Clonal identity of Candida albicans in the oral cavity and the gastrointestinal tract of pre-school children.

The clonal relationship between oral and fecal Candida albicans isolated from children of pre-school age was examined using RAPD analysis. Significantly higher levels of C. albicans were found in saliva, dental plaque, carious specimens and stools of 56 patients with severe caries as compared to 52 healthy control subjects. The highest prevalence was found in carious specimens and a strong correlation was observed between its presence in saliva, dental plaque, carious specimen and feces. RAPD analysis of isolates from 23 patients with simultaneous oral and fecal C. albicans revealed clonal counterparts present in both oral and stool samples in 15 cases; five patients harbored closely related strains; and three patients harbored unrelated strains. Our results demonstrate a strong correlation between oral and gastrointestinal C. albicans colonization. We assume that carious teeth may constitute an ecologic niche for C. albicans potentially responsible for recurrent oral and non-oral candidiasis.

Orofacial findings in the Klippel-Trénaunay syndrome.

The Klippel-Trénaunay syndrome is a triad of congenital anomalies characterised by haemangiomas, varicosities, and unilateral bony and soft tissue hypertrophy. Hypertrophy usually affects one distal limb, but trunk or face may be affected. Cutaneous haemangiomas (nevus flammeus) of varying extent and irregular contour are often present in the hypertrophic regions. Varicosities may also be part of the vascular lesions of the syndrome. Orofacial manifestations include facial asymmetry, jaw enlargement, and malocclusions as well as premature tooth eruption. Two cases of the Klippel-Trénaunay syndrome are presented here. Both of these show the typical hemifacial hypertrophy and premature eruption of teeth on the affected side. In the first case only the left mandibular region was affected. In contrast, in the second there was hypertrophy of the whole left side of the body including upper and lower jaws. This boy also suffers from congenital ideokinetic retardation, while the first was otherwise normal. Both cases differ from previously reported cases of the Klippel-Trénaunay syndrome in lacking any prominent facial nevus flammeus. In the first case there was also malformation of the crown of the first permanent molar on the affected side that has not been described previously.

Nursing-bottle syndrome caused by prolonged drinking from vessels with bill-shaped extensions.

Our investigating 186 infants between the ages of one and six with carious destruction of the maxillary primary incisors, it was learned which risk factors were responsible for the condition known as nursing bottle syndrome. One hundred and twenty-eight infants (68.8 percent) were given a nursing bottle, twelve (6.5 percent) a feeding cup or other bottles with bill- shaped extensions, and forty-one (22.0 percent) both a nursing bottle and vessels with bill-shaped extensions; in all cases the feeding was excessive and prolonged beyond the first year of life. An additional five infants (2.7 percent) were breast-fed excessively beyond the first year. The results confirm the risk of tooth destruction, typical of nursing bottle syndrome, by prolonged and frequent consumption of cariogenic beverages from vessels with bill-shaped extensions. It is important, therefore, that a warning regarding dental health hazards of such feeding methods be issued.

The treatment of mandibular cysts associated with osteogenesis imperfecta.

A fifteen-year-old boy with osteogenesis imperfecta (OI) and dentinogenesis imperfecta also had a big cyst in the mandible and needed surgical therapy. Six months postoperatively we saw a complete regeneration of the bone-structures. We came to the conclusion that cysts which appear independently from the disease of OI can heal after surgical intervention.

Effect of dental treatment and/or local application of amphotericin B to carious teeth on oral colonization by Candida.

Microbiological analyses of saliva and swabs were obtained from carious lesions of 54 children and adolescents with carious teeth, and of 49 boys and girls with healthy teeth. Candida species were isolated from the saliva of 36 (66.7%) subjects with active caries, but from the saliva of only one (2%) of the 49 caries-free subjects. Candida was detected in material removed from the carious lesion in 44 (81.5%) of the children with caries. Thirty patients with carious teeth and colonized by Candida were randomly divided into three groups of 10 individuals each, and either treated by complete dental restoration, by local application of amphotericin B or by a combination of dental treatment plus amphotericin B. The final microbiological control showed that thorough dental treatment alone eliminated fungi from the oral cavity in 90% of cases, whereas the local application of amphotericin B alone had a minimal effect on the candidal colonization of carious lesions. When, in addition to dental treatment, amphotericin B was applied, fungi were completely eliminated from the oral cavity of all subjects.

Recent findings in classification of osteogenesis imperfecta by means of existing dental symptoms.

The findings are based on a clinical investigation conducted on forty-nine patients suffering from osteogenesis imperfecta (OI), as well as on a questionnaire study in which 117 osteogenesis imperfecta-affected persons or their parents were involved. The survey established pathological tooth discolorations as well as tooth abrasions. Dentinogenesis imperfecta (DI) was more frequently found in primary teeth than in permanent teeth. There were no gender-specific differences. Radiological abnormalities were found in both, abraded and/or discolored teeth, as well as in clinically normal appearing teeth. In most cases there were club-shaped extensions of the pulp chambers and obliterations of the root canals. The probability that dentinogenesis imperfecta occurs as an accompanying symptom of osteogenesis imperfecta was not dependent on the degree of skeletal severity. The self-assignment according to A and B forms of osteogenesis imperfecta types I and IV in accordance with the presence/absence of dental symptoms was contradictory, since the literature was based on varying classifications.

Consequences of serious oral injury associated with the congenital analgia syndrome.

Three sisters at the ages of seven months, twelve years, and thirteen years presented with the initial damages to the oral tissues and the distinctive long-term effects in conjunction with the congenital analgia syndrome. The severity of this syndrome justifies the consideration of a prophylactic extraction of the primary dentition. A controlled mastication will be more likely with increasing age and eruption of the permanent teeth.

[Cariogenic carbohydrates in maltodextrin-containing breast milk food substitutes]. / Kariogene Kohlenhydrate in maltodextrinhaltigen Muttermilchersatznahrungen.

Ten infant formulas containing maltodextrin were analysed for fermentable carbohydrates using enzymatic analysis test-combinations and a spectrophotometer. Besides lactose, sucrose and fructose an assessment was made of sugars typically contained in maltodextrin and corn syrup, namely maltose, maltotriose and glucose. Total carbohydrate was up to 10.3 g in 100 ml standard sample. Cariogenic sugars were found in concentrations between 4.0 and 7.3 g/100 ml. Declaration of the different types of carbohydrates, especially of maltodextrin/corn syrup proved to be insufficient in some products and consequently the consumer is not able to understand their cariogenic potential.

[Fluoride release from toothpastes in the newly produced and stored states]. / Fluoridfreisetzung aus Zahnpasten im produktionsfrischen und gelagerten Zustand.

The free ionic concentration of fluoride of 16 toothpastes for adults, of 5 pastes for children, and of one fluoride gel were analysed straight after production and after 4 months of storage. The fresh products containing fluoride as inorganic salt of hydrofluoric acid or as organic fluoride salt contained more than 65% of the manufacturers declaration of ionic fluoride. In the pastes containing sodiummonofluorphosphate the assessed concentration of free fluoride ions was less than 20% of the declaration. After 4 months of storage more than 75% of the ionic fluoride found in the new products could still be detected. The pastes containing sodiummonofluorphosphate, however, showed an increase of the ionic concentration of fluoride.

[Cariogenic carbohydrates in maltodextrins, glucose syrups and maltodextrin-containing infant tea]. / Kariogene Kohlenhydrate in Maltodextrinen, Glukosesirupen und maltodextrinhaltigen Kindertees.

Five maltodextrins and five corn syrups each, seven instant teas containing maltodextrin and one tea produced on a protein-base were analysed for fermentable carbohydrates using enzymatic analyses test combinations and a spectrophotometer. Analysis of the maltodextrins and glucose syrups demonstrated the heterogenicity of this group of substances and also some incompleteness in the declaration of maltose, maltotriose and glucose, sugars typically contained in these products. In standard samples of the instant teas cariogenic sugars were found in concentrations up to 0.7%. As these sugars were not declared in any of the products, the consumer is not able to assess the cariogenic potential of the ingredient maltodextrin. The intake of products containing maltodextrins or corn syrups must lead to an uncontrolled sugar consumption.

[Bristle end rounding on end-tuft, sulcus and orthodontic brushes]. / Borstenabrundung an Bündel-, Sulkus- und Kieferorthopädischen Bürsten.

A scanning electron microscopic study of bristle ends of two end-tuft, two sulcular and one orthodontic brush has shown differences in quality and quantity. One product had only 1.4% "acceptable" bristle ends. With the remaining brushes this part varied between 67.0% and 95.1%. There was no correlation between the bristle end shapes and the brush type.

[Extraction of the deciduous anterior teeth and its consequences in children with the nursing bottle syndrome]. / Milchfrontzahnextraktion und ihre Folgen bei Kindern mit Nursing-Bottle-Syndrom.

On eighty children, whose rampant carious and predominant periapical diseased deciduous maxillary incisors had been formerly extracted, the outcomes of the early extraction were inspected in regard to the later development of the permanent teeth and the general state of health. For 68 children gypsum models were analysed, whether the early loss of deciduous incisors had led to deficiency of place in the front of the upper jaw. The early tooth extraction and conservation therapy resulted in a clear improvement of children's physical condition and ameliorated the starting situation of permanent teeth to be preserved healthy. The earlier the milk-incisors had to been extracted the greater was the danger of a belated eruption of the permanent incisors.

[Fluoride release in children's toothpastes]. / Fluoridfreisetzung bei Kinderzahnpasten.

Comparative investigations of six toothpastes for children obtainable on the German market were carried out to determine their bioavailable fluoride concentration in vitro and in vivo. Four products contained sodium monofluorophosphate, one sodium fluoride and another amine fluoride. The product containing sodium fluoride had, both in the toothpaste-saliva-mixture in the test-tube as well as in the aquadest-toothpaste-saliva-mixture, derived from the oral cavity the maximum proportion of dissolved fluoride (> 70%). The product containing amine fluoride still had > 45% of free fluoride, the sodium monofluorophosphate products however had 10% or less of free fluoride.

[The germ colonization of the oral cavity in small children with the nursing bottle syndrome]. / Keimbesiedelung der Mundhöhle bei Kleinkindern mit Nursing-Bottle-Syndrom.

46 infants, aged 23 to 77 months, presenting with the nursing bottle syndrome, were examined clinically [dmf(t)] and microbiologically. Saliva and carious tooth substance was analysed for the presence of Streptococcus mutans, Lactobacilli and Candida albicans, using in part commercial tests. For comparative reasons, a group of caries-free children, aged 37 to 77 months, was examined as well. Increased numbers of specific caries bacteria (mutans streptococci and lactobacilli) and of Candida albicans were found in saliva and in the carious material of children with diseased teeth. The results confirm that excessive drinking from nursing bottles over a period longer than the first 12 months of life does not only lead to problematic tooth decay and its consequences but also to pathological changes in the entire oral flora. The invasion of candida forces us to reconsider the development of caries in infants.

[Bristle anchoring and bristle end-rounding in adults' toothbrushes]. / Borstenverankerung und Borstenabrundung bei Erwachsenenzahnbürsten.

Scanning electron microscopic study of bristle heads of 8 toothbrush brands commercially available in the Federal Republic of Germany and Switzerland has shown qualitative variations in the rounding of bristle ends. The percentage of acceptable end rounding of the bristles was for 4 brands above 75% and for 2 brands 55-56%. For 2 products, the percentage was below 40%. The new method of welding bristle bundles at their base into the head of the toothbrush was used only by one producer.

[The finishing of the bristle ends in interdental brushes]. / Bearbeitung der Borstenenden bei Interdentalbürsten.

The result of a scanning electron microscopic study of fourteen interdental brushes, available on the German and Swiss market, was that all products have an insufficient finish of bristle ends. Only one brush showed 17.3% of acceptably rounded bristle ends. In addition, the unacceptable rounded bristle ends were classified, corresponding to their variation of form. The results allowed to estimate the degree of damaging potential of the periodontal tissues, using interdental brushes.

[Dental status and prosthetics in handicapped patients]. / Gebissbefunde und Zahnersatz bei pflegebedürftigen Senioren.

Fifty-one highly disabled inhabitants of a Hessian rest- and nursing home (on an average age of 83 years) have been interviewed and examined with respect to the dental conditions, the need for dental treatment as well as their dental hygienics. The averaged dental status was poor. Most of the senior probands did not have any teeth, all the others would have needed dental treatment because of caries and periodontal disease. None of the inhabitants had fixed partials; the existing removable dentures--mostly worn during the day--showed functional defects. There were no major differences between those persons, who cleaned their partials their own, and those one's, who needed the help of the home's staff.