Root resorption of primary molars and dental development of premolars in children with Osteogenesis Imperfecta medicated with bisphosphonates, grouped according to age and gender.

BACKGROUND: Osteogenesis imperfecta (OI) is an inherited disorder characterized by bone fragility and skeletal alterations. The administration of bisphosphonates (BPs) to patients with OI reduces pain, thereby improving their quality of life. The main mechanism of action of BPs is the inhibition of osteoclast action. In the oral cavity of children with OI during growth and development, physiological processes that require the function of osteoclasts occur. The aim of this investigation was to study the dental development of premolars and the root resorption of primary molars in children with OI medicated with BPs according to age and sex. METHODS: An observational and analytical study was designed. The study sample consisted of 26 6- to 12-year-old children with a confirmed diagnosis of OI treated with BPs with available panoramic radiographs. The control group consisted of 395 children with available panoramic radiographs. Both groups were divided into subgroups according to sex and age. The third quadrant was studied, focusing on the first left temporary molar (7.4), the second left temporary molar (7.5), the first left permanent premolar (3.4) and the second left permanent premolar (3.5). The Demirjian method was used to study the dental development of 3.4 and 3.5, and the Haavikko method was used to study the root resorption of 7.4 and 7.5. The Mann‒Whitney U test was used for comparisons, and p < 0.05 indicated statistical significance. RESULTS: The mean chronological age of the 421 patients was 9.21 years (95% CI 9.05-9.37). The sample was reasonably balanced by sex, with 52.5% (221 patients) boys versus 47.5% (200 patients) girls. Delayed exfoliation and tooth development were described in children with OI (p = 0.05). According to sex, the root resorption of primary molars and tooth development were significantly lower in boys in both groups and in girls in the OI group, but the differences between the age groups were not significant. CONCLUSIONS: Children with OI treated with BPs exhibit delayed dental development of the premolars and delayed root resorption of the primary molars. Boys exhibited delays in both variables, but the differences by age subgroup were not significant. These clinical findings support the importance of clinically and radiographically monitoring the dental development and root resorption of primary teeth in children with OI treated with BPs to avoid alterations of the eruptive process.

The influence of crossbite in early development of mandibular bone asymmetries in paediatric patients.

BACKGROUND: All authors agree that posterior crossbite is a malocclusion that affects mandibular growth and may lead to skeletal asymmetry but there are few data on which age these modifications are easily quantifiable. MATERIAL AND METHODS: For this study, the researchers used x-ray records of 217 children between 6 and 9 years of age, in the mixed dentition stage and with unilateral posterior crossbite. All the horizontal variables were traced and evaluated by the principal researcher, using the tpsDig version 2 computer program. Subsequently, a descriptive and statistical analysis was carried out, using the SPSS 17.0 for Windows program. RESULTS AND DISCUSSION: After analysing the vertical mandibular traces on the x-rays, the researchers found, in all cases, quantifiable differences between the crossbite side and the non-crossbite side. The differences between horizontal variables were statistically significant (p<0.005) for the entire sample (H3-H4), in the group of boys (H3-H4) and in the 7-year old age group (H1-H2 and H3-H4). Differences were observed in the size of the horizontal measures between the crossbite side and the non-crossbite side. Some of these differences were significant as a function of the sex and age of the study sample. Key words:Crossbite, Mandibular asymmetry, Panoramic.

Program for coordinated dental care under general anaesthesia for children with special needs.

AIM: To draw up a program for coordination of dental care for children with special needs between the Course at the Universidad Complutense de Madrid (UCMC) (Specialisation in holistic dental care for children with special needs), and the Disabled Children's Oral Health Unit (DCOHU) within the Madrid Health Service (SERMAS). MATERIAL AND METHODS: UCMC Protocol for children with special needs. Design of a clinical pathway based on consensus amongst the professionals involved. RESULTS: Algorithm for dental care for children with special needs. Matrix covering all activities and timing for full dental diagnosis in such patients (general health, oral health and behaviour) to facilitate proper referral of patients requiring general anaesthesia. Inclusion in the matrix of those responsible for each activity. CONCLUSIONS: Improved team work (University - primary health care) in patient evaluation, in provision of information to parents and guardians and in health care quality. From the teaching point of view, students learn to adopt a systematic approach in the decision-making process.

Criteria for selecting children with special needs for dental treatment under general anaesthesia.

OBJECTIVE: To study criteria for helping to select children with special needs for dental treatment under general anaesthesia. MATERIALS AND METHODS: Group of 30 children (aged under 18) examined on the Course at the Universidad Complutense de Madrid (UCM) (Specialisation on holistic dental treatment of children with special needs) and subsequently referred to the Disabled Children's Oral Health Unit (DCOHU) within Primary Health Care Area 2 of the Madrid Health Service (SERMAS) where dental treatment under general anaesthesia was given during 2005. Relevant data were taken from their case histories with regard to their general health, oral health and behaviour. RESULTS: In most of the children (22 children), it was possible to carry out a complete dental diagnosis. With regard to medical diagnoses, the most frequent pathology was cerebral palsy (8 children), but it was not possible to establish a link between the pathology and the use of general anaesthesia. With regard to oral health, most of the children received restorative treatment in all 4 quadrants (26 children). On the basis of scales for behavioural evaluation and movement, most of the children (17 children) showed clearly negative behaviour, with movements that interrupted or hindered examination. CONCLUSIONS: With the exception of certain specific medical problems, the reasons for using general anaesthesia for dental treatment in children with special needs are extensive treatment needs and bad behaviour, both of which can be judged objectively.

Valoración de la microfiltración de Compoglass® en molares temporales / Evaluation of Compoglass® microleakage in primary molars

El propósito de este estudio ha sido evaluar el sellado marginal que proporciona Compoglass® (Vivadent), una resina compuesta modificada con poliácidos, en molares temporales. Se realizaron 12 cavidades de clase II en la superficie distal de 12 molares temporales exodonciados sanos, obturándolas con Compoglass. Tras someterlas a un proceso de envejecimiento, se sellaron los dientes excepto en la zona de las restauraciones y se sumergieron en azul de metileno al 5 por ciento durante 4 horas. Después, se seccionaron longitudinalmente y se fotografiaron a 40 aumentos. La microfiltración se limitó al esmalte dentario en todas las muestras. Sólo se observó filtración en los márgenes gingivales y únicamente en el 36,36 por ciento de las muestras. Compoglass proporciona un sellado marginal aceptable para su uso clínico en la dentición temporal (AU)