Does prenatal restraint stress change the craniofacial growth pattern of rat offspring?

A major and frequently encountered condition underlying the long-term programming effects of the intrauterine environment is exposure to stress. Gestational stress is an environmental factor that induces physical and behavioral alterations in offspring. Seventy female virgin Wistar rats were mated with one male rat for a maximum of four times, after which 52 pregnant rats were divided into two groups. In the experimental group the rats were exposed to restraint stress during pregnancy, whereas the control group did not receive the stress protocol. One male litter was randomly chosen from the offspring of each rat with 8-13 pups. A total of 40 male rat offspring were available for analysis. Thirty-one linear and angular measurements were analyzed in both study groups to investigate whether prenatal restraint stress changes the craniofacial growth pattern of rat offspring. In the prenatally stressed group, anterior cranial base length and viscerocranium measures were significantly increased compared with the control group, whereas cranial width, mandibular dimensions, and posterior cranial height and length remained unchanged. Furthermore, the prenatally stressed group showed backward rotation of the midface and decreased flattening of the cranial vault. It was concluded that prenatal chronic stress can induce alterations in the craniofacial growth pattern by promoting endochondral growth in the cranial base and nasal septum.

Oral health status, dental anxiety, and behavior-management problems in children with oppositional defiant disorder.

Mental disorders have been shown to affect children's oral health. This study was carried out to investigate the oral health status, dental anxiety (DA), and behavior-management problems (BMPs) during dental treatment in 6- to 9-yr-old children with oppositional defiant disorder (ODD)/attention-deficit hyperactivity disorder (ADHD). The study and control groups included 40 children with ODD/ADHD and 80 normal children, respectively. All participants received an amalgam restoration. During the procedure, the children's behavior was assessed using the Frankl Rating Scale and the Verbal Skill Scale. Parents rated their children's DA using the parental version of the Children's Fear Survey Schedule-Dental subscale (CFSS-DS). Comorbid anxiety disorders were assessed using the Kiddie-Sads-Present and Lifetime Version questionnaire. Oral health status was assessed using the gingival index and the decayed, missing, and filled teeth score for permanent (DMFT) and primary (dmft) teeth. The findings showed that DA and BMPs were significantly higher in children with ODD/ADHD than in the controls. Furthermore, the frequency of DA and BMPs was higher in children with both ODD/ADHD and a comorbid anxiety disorder than in those without comorbid anxiety disorder. Children with ODD/ADHD had significantly higher DMFT/dmft scores than those in the control group, whereas the difference in gingival index was not statistically significant. In conclusion, children with ODD/ADHD had higher levels of DA, BMP and poorer oral health status.

Chondroectodermal dysplasia (Ellis-van Creveld syndrome): a case report.

Ellis-van Creveld (EVC) syndrome is a form of skeletal and chondroectodermal dysplasia, occurring with and without systemic involvement. Taurodontism of permanent and primary molars and upper posterior supernumerary teeth are rarely associated with this syndrome. A 5-year-old girl presented with early childhood caries and hypodontia. She had labiogingival adhesion, labiogingival frenulum hypertrophy, accessory labiogingival frenula, and a serrated appearance of the gingiva. She was also short in stature. All major features of chondroectodermal dysplasia were present. EVC syndrome requires multidisciplinary therapeutic planning, and the dentist plays a fundamental role in management of the oral and dental manifestations.

Dental management of oculodentodigital dysplasia: a case report.

Oculodentodigital dysplasia is an extremely rare autosomal dominant pleiotropic disorder. The syndrome is characterized by abnormal facial features, central nervous system involvement, syndactyly and clinodactyly of fourth and fifth fingers, dry and lusterless hair, generalized enamel hypoplasia and odontodysplasia. Combination of odontodysplasia, poor oral hygiene, and parental neglect can lead to extensive destruction of tooth structure and the treatment options become limited. Early diagnosis with a proper treatment plan and meticulous oral hygiene program helps eliminate the necessity of multiple tooth extractions. This case report describes the comprehensive dental treatment aimed at rehabilitation of function and aesthetics of the dentition in an 8-year-old boy with oculodentodigital dysplasia.

Site-specificity of pain sensitivity to intraoral anesthetic injections in children.

A total of 455 children (242 males and 213 females) aged 5-6 years were investigated for their pain reactions to maxillary and mandibular infiltration anesthesia, middle superior alveolar nerve block, posterior superior alveolar nerve block, greater palatine nerve block, nasopalatine nerve block, and inferior alveolar nerve block, and the responses were quantified using the sound, eye and motor (SEM) scale. Administration of nasopalatine nerve block produced maximum pain (median SEM score: 10) while that of posterior superior alveolar nerve block and inferior alveolar nerve block was accompanied by minimum pain (3 and 4, respectively). There was no significant gender-specific difference in pain reactions (P = 0.39). Administration of local anesthesia in the maxilla was more painful than injections into the mandible (7 versus 5, P < 0.05). Furthermore, infiltration into the anterior and posterior segments of the maxilla produced maximum and minimum pain reactions, respectively (8 versus 3, P < 0.001). It seems that the anatomical location of an injection is one of the most important determinants of pediatric pain reaction, and that mandibular injections are generally less painful. Prioritization of treatment by consideration of site-dependent variability in pain sensitivity may help to achieve optimal behavioral control during dental treatment in young children.

Study of root canal accessibility in human primary molars.

The aim of the present study was to provide a general scheme for pulpectomy of primary molars that may be useful for decision-making about negotiation of root canals and selection of appropriate instruments. A total of 160 vital primary molars in 85 patients (40 males, 45 females) aged 4-6 years were selected. After taking primary radiographs, local anesthesia was induced, and the teeth were isolated using a rubber dam. Canal accessibility index (CAI) and tooth accessibility index (TAI) were calculated according to initial file size. Mandibular first molars had either three canals (79.2%) or four canals (20.8%), and all second molars had four canals. Maxillary first molars had three canals and second molars had either three canals (70.9%) or four canals (29.1%). Lower accessibility of the mandibular first molar distobuccal root accounted for the lower accessibility of these teeth in comparison with mandibular second molars. While three-canal maxillary second molars were more accessible due to the lower accessibility of the distobuccal canal of the maxillary first molar, poor accessibility of the distal canal in four-canal second molars was responsible for the difficult accessibility of these teeth. In conclusion, it seems that the accessibility of a single canal in each tooth determines the difficulty of accessibility for any given tooth. Moreover, while primary second molars are more accessible than first molars, all of them are negotiable.