Oral mucormycosis in children with leukemia: report of 2 cases.

Mucormycosis is a rare acute opportunistic infection caused by a saprophytic fungus, which belongs to the order Mucorales. This report describes intraoral mucormycosis in 2 children with acute leukemia who were undergoing chemotherapy and had febrile neutropenia. A 7-year-old boy with acute myeloid leukemia and a 9-year-old boy with acute lymphoblastic leukemia were referred to the Department of Pediatric Dentistry at Cukurova University for their intraoral soft tissue lesions, which were diagnosed as mucormycosis by histologic examination. While, for the first case, the lesion was debrided under general anesthesia and medical antifungal therapy was performed, only medical management was done, without any debridement, for the second case. Early recognition of mucormycosis is necessary to limit the spread of infection, which can lead to high morbidity and mortality. Therefore, health practitioners should be familiar with the signs and symptoms of the disease.

The effect of age, gender and socio-economic factors on perceived dental anxiety determined by a modified scale in children.

PURPOSE: The aim of this study was to examine the validity and reliability of the Com-DAS (combined dental anxiety scale) as an indicator for children's perceived dental anxiety and to investigate the effect of age, gender and socio-economic factors on dental anxiety. MATERIALS AND METHODS: A total of 258 children aged between 8 and 12 years, who had not visited a dentist before, were randomly selected from three different socio-economic status groups. A new scale was developed by combining the C-DAS (Corah's dental anxiety scale) and FIS (facial imaging scale), and named Com-DAS. Original C-DAS was used for validation. RESULTS: There was a high correlation between C-DAS and Com-DAS (r = 0.69). The lowest correlation was in 8-year-old children (r = 0.46), however the mean difference between the scales in this age group was not statistically significant (p > 0.05). The Com-DAS scores showed no statistical difference according to gender, whereas there was a significant difference according to age and socio-economic status (p = 0.001 in both cases). CONCLUSION: The Com-DAS used in this study may be of use in those communities where the children and their families have limited literacy skills and their understanding of modern dental procedures may be influenced by non-qualified dental practice.

The oral health status of street children in Adana, Turkey.

AIM: To determine the oral health status of street children and compare the results with a group of non-working children in Adana, Turkey. Street children are generally defined as any boy or girl for whom the street has become his or her habitual abode and/or source of livelihood; and who is inadequately protected, supervised, or directed by responsible adults. STUDY DESIGN: Demographic data including education, employment and social insurance of parents and number of siblings, was obtained. A formal interview with structured questions was used in order to determine the oral health behaviour of the children. Oral examinations were performed according to the criteria of the WHO oral examination form. RESULTS: The oral health behaviour of street children was significantly different from non-working children. While DMFT and dmft scores of the street youths were significantly lower than the control group, they had higher CPITN scores (p< or =0.001). CONCLUSION: Street children are commonly faced with oral health problems, especially periodontal problems. Therefore, the dental and periodontal needs of this particular population must be addressed. Oral health policies and preventive services including oral health promotion programmes which aim to give information about dental issues and to make positive changes in behavioural and environmental factors should be developed. The priority should be to control the factors which result in the occurrence of new dental problems.

Complications of pediatric denture misuse: a case report.

The multiple loss of primary molars due to caries or other reasons in the primary or mixed dentition can lead to severe mutilation of the developing dentition. It is advisable to construct a removable appliance to maintain the relationship of the remaining teeth and to guide the eruption of the developing teeth in order to prevent the child from developing psychological and speech problems. However, parental and patient cooperation are imperative if the pediatric patient is to exercise the necessary care to maintain the denture in a clean and healthy condition. This case report identifies the complications that can arise from the uncontrolled misuse of a pediatric denture. It is concluded that as well as the parents, the pediatric dentists play an important role in the follow-up of the young patients for whom pediatric dentures are constructed. Additionally, patients should be re-called for check-up visits or instructed to refer to the dental clinics in 6-month intervals. Brochures that inform the patients and their parents about the application and care of pediatric dentures and space maintainers should be given.

Apical microleakage of root-end cavities prepared by CO2 laser.

This in vitro study in extracted human teeth was designed to compare the degree of dye penetration of root-end cavities prepared by CO2 laser, ultrasonic retrotip, or rotary instrument. Eighty-two human anterior teeth were prepared and obturated with laterally condensed gutta-percha and sealer. Root-end resection was performed at 90 degrees, 3 mm from apex. Root-end cavities were prepared by CO2 laser beam, ultrasonic retrotips, or bur and were filled with amalgam. The teeth were isolated and immersed in basic fuchsin at 36 degrees C for 48 hours. The roots were split longitudinally and examined by a stereomicroscope. Leakage was quantified by linear measurement of dye penetration with the aid of image-analyzing software. Apical leakage in the CO2 laser group was significantly less than in the ultrasonic retrotip and bur groups. The difference between the ultrasonic and bur groups was insignificant. Based on the results of this in vitro study, application of CO2 laser for root-end cavity preparation appears to decrease the apical leakage.

The results of a preventive dental program for pediatric patients with hematologic malignancies.

PURPOSE: The aim of this retrospective study was to assess the safety of dental treatment in pediatric patients with acute lymphoblastic leukema (ALL), and Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL), and to report any complications related to dental treatment during a preventive dental program covering a 4-year period. MATERIALS AND METHODS: In this study 74 preventive fissure sealants, 69 fillings and 81 extractions along with periodontal treatment that included prophylaxis and/or scaling were performed on 124 patients with a mean age of 7.00+/-2.3. The patients were monitored for at least three weeks after the treatment for bleeding, pain, local and/or systemic infection, fever, delayed wound healing or any other complication. RESULTS: Two patients (one ALL and one HL) suffered delayed wound healing after extractions which resulted in the delay of chemotherapy. In three of the patients who were in remission-induction phase of ALL, oral mucositis occurred in the cheek mucosa adjacent to extraction sites and five patients had tooth staining due to the routine use of a chlorhexidine mouthrinse. The healing was uneventful in all other patients. CONCLUSIONS: The findings of this study suggest that with special precautions such as adequate hematological values, timing of the intervention and supportive medical care, dental treatment can be safely performed in pediatric patients with hematological malignancies.

Clinical evaluation of the plaque-removing ability of three different toothbrushes in a mentally disabled group.

The aim of the study was to evaluate the efficacy of plaque removal of three different toothbrushes on mentally disabled children in two different age groups. A manual triple-headed brush (SuperBrush; Dento Co. AS [junior, regular]) compared with a new manual toothbrush (CrossAction; Oral-B [35 compact, 40 regular]) and an electric toothbrush with an oscillating rotating head (Braun Plaque Control 3D [Braun 3D]; Oral-B [D15525]). Fifteen children aged 6-12 (Group A) and 15 children aged 13-18 (Group B) with mild mental disabilities participated in the single-blind clinical study. To obtain a plaque-free condition at baseline, professional tooth-cleaning was performed on each participant. After instructions on how to use the toothbrushes, each group started the experiment. After 1 week of application, the Quikley Hein (QH) plaque index and the approximal plaque index (API) were used to assess the oral hygiene status of each participant. This was followed by a week of recess before each group switched to the next type of toothbrush. The study lasted for 5 weeks. Compared to the two other brushes, the Braun 3D was more effective in removing plaque (means of QHI: 1.54 (Braun 3D), 1.77 (SuperBrush), and 2.15 (CrossAction) in total; means of API 1.37 (Braun 3D), 1.52 (SuperBrush), 1.94 (CrossAction). The study indicated that the electric toothbrush is the most effective for removing dental plaque in mentally disabled children, whereas the SuperBrush is a good alternative.