Knowledge of preschool teachers in the prefecture of Attica of early childhood oral health. Association with their demographic and personal characteristics.

AIM: To investigate the knowledge of preschool teachers of early childhood oral health (OH) and its association with demographic and educational characteristics as well as with personal oral health habits and attitudes. METHODS: Teachers (594) of preschool children were invited to complete a questionnaire with 40 questions on demographic data, knowledge of early childhood OH issues, personal OH habits and attitudes, and participation in OH educational programmes at preschools. Statistical analysis included descriptive statistics, Spearman correlation coefficients, multiple linear and logistic regression modelling (p ≤ 0.05). RESULTS: The mean age of participants was 40.9 years (SD 7.5), 68.5% of them had children of their own, 72.6% had not attended any OH educational course during their studies, 70% believed that they had insufficient knowledge to implement an OH educational programme, 44.6% had implemented such a programme, 26.8% knew that the first dental visit should be at a child's first birthday and 36.7% knew the correct age that tooth brushing should start. The most significant factors that influenced overall teachers' knowledge on early childhood oral health were: their participation in OH educational programmes (p < 0.001), their belief that OH courses during their studies were necessary (p = 0.01), their confidence on OH knowledge (p = 0.03) and parenthood (p = 0.05). CONCLUSIONS: Based on the results of this study, there was a lack of knowledge among preschool teachers in significant OH issues for that age. Moreover, limitations in implementing OH educational programmes at preschools were attributed mainly to lack of self-confidence in relevant knowledge. Nevertheless, participants acknowledged the significance of OH and were willing to participate in relevant teacher training.

Effect of a chlorhexidine/thymol and a fluoride varnish on caries development in erupting permanent molars: a comparative study.

AIM: To compare the caries preventive effect of a chlorhexidine/thymol-containing antibacterial varnish with a fluoride varnish when topically applied during the eruption of permanent molars. METHODS: The study group consisted of 189 patients, 5-14 years of age, with one 1st or 2nd permanent molar in the process of eruption. After stratification for type of molar and stage of eruption, the patients were randomised to either quarterly topical applications with an antibacterial varnish (Cervitec(®) Plus; CV group) or biannual applications with a fluoride varnish plus biannual treatments with placebo varnish (Fluor Protector; FV group). The duration of the study was 2 years. The primary endpoint was caries incidence (initial and cavitated) in the erupting molars and the secondary outcome was salivary mutans streptococci (MS) counts. RESULTS: The groups were balanced with respect to socio-economy, oral hygiene, dietary habits and caries experience at baseline. The dropout rate was 11.6 %. The caries incidence was low (< 10 %) in both groups and there was no significant difference between the CV and FV groups with respect to occlusal caries development in the erupting molars (relative risk 1.08, 95 % CI 0.94-1.25). Significantly lower levels of salivary MS were disclosed in the CV group at the end of the study (p < 0.05). CONCLUSIONS: No difference in occlusal caries development in young permanent molars was displayed after topical applications of either a chlorhexidine/thymol varnish or a fluoride varnish during tooth eruption.

Caries-preventive effectiveness of fluoride varnish as adjunct to oral health promotion and supervised tooth brushing in preschool children: a double-blind randomized controlled trial.

OBJECTIVES: To evaluate the effect of biannual fluoride varnish applications in preschool children as an adjunct to school-based oral health promotion and supervised tooth brushing with 1000ppm fluoride toothpaste. METHODS: 424 preschool children, 2-5 year of age, from 10 different pre schools in Athens were invited to this double-blind randomized controlled trial and 328 children completed the 2-year programme. All children received oral health education with hygiene instructions twice yearly and attended supervised tooth brushing once daily. The test group was treated with fluoride varnish (0.9% diflurosilane) biannually while the control group had placebo applications. The primary endpoints were caries prevalence and increment; secondary outcomes were gingival health, mutans streptococci growth and salivary buffer capacity. RESULTS: The groups were balanced at baseline and no significant differences in caries prevalence or increment were displayed between the groups after 1 and 2 years, respectively. There was a reduced number of new pre-cavitated enamel lesions during the second year of the study (p=0.05) but the decrease was not statistically significant. The secondary endpoints were unaffected by the varnish treatments. CONCLUSIONS: Under the present conditions, biannual fluoride varnish applications in preschool children did not show significant caries-preventive benefits when provided as an adjunct to school-based supervised tooth brushing with 1000ppm fluoride toothpaste. CLINICAL SIGNIFICANCE: In community based, caries prevention programmes, for high caries risk preschool children, a fluoride varnish may add little to caries prevention, when 1000ppm fluoride toothpaste is used daily.

Histological validation of a laser fluorescence device for occlusal caries detection in primary molars.

AIM: This was to validate in vitro a laser fluorescence device, DIAGNOdent 2095 - DD, on the detection of occlusal caries in primary molars using the histological examination as the gold standard and to compare the laser fluorescence findings to the results of the conventionally used diagnostic methods. STUDY DESIGN AND METHODS: 111 occlusal pits in 24 extracted primary molars were examined for caries by one trained operator (Intra-examiner Reliability K>0.83), using direct visual (DV), indirect visual (IDV), radiographic (XR) and fluorescence (DD) examinations and then the extent of caries was determined histologically. Sensitivity, specificity, accuracy and the area under the ROC curve - AUC were calculated for all methods, using the histological evaluation as the gold standard. STATISTICS: Differences between examination methods were estimated by pair-wise comparison of their respective AUC. RESULTS: DD's sensitivity for enamel and for dentine lesions respectively was 0.90 and 0.36, its specificity 0.36 and 0.91 and its accuracy 0.61 and 0.65. The DD device exhibited better sensitivity than specificity for enamel lesions and better specificity than sensitivity for lesions into dentine. The DD device was found to have the highest sensitivity for lesions into enamel, specificity and accuracy and as well as the largest AUC compared with all other methods. For lesions into dentine however, according to AUC values the DD was not statistically significant different from the other methods. CONCLUSION: Compared with the other methods, the DD had the highest validity for enamel caries while its validity for caries into dentine was not statistical different from the other methods.

Oral health status and behaviour of Greek patients with cleft lip and palate.

AIM: This was to record the oral health profile and more specifically the prevalence of carious and hypoplastic lesions in children and adolescents with cleft lip and palate (CLP). STUDY DESIGN AND METHODS: The study group consisted of 41 children and adolescents (4-18 years-old) with CLP group while a similar number of non-cleft persons (HLP) matched for sex, age and orthodontic treatment (75.6%), was used as the control group. Information regarding the oral health habits, medical and dental history were collected using a questionnaire. Stimulated saliva was collected to evaluate the flow rate and buffering capacity as well as the levels of mutans streptococci and lactobacilli using the chair-test CRT(R) (Ivoclar -Vivadent). Oral hygiene (OH) was assessed using the index of Silness and Loe [1964]. The prevalence of initial/white spot and cavitated carious lesions as well as hypoplasia was evaluated based on the criteria by ICDAS [2005] and Nyvad et al [2008] as well as Koch et al [1987] respectively. The statistical analysis was carried out using the t-test and the chi- square test. RESULTS: Approximately half of the CLP and HLP subjects were brushing their teeth 2 x per day. Both groups reported an average of 3 main and 2 snack meals per day. Levels of mutans streptococci and lactobacilli as well as the quality of the saliva were similar for both groups. The plaque index score was significantly higher in the CLP than in the control group (p=0.0003). The prevalence of cavitated carious lesions was similar in both groups but that of the initial/white spot lesions, especially at the area of maxillary incisors, was higher in the CLP group (85%, p=0.000). CONCLUSIONS: The increased numbers of initial/ white spot lesions combined with poor OH found in the CLP group predispose for an increased risk of further development to carious cavitated lesions. Taking into consideration that the majority of those patients were under orthodontic treatment, the application of an intensive individualized oral health preventive program, focused on remineralisation of the initial caries, is imperative.

The microbiota on different oral surfaces in healthy children.

INTRODUCTION: Knowledge of the early oral colonization patterns could provide a better understanding of oral biofilm development and disease initiation that in turn could be the basis for early preventive programmes. METHODS: Microbial samples were collected from five different oral habitats from a total of 93 children (age 3-12 years), attending the Dental School of the University of Athens, who were split into three age groups. A total of 38 microbial species were sought out by the checkerboard DNA-DNA hybridization technique. RESULTS: All of the test species, except Parvimonas micra and Porphyromonas gingivalis, differed significantly among sample locations providing quite distinct microbial profiles for the different oral surfaces. Supragingival and subgingival plaque had similar profiles and exhibited higher proportions of Actinomyces species and Green complex while soft tissue samples were dominated by streptococci of the Yellow complex. The profiles of the tongue dorsum and saliva were also similar. Many of the species were in similar proportions in all three age groups for a given location. Periodontal pathogens showed increases in proportions with increasing age. Specifically, the Red complex species (Tannerella forsythia, P. gingivalis, Treponema denticola) showed a significant increase in proportion with age (P < 0.05) in all sample locations. CONCLUSIONS: The results showed a pattern of colonization in children similar to that previously found in adults. Differences in the profile between age groups suggest a gradual maturation of the oral microbiota, with it being made up of an increasing number of Orange and Red complex species.

Effect of blue light on the proliferation of human gingival fibroblasts.

OBJECTIVES: Previous studies have reported that blue light, under conditions similar to those used for orthodontic bonding, influences several aspects of cellular physiology. The purpose of this study was to investigate the effect of the exposure to blue light curing sources, i.e. halogen, light emitting diode (LED) and plasma arc irradiation, on the proliferation of human gingival fibroblasts. METHODS: Primary cultures of human gingival fibroblasts were exposed to halogen, LED and plasma arc irradiation for 240, 180 and 120 s, respectively. The effect of blue light on DNA synthesis and cell proliferation was estimated by tritiated thymidine incorporation and direct cell counting, respectively. The possible involvement of an oxidative stress on the effect of blue light irradiation was studied by using N-acetyl-cysteine. Finally the formation of DNA double-strand breaks after irradiation was studied by immunofluorescence with an antibody against histone H2A.x phosphorylated in Ser139. RESULTS: Blue light showed no immediate effect on the regulation of DNA synthesis. However, exposure of cells to these light sources inhibits cell proliferation measured one week after irradiation. This phenomenon is not attributed to the formation of DNA double strand breaks and cannot be annulled by N-acetyl-cysteine. SIGNIFICANCE: The results presented here indicate a mild inhibition of gingival fibroblasts' proliferation after exposure to blue light and necessitate further study to clarify the exact mechanism underlying this effect.

Pulpotomy in primary teeth: review of the literature according to standardized criteria.

AIM: To assess the relevant literature using a modification of the criteria listed in the introductory paper to this issue [Curzon and Toumba, 2006], and to review several new publications on pulpotomies with different materials and techniques that appeared after previously published reviews. METHODS: A search of the literature on pulpotomies was identified using Medline between the years 1966-2005. The search generated 358 citations and sieving of these papers was conducted by examining the paper title and assessing its relevance [Loh et al., 2004]. Only clinical studies (non-specified) and retrospective studies were included for assessment. There were 17 criteria (considered major) weighed 2 points and 8 criteria weighed 1 point. A paper that would score between 38-42 points (90+ %) was assessed as Grade A, a score from 32 to 37 points (75-89%) was Grade B1, and between 25 to 31 points (60-74%) Graded B2. All other papers that reached 24 points or less (less than 59%) was rated Grade C. RESULTS: Of the 358 papers originally identified 48 clinical trials were evaluated according to the set of criteria. There was only one paper graded A, 5 papers graded B1, 3 graded B2 and 39 received a grade C. Formocresol or ferric sulphate medicaments were found to be likely to have similar clinical/radiographic results, and MTA seemed to be a more favourable pulp dressing. CONCLUSION: No conclusion can be made as to the optimum treatment or technique for pulpally involved primary teeth. More high quality, properly planned prospective studies are necessary to clarify these points.

Progression of proximal caries in children with different caries indices: a 4-year radiographic study.

AIM: This was to investigate survival rate, median survival time and differences in the progression of different stages of proximal caries in 196 children, aged 6 to 8 years old, with different caries index at baseline examination. METHODS: Based on DMFS/dmfs values, children were categorized as low, moderate and high caries index groups. Subjects with DMFS/dmfs smaller or equal to half of a child's age were classified as low caries index group, children with DMFS/dmfs greater to half and smaller than or equal to the child's age as moderate, while those with DMFS/dmfs greater than the child's age as high. Proximal caries and its progression were diagnosed from bitewing radiographs taken at 1-year intervals over a period of 4 years. The mesial surface of the first permanent molars, mesial and distal surfaces of the first and second primary molars and distal surfaces of the primary canines were examined. Sound surfaces, caries lesions in the external and internal half of the enamel and external, middle, internal third of the dentine as well as filled, extracted and exfoliated teeth were recorded. STATISTICS: A life table analysis was performed to estimate survival rate and median survival time of each state of proximal caries and differences between the groups in the progression of the proximal lesions were tested with the Wilcoxon pairwise comparison statistic. RESULTS: There were statistically significant differences in the caries rate of the sound proximal surfaces of the primary teeth between the low and high caries index groups. Also, statistically significant differences between these two groups were found in the progression of the external half of the enamel caries in the first permanent molars and in the primary teeth. CONCLUSIONS: A high caries index increases the risk of developing caries in the sound proximal surfaces of posterior primary teeth and causes faster progression of the external half of the enamel lesions in the first permanent molars and posterior primary teeth.

A comparative study on the prevalence of enamel defects and dental caries in children and adolescents with and without coeliac disease.

AIM: This was to test for differences in the prevalence of enamel defects and dental caries between children and adolescents with and without coeliac disease (CD). MATERIALS AND METHODS: The sample consisted of 27 children and adolescents, aged 3 to 18 years with CD, and a control group of 27 healthy subjects matched by age and gender. Enamel defects were diagnosed and classified according to criteria described by Aine [1986], while dental caries was recorded as DMFT(S) and dmft(s) indices [Koch, 1970]. Dental plaque was recorded by the Plaque Control Record Index. Information related to medical history, oral hygiene habits, use of fluoride, history of dental trauma and socioeconomic factors was collected by a structured parental questionnaire. Also, in children with CD the age of initiation and diagnosis of the disease was recorded. STATISTICS: The chi square and the paired t-test were used for the statistical analysis of the qualitative and quantitative data respectively. The logistic multiple regression analysis was applied to test whether the time period between the initiation and diagnosis of CD and other related factors had a significant (p

Judgement criteria for molar incisor hypomineralisation (MIH) in epidemiologic studies: a summary of the European meeting on MIH held in Athens, 2003.

AIM: This paper reviews the proceedings and conclusions of a meeting of experts concerned with the problem of hypomineralised incisors and molars (MIH). The aims of this meeting were to establish criteria for the judgement of MIH, to select representative cases and to discuss how the name of the condition was best described as hypomineralised, or hypomaturated, first permanent molars. CONCLUSION: There was not complete agreement as to the correct diagnosis and aetiology of the condition. A suggested list of definitions of the judgement criteria to be used in diagnosing Molar Incisor Hypomineralisation (MIH) for prevalence studies was agreed upon.

Multifactorial analysis of the aetiology of craniomandibular dysfunction in children.

OBJECTIVES: It is generally accepted that the aetiology of craniomandibular dysfunction (CMD) is multifactorial. Different types of malocclusion, oral parafunctions especially bruxism, trauma of the mandible or temporomandibular joint (TMJ) and emotional stress are known aetiologic factors. Research has been conducted into the relationship between each of these aetiologic factors and the signs and symptoms of CMD. However, such an approach does not control for the simultaneous effect of other factors responsible for the development of the dysfunction. The purpose of this study was to investigate the effect of each aetiologic factor on the signs and symptoms of CMD in children, controlling for the effect of all other known factors by means of a multifactorial analysis. METHODS: A sample of 314 children, aged 6-8 years, was examined clinically for signs of CMD and morphologic and functional malocclusion. Symptoms of CMD and oral parafunctions were recorded by the same investigator in an interview. Emotional stress was measured through urinary catecholamines including epinephrine, norepinephrine and dopamine, detected in a 24-h urine sample, using high performance liquid chromatography. A questionnaire was distributed to the parents to collect information regarding socioeconomic factors and the history of dentofacial injuries. A logistic multiple regression was carried out to estimate the partial effect of each aetiologic factor. A 95% probability level was used. RESULTS: Posterior crossbite with lateral shift significantly affected the probability of child developing deviation of the mandible on opening. Similarly, posterior crossbite and epinephrine had a significant impact on TMJ tenderness, overjet had an effect on clicking, clenching and biting of objects had an effect on muscle tenderness, and lip/cheek biting influenced dysfunctional opening. Of the symptoms reported, pain on wide opening was affected significantly by lip/cheek biting. CONCLUSION: On the basis of these results, it can be suggested that parafunctional and some structural and psychological factors may increase the probability of the child developing the signs and symptoms of CMD.

In vitro study of penetration of flowable resin composite and compomer into occlusal fissures.

UNLABELLED: The penetration of a sealant into the tooth fissures can establish longer retention time for a pit and fissure sealant restoration. AIM: This in vitro study was to evaluate the penetration ability of two low-viscosity resin materials, a composite and a compomer, applied with and without their bonding agents in comparison to an unfilled resin sealant. METHODS: Forty premolars with shallow/wide (group I) and forty with deep/narrow occlusal fissures (group II) were used. Each group was divided into five subgroups (A-E). The teeth in the subgroups were sealed as follows: A - Delton LC Clear (unfilled resin); B - Dyract flow (compomer); C - Prime&Bond NT (bonding agent) and Dyract flow; D - Tetric flow (resin composite); E - Syntac Sprint (bonding agent) and Tetric flow. Longitudinal sections were cut along the mesiodistal direction of fissures and examined under a videomicroscope. The resin penetration was rated according to the scale "low", "medium", "high", indicating penetration up to one third and two thirds of fissure depth and to the fissure bottom, respectively. RESULTS: These revealed the following: a) the penetration of all sealants was higher in shallow/wide than in deep/narrow fissures; b) the low-viscosity resin materials provided higher penetration than the unfilled resin sealant in shallow/wide fissures, whereas the unfilled resin achieved superior penetration rates in deep/narrow ones; c) the combination of a hydrophilic sealant (Dyract flow) with a hydrophilic bonding agent (Prime&Bond NT) significantly promoted the penetration depth in deep/narrow fissures. CONCLUSION: The penetration ability of all sealants was higher in shallow/wide than in narrow/deep fissures; low-viscosity resin composite and compomer provided higher penetration efficiency than the unfilled resin sealant in shallow/wide fissures, whereas the unfilled resin achieved superior penetration rate in deep/narrow ones. The combination of a hydrophilic sealant with a hydrophilic bonding agent significantly enhanced the penetration depth in deep/narrow fissures.

Clinical studies on ferric sulphate as a pulpotomy medicament in primary teeth.

AIM: The purpose of this paper is to review three prospective and two retrospective studies that have been published on the use of ferric sulphate as a pulpotomy medicament and, also, present the results of a recently completed, 3 year comparative study in pulpotomized primary teeth using ferric sulphate and diluted formocresol. The most important finding from the reviewed studies was that ferric sulphate gives very good clinical and radiographic results with high tooth survival rates and with no statistically significant differences from that of formocresol. Internal resorption is a common radiographic finding in both ferric sulphate and formocresol treatments with no statistically significant differences between them. However, internal resorption differs in size and progression rate among teeth. There were cases reported in which the size of the internal resorption was very small and unchanged over time, and even cases where the area of the resorption was self-repaired with hard tissue. Some of the authors considered only teeth with progressing and/or extensive internal resorption as failures, while small size and unchanged with time internal resorption was not considered as failure. CONCLUSION: Based on the data of the reviewed studies it is suggested that ferric sulphate be used, rather than formocresol, for pulpotomies of primary teeth as the latter has been blamed for systemic and local side effects on the developing successors.

Urinary catecholamines as a measure of emotional stress in children with a digit-sucking habit: a preliminary study.

This cross-sectional study investigated the relationship between digit-sucking habit and emotional stress measured by the urinary catecholamines in 314 children, boys and girls, ages six to eight years. The digit-sucking habit was recorded by an interview. A twenty-four hour urine sample was collected for each subject and a representative sample was analyzed by the HPLC technique to assay the catecholamine content. Socioeconomic factors were recorded by a questionnaire distributed to the parents. The logistic multiple-regression analysis was used to test the impact of catecholamines and other related factors on the presence of a digit-sucking habit. The results showed that emotional stress measured by the urinary catecholamines did not have a significant effect on the presence of a digit-sucking habit. Of the socioeconomic factors, father's education had a significant negative effect on the presence of the habit. The evidence provided by this investigation cannot support the view of psychoanalytic theory that continuation of the habit beyond the early childhood is due to emotional stress.

Emotional stress and craniomandibular dysfunction in children.

This study investigated the relationship between craniomandibular dysfunction (CMD) and emotionally stressful states measured by the urinary catecholamines in 314 children aged six to eight years. The children were examined clinically and interviewed by the same investigator. During the clinical examination the following variables were recorded: maximal mouth opening with and without pain, deviation of the mandible in opening wide, muscle and temporomandibular joint (TMJ) tenderness or pain and sounds from the TMJ. The variables recorded during the interview were headaches, difficulties in opening wide, pain upon opening wide, and clicking. A questionnaire was distributed to the parents to collect information regarding socioeconomic factors. A 24-hour urine sample was collected for each subject and analyzed by the high performance liquid chromatography (HPLC) technique to assay the catecholamine content. The logistic multiple regression analysis was carried out to test whether craniomandibular dysfunction was affected by the studied variables. A 95% probability level was used. The results showed that epinephrine had a significant effect on TMJ tenderness, while norepinephrine and dopamine did not have a significant association with any of the signs and symptoms of CMD. The data suggest that emotionally stressful states increase the probability of developing TMJ tenderness in children of this age.

Caries increment in children and urinary catecholamines: findings at one-year.

This one-year follow-up study investigates the relationship between urinary catecholamine levels and dental caries increment in 314 children, boys and girls, ages six to eight years. Dental caries was recorded clinically and radiographically and oral hygiene was evaluated by recording the dental plaque. A 24-hour urine sample was collected for each subject, in a year interval, and a representative sample was analyzed by the HPLC technique to assay the catecholamine content. Socioeconomic factors such as parental age, education, and profession were recorded by a questionnaire distributed to the parents. Of the examined children, forty-four (16 boys and 28 girls) did not develop new dental caries and constituted the Caries-Free group. Two New Caries groups, A and B, of forty-four children each (16 boys and 28 girls) were matched by age and sex. Differences were tested in the quantitative and qualitative data by the paired t-test and the chi 2 test, respectively, while a regression analysis was applied to measure the effects of norepinephrine and dopamine on epinephrine. The logistic multiple-regression analysis was used to test, in the entire population, the impact of catecholamines and other related factors on the probability of a subject's developing new dental caries. The 95 percent probability was used. The results showed statistically significant differences in epinephrine and norepinephrine values between Caries-Free and New Caries group A in both examinations. Also, significant differences were found between Caries-Free and New Caries group B in epinephrine and norepinephrine at the first examination, while at the second examination the difference was significant only in epinephrine. The data provide evidence, therefore, that an emotionally stressful state can be an etiologic factor of dental caries.

Urinary catecholamine levels and incidence of dentofacial injuries in children: a 2-year prospective study.

Urinary catecholamines have been used to measure emotionally stressful states which may have an impact on dentofacial injuries. This prospective study investigated the hypothesis that urinary catecholamines such as epinephrine, norepinephrine and dopamine do not affect significantly the incidence of dentofacial injuries in children. As a test of this hypothesis 204 children, males and females, aged 8 to 10 years, were included in the study. After a first examination, each subject was re-examined, at one-year intervals, over a period of two years. Dentofacial injuries were recorded by a clinical examination and a questionnaire. Three 24-h urine samples, with an interval of one year between each, were collected and analyzed by the high performance liquid chromatography technique to assay the catecholamine content. Socio-economic factors were recorded by a questionnaire. Using the panel of data collected, the logistic multiple regression model was employed to test whether the incidence of dentofacial injuries was affected by the studied variables. The 95% probability level was used. Specificity and sensitivity as well as the positive and negative predictive rates were computed. The results showed that epinephrine had a significant correlation with the incidence of dentofacial injuries. Other factors found to have a significant impact were child's age and gender. The values of sensitivity and specificity were 81% and 69% respectively, while the positive and negative predictive rates were 68% and 82% respectively. The data, therefore, provided evidence that emotionally stressful states measured by the urinary catecholamines were prominent etiologic factors of dentofacial injury.

Clinical evaluation of a polyacid-modified resin composite (compomer) in Class II restorations of primary teeth: a two-year follow-up study.

PURPOSE: The aim of the study was to assess the clinical performance of a compomer restorative material (Dyract, DeTrey/Dentsply) for the restoration of Class II cavities, extended into dentin in primary teeth. METHODS: The sample of the study consisted of 25 patients with 68 restored cavities. The restorations were evaluated with the modified Ryge criteria at baseline and after 6, 12 and 24 months. Examination was clinical, radiographic, and observation of cast replicas under scanning electron microscope (SEM). RESULTS: After 24 months, 100% of the restorations were retained, 3% presented bulk fractures, and 6% developed secondary caries at cervical margins. After 24 months, there was a significant reduction in marginal integrity while there was only slight change in anatomic form. Proximal contact was defective in 6% of the restorations and 8% showed marginal discoloration. SEM evaluation revealed a generalized occlusal and scattered marginal wear with no marginal gaps. CONCLUSION: The compomer presented acceptable clinical performance in Class II restorations of primary teeth after 24 months in service.

Urinary catecholamine levels and bruxism in children.

This study was performed to test the hypothesis that emotionally stressful states measured by the urinary catecholamines may affect the development of bruxism. Three hundred and fourteen children, boys and girls, aged 6-8 years were included in this study. Bruxism was recorded by a clinical examination and an interview. Positive evidence of this parafunction was defined as the presence of both historical and clinical indicators. Information concerning systemic and socio-economic factors was collected by a questionnaire. A 24-h urine sample was collected for each subject and analysed by the high performance liquid chromatography technique to assay the catecholamine content. Of the total of 273 children who had a complete 24-h urine sample, 167 were identified to be with and without positive evidence of bruxism. The logistic multiple-regression analysis was carried out to test whether the presence of bruxism was affected by the variables studied; 95% probability was used. The results showed that epinephrine and dopamine had a significant and strong association with bruxism. The data therefore provide support for the concept that emotional stress is a prominent factor in the development of bruxing behaviour.