Application of Contemporary Magnifying Methods in the Diagnostics of Occlusal Carious Lesions on First Permanent Molars in Children.

INTRODUCTION: Dental operating microscopes (DOM) enable dentists to examine, with the aid of magnification and photodocumentation in clinical conditions, the occlusal anatomy of newly erupted permanent molars and to detect any early carious lesions more precisely. AIM: To determine the advantages of magnifying technology in detecting early occlusal carious lesions in newly erupted permanent first molars. MATERIALS AND METHODS: We examined 176 first molars of 44 children divided into two age groups: 7-8 and 9-10 years. The surfaces of each of the teeth were examined after they were cleaned with a brush without paste. The diagnoses were first made using only illumination and a clinical examination. These were followed by a visual examination of the occlusal surface using a DOM at ×8 magnification. A photo of the occlusal surface was then taken with a camera at the respective magnification for the purposes of photodocumentation. RESULTS: This study demonstrated that dental operating microscopes increased by 7% the rate of successful detection of early caries lesions on the occlusal surfaces. There was also a significant increase of the number of diagnosed cavitated caries in the dentine in comparison with those detected with naked eye. Using DOMs in pediatric dentistry facilitates the more detailed and precise diagnosing of early stage carious lesions and/or cavitations in the fissures. CONCLUSION: The use of a DOM facilitates differential diagnosing between deep fissures and early carious lesions, which is a key point in the assessment of occlusal surfaces of newly erupted permanent molars, necessary for their preventative sealing and micro-invasive treatment.

Depth of Gingival Sulcus in Healthy Children with Erupting Permanent Teeth.

INTRODUCTION: Measuring the gingival sulcus depth in children while their permanent teeth erupt is rather difficult especially if using reference norms for adults for a base. AIM: Assessment of the depth of the gingival sulcus during the period of tooth eruption in healthy children. MATERIALS AND METHODS: Thirty children were included in the study (age range 6 - 14 yrs). The children had good oral hygiene and no history of systemic disease. They were clinically examined - their dental statuses were taken, stages of permanent teeth eruption (up to 1/3 of the clinical crown, between 1/3 and 2/3, over 2/3, in occlusion contact), and their gingival sulcus depth was measured at 6 distovestibular, vestibular, mesiovestibular, mesiolingual, lingual, and distolingual sites using an electronic probe Parometer (Orange). It was concluded that the one with the highest value would be considered the maximum depth of the sulcus. RESULTS: The gingival sulcus depth in fully erupted teeth is very similar to that in healthy adults (2.20 - 0.49 mm). The change of sulcus depth in incisors and canines has a variation of 1.5 mm, which at the end of eruption is close to those in adults. Maximum sulcus depth for molars, premolars and incisors was measured distovestibularly, and for canines - mesiovestibularly. CONCLUSION: At the various stages of eruption, the depth of the gingival sulcus plausibly decreases in all tooth types, and by the end of eruption it reaches a depth similar to that of the adult standard. Most indicative in regard to depth are the vestibular probing point.

Subgingival Microbiota during Formation of Permanent Dentition.

BACKGROUND: Periodontal pathology in children has distinctive characteristics that can be accounted for by the peculiarities of the age, the dynamically changing oral environment, and the processes of formation and stabilization of periodontal structures during teeth eruption. AIM: The aim of this study was to investigate the composition of the subgingival microbiota during permanent dentition formation in puberty. MATERIALS AND METHODS: The study included 30 children aged between 10 and 15 years without gingivitis (up to 25% PBI), with good oral hygiene, with no systemic diseases or reception of antibiotics for 3 months. The clinical status of all children was assessed using a specially designed chart based on the periodontal examination chart of a child adopted by the Department of Pediatric Dentistry, FDM-Sofia. Gingival sulcus samples were taken with a paper pin from 6 teeth for a PCR - Real Time study of 9 control strains (a comprehensive sample). The samples were sent for investigation in standardized containers. RESULTS: C. gingivalis (green complex) was found in almost all tested children and F. nucleatum (orange complex) - in more than half of them. The rest of the tested samples for microorganisms was isolated in just few of the children (6% - 17%). A. actinomycetemcomitans and P. gingivalis were not isolated in this study. CONCLUSION: The results of the study suggest that a significant amount of the periodontal pathogens migrate to the subgingival zone relatively early, immediately after the permanent teeth eruption, and become a risk factor for the development of periodontal disease.