Oral health status and its relation with medication and dental fear in children with attention-deficit hyperactivity disorder.

OBJECTIVE: The objective of this study was to determine the ora-dental health and its relation with medication and dental fear in a group of Turkish children with attention-deficit hyperactivity disorder (ADHD). SUBJECTS AND METHODS: The levels of dental fear of children were determined with The Dental Subscale of Children's Fear Survey Schedule (CFSS-DS). The oral and dental health evaluation was performed. This study included a total of 117 children aged between 6 and 15 years and they were examined under two groups as "ADHD" (n = 59) and "Control" (n = 58). Ora-dental health variables were compared between the groups and were also analyzed in accordance with dental fear and medication. RESULTS: ADHD children and the control group exhibited similar CFSS-DS scores (15-32). No significant differences existed in df(t)/df(s), DMF(T)/DMF(S), d/D values, and presence of the white spot lesions. ADHD children's Mutans streptococci and Lactobacillus quantities were found significantly higher than the control group. The incidence of parafunctional habits of the ADHD children was also found high. CONCLUSIONS: ADHD children that were medicated exhibited similar dental caries prevalence and periodontal health status. Although ADHD group had similar dental-periodontal health status and dental fear level with the control group and using ADHD medicines did not make a significant effect on the ora-dental health parameters, the patients should be carefully followed up because they were categorized in high caries risk groups.

Early Colonization of Lactobacillus reuteri after Exposure to Probiotics.

UNLABELLED: The aim of the present in vivo animal study is to investigate the ability of L. reuteri to colonize the oral flora during infancy. STUDY DESIGN: Twenty four rats, aged 1 month, which were pre-analyzed for mutans streptococci and L. reuteri absence in their saliva, were randomly divided into 3 groups. The control group was infected with S. mutans ATCC 25175 at the 2nd month, three times a day for 14 days. S. mutans counts were determined with microbiological saliva analyzes obtained by standard methods of oral swabbing at 3rd, 4th and 5th months. The second group, Probiotic I group, was also infected with S. mutans at the 2nd month, and further infected with L. reuteri ATCC 55730 (1×10(8)),5 drops per day for 25 days, at the 3rd month. S. mutans and L. reuteri counts were determined at the 3rd, 4th and 5th months. Plates were incubated anaerobically at 37°C for 48 h, after which colonies were confirmed as L. Reuteri. RESULTS: Regarding intragroup analysis, S. mutans counts of the Control group increased steadily during the 3rd. and 4th. months, and a statistically significant (p<0.05) reduction was registered at the 5. month. S. mutans counts of the Probiotic I group increased steadily during the 3rd. and 4th. months, and again a statistically significant (p<0.05) reduction, parallel with the Control group, was registered at the 5th. month. In the Probiotic II group, S. mutans counts started at a higher level than the Control group and there was a statistically significant (p<0.05) reduction of S. mutans at the 5th. month. CONCLUSION: It may be concluded that, L. reuteri promised a better colonization as a 'first colonisation strain'.

Development of novel formulations containing Lysozyme and Lactoferrin and evaluation of antibacterial effects on Mutans Streptococci and Lactobacilli.

OBJECTIVE: The aim of this study was to determine the antibacterial effect of different formulations containing Lysozyme and Lactoferrin and drug delivery system as well as poloxamer 407 with the trade name of Pluronic F-127 and/or freeze dried liposome containing DOTAP [freeze dried Liposomal DOTAP] on Streptococcus sobrinus, Streptococcus mutans and Lactobacillus acidophilus in comparison with 0.2% chlorhexidine. MATERIALS AND METHODS: The antibacterial effect was assessed by determining the minimum inhibitory concentrations (MIC) for the study and control groups on Streptococcus sobrinus, Streptococcus mutans and Lactobacillus acidophilus. The amounts of biofilm formation accumulation of Mutans Streptococci for 24h on sterile hydroxyapatite discs after application of different formulations were evaluated. The different formulations studied were: (1) Sorensen's Buffer Solution, (2) a gel formulation containing only poloxamer 407, (3) Lysozyme and Lactoferrin dissolved in Sorensen's Buffer Solution, (4) poloxamer 407 combined with the third formulation, (5) Freeze dried Liposomal DOTAP dissolved in Sorensen's Buffer Solution, (6) Freeze dried Liposomal DOTAP combined with poloxamer 407 dispersed in Sorensen's Buffer Solution, (7) Freeze dried Liposomal DOTAP combined with the third formulation, and (8) Lysozyme and Lactoferrin dissolved in Sorensen's Buffer Solution, which was then incorporated into poloxamer 407 and combined with Freeze dried Liposomal DOTAP. The positive and negative control groups were 0.2% chlorhexidine gel and empty hydroxyapatite discs, respectively. Statistical evaluation was carried out with Kruskal-Wallis and Dunn's multiple comparison tests. RESULTS: It was observed that the first, third and fifth groups did not have any antibacterial effects on the tested bacteria. The groups that contained poloxamer 407 had nearly identical antibacterial effects on Mutans Streptococci and L. acidophilus. These formulations also inhibited biofilm formation of the bacteria (p<0.05) more effectively. In the positive control group, there was no biofilm formation. CONCLUSIONS: Among the formulations containing poloxamer 407, the one containing Lysozyme and Lactoferrin exhibited the highest inhibitory effect on the tested bacteria. This novel formulation can be beneficial as an antibacterial agent for the prevention of dental caries and biofilm formation.

In vitro assessment of the recurrent doses of topical gaseous ozone in the removal of Enterococcus faecalis biofilms in root canals.

AIM: To evaluate the potential antibacterial effect of recurrent doses of topical gaseous ozone on the Enterococcus faecalis biofilms0 growth in human root canals in vitro. MATERIALS AND METHODS: One hundred and thirty four human single-rooted mandibular premolars were enlarged to a size 35 K-File. Each root canal were inoculated with an overnight culture of Enterococcus faecalis 0ATCC 29212 in tryptic soy broth for 24 hours and incubated for 7 days at 37°C. At 7-day interval, 4 specimens were prepared for Scanning Electron Microscope (SEM) analysis to confirm the presence and purity of biofilms whilst the other contaminated root canals were irrigated and disinfected. One hundred root canals of total 134 specimens were selected to create the experimental groups and divided into 5 subgroups. In each experimental group ( n = 20) root canals), recurrent ozone doses were applied with different irrigation and disinfection protocols in 5 different time intervals. Bacterial growth was analyzed by counting viable E. faecalis on tryptic soy agar plates. RESULTS: According to intergroup comparison results observed in the final sample collection analysis, the amount of remaining bacteria in the positive control group were found to be significantly higher compared to Groups 1, 2, 3, 4, 5 and the material control group ( P < 0.01). The remaining amount of bacteria in the last count of Group 1 were found to be significantly higher compared to Group 2 ( P < 0.05), Group 4 ( P < 0.01), Group 5 (P < 0.05) and the material control group (P < 0.01). CONCLUSION: The application of topical gaseous ozone in recurrent doses provides a positive effect in the removal of E. faecalis biofilm from root canals. However, during disinfection procedure, the combined use of recurrent doses of topical gaseous ozone with 2% NaOCl enhanced its antibacterial effect against E. faecalis biofilm.

Salivary detection of periodontopathic bacteria in periodontally healthy children.

BACKGROUND: Salivary occurrence of periodontopathic bacteria is of interest especially in children as a risk indicator for the transmission, development and control of periodontal disease. We assessed the prevalence of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Prevotella intermedia, Prevotella nigrescens and Treponema denticola as microbial complexes in the saliva of children with mixed dentition and healthy gingiva. MATERIALS AND METHODS: Paraffin-stimulated saliva samples were collected from 41 children (22 boys and 19 girls), aged 6-13 years old. Gingival health was determined during the initial screening exam. The test bacteria were identified using a 16S rRNA-based PCR analysis. RESULTS: P. nigrescens was the most frequent species (80%), followed by T. denticola (32%), A. actinomycetemcomitans (24%) and P. gingivalis (12%). P. intermedia and T. forsythia were not detected. P. nigrescens was also common species in combinations. Paired and triple bacterial combinations were found in 24% and 20% of all children, respectively. There was no positive association between bacterial combinations in colonization and subject's gender (P>0.05, Fisher exact test). CONCLUSION: The salivary presence of P. nigrescens, T. denticola, A. actinomycetemcomitans and P. gingivalis but not P. intermedia and T. forsythia can occur in childhood without clinical signs of gingival disease. Thus, the possible risk of bacterial transmissions through saliva and, the need to screen for periodontal pathogens should be considered before mixed dentition.

Fluconazole and/or hexetidine for management of oral candidiasis associated with denture-induced stomatitis.

OBJECTIVE: The aim of the present study was to compare the influence of fluconazole capsules and/or hexetidine mouthrinses for the management of oral candidiasis associated with denture stomatitis. DESIGN RELEVANT: Sixty-one patients (ages 43-76 years, mean: 61) admitted to the Department of Oral Surgery and Medicine and diagnosed as suffering from oral candidiasis associated with denture stomatitis by microbiological examination were involved. MATERIALS AND METHODS: Patients in group 1 (n = 21) were given only fluconazole capsules (Zolax 50 mg once a day), those in group 2 (n = 18) were given only hexetidine mouthrinses (Heksoral 0.1%, twice daily), whereas those in group 3 (n = 22) were given both fluconazole capsules and hexetidine mouthrinses for 14 days. The yeast colonies of the saliva samples were counted and calculated as the number of colony forming units per milliliter. The presence of yeasts in the lesion and denture samples were evaluated as present/absent according to their growth on cultures. Candida albicans was identified by means of germ tube analysis. RESULTS: Patients in groups 1, 2 and 3 had a statistically significant decrease in the amount of C. albicans in saliva, lesions and dentures after treatment, when compared with pretreatment results (P < 0.05). Candida albicans counts in saliva, lesion and denture after treatment detected no statistically significant difference when the three groups were compared. CONCLUSION: Of the three study groups, group 2, where hexetidine was the only medication prescribed, was found to be superior on account of fewer potential complications. We conclude that dentists should employ a more conservative intervention with oral mouthrinses rather than risk adverse effects and complications of systemic drugs for the management of oral candidiasis.

The effect of bone marrow transplantation on systemic and oral health in Fanconi's aplastic anemia.

Fanconi's anemia (FA) is an autosomal-recessive disorder characterized by a progressive pancytopenia, diverse congenital abnormalities and increased predisposition to malignancy. Sixteen children with FA, aged between 4 to 16 were divided into two groups according to treatments. Nine children had bone marrow transplantation and seven children were treated with steroid and/or anapolan. The changes in dental caries, caries-associated microflora, salivary status and periodontal health were investigated in children with FA. Data were analyzed by one-way ANOVA. A statistically significant difference was found in hematological findings between children who have received bone marrow transplantation (BMT+) and the others, who have not received (BMT-). There was no significant difference in dental caries experience, salivary flow rate, buffering capacity, mutans streptococci and Lactobacilli levels between the study groups. A statistically significant difference was found in gingival index, plaque index, bleeding on probing, probing depth scores between the patients with FA in BMT(+) and BMT(-) groups (p<.05). In conclusion, besides systemic control, additional preventive measures during their whole life to maintain oral health is necessary in these children.

In vitro plaque formation on some dental filling materials.

The purpose of this study was to investigate the effects of filling and lining materials in various compositions on Streptococcus mutans. Five glass-ionomer cements (Vitrebond, XR Ionomer, Ketac-Bond, Shofu Base Cement, Shofu Lining Cement) and two composite materials (Heliomolar-RO, Concise) were used in this study. Samples from these materials were prepared in sterilized conditions and hung in tryptic soy broth medium containing 5% sucrose. The media were inoculated with Streptococcus mutans ATCC 13419. After 5 days, the plaque that had accumulated on the surfaces was scraped off and weighted in wet and dry conditions. Then the colonies were counted and evaluated in comparison with each other. The least amount of plaque and colony numbers were found on Vitrebond material disks. In conclusion, there were no differences among XR Ionomer, Heliomolar-RO and Ketac Bond. Concise gave better results than some materials containing fluoride; whereas the most abundant amounts of plaque were found on Shofu Lining Cement and Shofu Base Cement.

Bacteriology of dentoalveolar abscesses in patients who have received empirical antibiotic therapy.

We investigated aspirates of pus from dentoalveolar abscesses in 13 patients who had received empirical antibiotic therapy within 1 month before presentation at our facility. The antibiotics administered were lincomycin, amoxicillin, ampicillin, or a cephalosporin. Information on antibiotic therapy was obtained from the patients' medical histories. Cultures of all dentoalveolar abscesses yielded organisms. A total of 70 isolates (42 anaerobes and 28 facultative organisms) were recovered, representing 5.3 isolates (3.2 anaerobes and 2.1 facultative organisms) per specimen. The counts of bacteria ranged from 5 X 10(7) cfu/mL to 8 X 10(11) cfu/mL (mean count, 1.4 X 10(11) cfu/mL; median count, 2.3 X 10(10) cfu/mL). The predominant isolates were Prevotella species (25.7% of isolates), Peptostreptococcus species (17.1%), and Streptococcus species (14.2%). This study illustrates the polymicrobial nature of dentoalveolar abscesses as well as the predominant role played by anaerobic bacteria.

The presence of black-pigmented gram-negative anaerobes in the oral cavity of edentulous subjects.

The aim of this study was to investigate whether black-pigmented Gram-negative anaerobes are part of the indigenous oral flora of edentulous subjects with or without dentures. Group I consisted of 11 subjects with dentures (mean age 63.6 years, range 52-75) and Group II consisted of 39 subjects with complete dentures in both jaws (mean age 59.3 years, range 37-80). Two microbial samples for microbiological examination were taken from each subject. One of them was from the dorsum of the tongue and the other was from saliva. Black-pigmented Gram-negative anaerobes > 10(7) cfu/ml were found in both samples. In 50 edentulous subjects, they were found more commonly from tongue (40%) than from saliva (26%). None of the subjects had Porphyromonas gingivalis. There was no statistically significant difference (P > 0.05) between the presence of black-pigmented Gram-negative anaerobes on tongue and in saliva in the two groups. Our results suggested that high levels of black-pigmented Gram-negative anaerobes may belong to the indigenous oral flora in edentulous mouths with or without dentures.

Antibacterial efficacy of root canal medicaments.

The antibacterial efficacy of four endodontic medicaments was studied in vitro. Calcium hydroxide (CALACEPT), camphorated parachlorophenol (CPCP), Cresophene, and 2% iodine-potassium iodide (IKI) were tested against four anaerobic microorganisms, Streptococcus mutans, Peptostreptococcus anaerobius, Porphyromonus gingivalis and Fusobacterium nucleatum, for 10 or 15 min. IKI was effective only against F. nucleatum and P. gingivalis, and the others were effective against all four microorganisms.