta-percha in the nearest future.

Incidence rate of Candida species in the oral cavity of middle-aged and elderly subjects.

PURPOSE: The aim of this study was to determine the incidence rate of oral Candida species in middle-aged and elderly subjects. MATERIAL AND METHODS: The study carried out in 103 adults aged 35-92 years, in which 32 (31.1%) used complet or partial acrylic dentures. Mycological tests were performed by using culture (Sabouraud agar) and API 20C AUX (bioMérieux) for identification of the species level. Material for analysis included swabs taken from the palate mucosa and mucosal part of denture surfaces in denture wearers, as well as, from tooth surface and/or dentine carious lesions. The dental caries status of each patients was evaluated using DMF index (WHO 1986 criteria). RESULTS: Yeasts of Candida genus were isolated in 65/103 (63.1%) adults. The incidence rate of Candida spp. was higher in adults without dentures (46/71; 64.8%) compared to denture wearers (19/32; 59.4%); however, the differences were not statistically significant (p = 0.59 > p = 0.05). Candida albicans were the most frequently isolated species, and with a comparable rate (p = 0.06), both in adults with and without dentures (17/32; 53.1% and 38/71; 53.5%, respectively). In 3 individuals without dentures, two other species were found apart from C. albicans, namely C. glabrata (2x) and C. krusei (1x). In a total of 11/49 (22.5%) strains belonging to 5 non-C. albicans species were detected in adults without dentures, while in denture wearers only 2/19 (10.5%) other species were found (C. krusei and C. oralis) (p = 0.26 > p = 0.05). Strains of C. glabrata species were isolated only from the elderly. No significant differences were noted in the incidence of Candida spp. between middle-aged subjects (35-44 years) (35/52; 67.3%) and the elderly (> 55 years) (30/51; 58.8%) (p > 0.05), both in denture wearers and non-denture wearing subjects. However, the frequency of oral Candida spp. strains was increased in advanced age subgroup 71-92 years (74.2%) compared with 56-70 years (35.0%) of elderly subjects (p < 0.05), only in denture wearers (30.0% vs 5.0%) (p < 0.05). The sex and DMF index distribution of both subject groups had no significant influence on the numbers of Candida spp. detected. CONCLUSIONS: Yeasts of the genus Candida were isolated at a comparable rate (p > 0.05) from the oral cavity of adults with and without dentures, as well as in middle-aged (35-44 years) and elderly subjects (56-92 years). However, a significant difference was observed only between elderly subgroups aged 56-70 (35%) and advanced age subgroup 71-92 years (74%).

Microorganisms in root carious lesions in adults.

PURPOSE: Root caries is emerging as a significant problem in the middle aged and elderly subjects because of the improving general health conditions, and medical and technological advances. The purpose of this investigation was to assess the prevalence of aerobic and anaerobic bacteria as well as yeasts of Candida genus in root carious lesions in middle-aged and older adults. MATERIAL AND METHODS: Specimens of root carious lesions were collected from 78 adults for bacteriological and mycological studies. Standard procedures of culture, isolation, and identification of aerobic and anaerobic bacteria, and fungi were used in the study. RESULTS: The analysis of results was performed independently in two age groups of adults, i.e. 52 subjects aged 35-44 years (middle age) and 26-aged 55-72 years (older age). There were 120 bacterial strains isolated from root carious lesions in middle-aged subjects, 63 (52.5%) strains belonged to 5 genera of aerobic bacteria and 57 (47.5%)--to 7 genera of anaerobic bacteria (p > 0.05). While in the second group, 85 strains were isolated, 54 (63.5%)--6 genera of aerobic bacteria and 31 (36.5%)--4 genera of anaerobic bacteria (p = 0.0004). There were no differences between the isolation rate of a various species in both examined groups, except for Streptococcus spp., S. oralis, Micrococcus spp., Neisseria spp. and Veillonella spp., which statistically significantly most frequent occurred in elderly (p < 0.05). The yeasts of Candida genus of 4 species (C. albicans, C. lusitaniae, C. pelliculosa, and C. pulcherrima) were isolated from middle-aged subjects (32.7%) with the comparable rate to older adults (30.8%; only C. albicans) (p > 0.05). Among all isolated microorganisms, Candida spp., were comprised about 10% in both examined groups (p > 0.05). CONCLUSIONS: Aerobic Gram-positive cocci (Staphylococcus spp. and Streptococcus spp.) as well as anaerobic ones (Peptostreptococcus spp.), and Candida albicans were occurred most frequently in root carious lesions in middle-aged and older adults.