Biomimetic Enamel Regeneration Using Self-Assembling Peptide P11-4.

The recent understanding of the etiology and pathology of dental caries has shifted its treatment from invasive drill and fill conventional strategies to noninvasive and/or minimally invasive approaches. Guided tissue regeneration (GTR) is a well-established therapeutic approach in medicine and periodontal and oral surgery. Recently, the concept of biomimetic regeneration has been further expanded to treat the loss of hard dental tissues. Self-assembling peptides have emerged as a promising biomaterial for biomimetic regeneration due to their ability to construct a protein scaffold in the body of early carious lesions and provide a matrix that promotes remineralization. This review article accompanies the development of self-assembling peptide P11-4 for the treatment of initial carious lesions. In vitro and in vivo studies on the safety, clinical applicability, and efficacy of P11-4 are discussed. Furthermore, different treatment options and potential areas of application are presented.

Referral patterns and general anesthesia in a specialized paediatric dental service.

OBJECTIVES: The caries patterns of child populations in Germany have changed during the last 20 years. This affects the referrals and provision of specialist dental care for children. This study has two aims: first, to investigate referrals received by a specialized pediatric dental institution in 1995 and 2008, and second, to assess the treatments performed during full oral rehabilitations under general anesthesia in this institution from 2007 to 2008. METHODS: All data of referred patients were evaluated for 1995 and 2008 separately. Comparisons were carried out for different socio-demographic, medical, and dental parameters. All patients treated under general anesthesia (GA) between March/2007 and December/2008 were examined retrospectively and their data were analyzed. RESULTS: In 1995 (n = 191), significantly older children were referred to specialized pediatric dental care compared to 2008 (n = 179). In addition, a shift of surgical referrals to very young children with high caries levels was clearly noticed, resulting in considerably more oral rehabilitation performed under GA in 2008 (n = 73). Thus, the mean values of 6.4 fillings and 2.7 extractions per child were quite high. CONCLUSIONS: Preventive treatment approaches for primary dentition in Germany need further improvement by focusing on high caries-risk groups, as specialized pediatric dentistry bears the great burden of providing oral rehabilitations under GA in young children.

Overweight and dental caries: the association among German children.

OBJECTIVES: The aim of this study was to determine the relationship between iso-body mass index (iso-BMI) and both dental caries status and caries increment among German school children. METHODS: Six hundred and ninety-four students (age range 9-12 years, mean 10.34 ± 0.56, 48% females) were recruited from the fifth grade of 18 primary schools. Weight, height, and oral health data number of decayed, missing and filled teeth (DMFT) as well as parent/legal guardian questionnaire (measuring SES) were collected during school dental examination at baseline and after one and a half-year follow-up. The body mass index (BMI) was calculated using the international classification system for childhood overweight and obesity (iso-BMI). Statistical analyses were performed using Poisson regression models. RESULTS: Iso-BMI was significantly associated with dental caries prevalence and severity in the permanent dentition (P = 0.039). Low-normal weight children had a lower mean DMFT (0.56) than did overweight/obese children (0.70). In addition, a border-line significant association was found between overweight/obese children and caries increment (P = 0.055). CONCLUSION: Although iso-BMI was associated with dental caries prevalence and severity, the association between caries increment and iso-BMI did not reach a statistical significance. Overweight/obese children however acquired more additional carious lesions during the follow-up period than children with low-normal weight.

Early childhood caries and feeding practices in kindergarten children.

OBJECTIVE: To determine the prevalence and severity of early childhood caries (ECC) and its relation to feeding practices in Syria. METHOD AND MATERIALS: A total of 400 children aged 3 to 5 years (mean age ± SD, 4.2 ± 0.5) were screened from 20 randomly selected kindergartens in Latakia, Syria. Dental examinations were carried out by a specialist in pediatric dentistry using DMFT and DMFS indices and an ECC scoring system. Information regarding feeding practices during early childhood was also collected. RESULTS: Caries was seen in 70% of the children, with a total mean DMFT value of 4.25 ± 4.2 per child. The mean values increased from 2.4 ± 3.2 DMFT at age 3 to 5.6 ± 4.9 at age 5 (4.1 ± 6.3 and 12.8 ± 12.0 DMFS, respectively). Age and feeding practices showed statistically significant associations with caries (P < .001). The mean DMFT in the bottlefed children was 5.33 ± 4.6 compared with only 3.27 ± 3.5 in predominantly breastfed children. Forty-eight percent of the children had ECC, and 24% showed a severe degree with carious defects and open caries lesions. A significantly higher prevalence and severity of ECC was observed in children who were bottlefed (z-statistic, -2.1; P = .036) compared with breastfed children. CONCLUSION: In addition to a high prevalence of caries and ECC in preschool children, bottlefeeding led to even higher caries rates in Syria. Since the caries was largely untreated, preventive and restorative dental programs should be implemented.

Microleakage assessment of a repaired, nano-filled, resin-based fissure sealant.

PURPOSE: The purpose of this study was to evaluate the effects of different repairing techniques of a fractured sealant on microleakage in vitro. METHODS: A nono-filled flowable composite (Filtek Z350) was placed on the occlusal surfaces of 112 intact extracted molars following cleoning by prophylaxis and acid etching. Sealant failure was produced on the entire sample. The teeth were then randomly allocated into 4 groups, each representing a different method of repair: group 1 (control)-prophylaxis brush followed by acid etching and 10 seconds of curing time; group 2-prophylaxis brush, acid etching, application of bonding agent, and 10 seconds of curing time; group 3-prophylaxis brush, acid etching, and 5 seconds of curing time; and group 4-prophylaxis brush, acid etching, and 20 seconds of curing time. Then, they were pointed with varnish and immersed in 1% methylene blue. The teeth were then sectioned, and a total of 648 surfaces were scored for microleakage. RESULTS: Statistical analysis did not demonstrate any one method of repair to be superior to the control method. There were no significant differences in microleakage between 10 and 20 seconds of curing time. CONCLUSION: Prophylaxis brush, acid etching, and light-emitting diode light curing for 10 seconds seems to be the simplest and the most appropriate method of repair and is, therefore, recommended.

Paediatric mandibular fractures: report of a case.

The conservative approach in the treatment of maxillofacial trauma in children has been widely adopted. The type of fracture and its presence within the growing facial skeleton along with the presence of tooth buds may result in different management strategies to that employed in adults. An understanding of conservative treatment options is essential to make informed choices which will best manage these injuries, and an example is presented in this paper. This case report describes a 14-year-old boy who sustained trauma to the chin as a result of a fall, causing a mandibular symphyseal fracture. He was successfully treated by the means of applying direct interdental wiring combined with an acrylic splint.