PHACES syndrome and multi-regional odontodysplasia: a case report.

PHACES syndrome is an acronym for the syndromic presentation of Posterior fossa malformation, Hemangioma, Arterial anomalies, Coarctation of aorta/cardiac defects, Eye abnormalities and Sternal malformations. Infantile hemangiomas are the most common tumors of infancy. Regional odontodysplasia, commonly referred to as "ghost teeth", is a rare localized developmental malformation of enamel and dentin with varying levels of severity that results in unusual clinical and radiographic appearances of affected teeth. This report describes a rare case of a two-year-old Caucasian male diagnosed with PHACES syndrome also presenting with multi-regional odontodysplasia. Ten of twenty teeth were dysplastic. The patient was treated under general anesthesia in a hospital setting. All affected primary teeth were extracted due to sensitivity, abscess and extremely poor long-term prognosis. Moving forward, a long-term interdisciplinary approach will be necessary to address this child's dentition as it develops.

Focal Epithelial Hyperplasia in a Child with Hereditary Sensory and Autonomic Neuropathy type IV: A Rare Co-Occurrence.

Hereditary sensory and autonomic neuropathies (HSAN) are a set of rare neurological conditions with five differing phenotypes. Type IV HSAN is notable for congenital insensitivity to pain. Focal epithelial hyperplasia (Heck's disease), a variant of human papillomavirus (HPV), presents as intraoral papules. The purpose of this report is to present the case of a five-year-old patient with HSAN type IV who was referred by her pediatric dentist to evaluate a tongue mass. Her medical history included recurrent urinary tract infections and verrucae on her hands and self-mutilation of the tongue and hands. Her dental history revealed that she had self-extracted 14 primary teeth. A soft tissue exam revealed flat surface papules on the tongue and a raised yellow, white and pink lesion on the right lateral tongue, which was diagnosed as focal epithelial hyperplasia. The co-occurrence of HSAN type IV and focal epithelial hyperplasia is a rare case that demonstrates the need for coordination among medical and dental professionals to achieve the optimal outcome. (J Dent Child 2019;86(3):154-7).

Integrating the PILP-mineralization process into a restorative dental treatment.

The addition of charged polymers, like poly-aspartic acid (pAsp), to mineralizing solutions allows for transport of calcium and phosphate ions into the lumen of collagen fibrils and subsequent crystallization of oriented apatite crystals by the so-called Polymer-Induced Liquid Precursor (PILP) mineralization process, leading to the functional recovery of artificial dentin lesions by intrafibrillar mineralization of collagen. OBJECTIVE: To evaluate the feasibility of applying the PILP method as part of a restorative treatment and test for effectiveness to functionally remineralize artificial lesions in dentin. MATERIALS AND METHODS: Two methods of providing pAsp to standardized artificial lesions during a restorative procedure were applied: (A) pAsp was mixed into commercial RMGI (resin modified glass ionomer) cement formulations and (B) pAsp was added at high concentration (25mg/ml) in solution to rehydrate lesions before restoring with a RMGI cement. All specimens were immersed in simulated body fluid for two weeks to allow for remineralization and then analyzed for dehydration shrinkage, integrity of cement-dentin interface, degree of mineralization, and changes in the nanomechanical profile (E-modulus) across the lesion. RESULTS: After the remineralization treatment, lesion shrinkage was significantly reduced for all treatment groups compared to demineralized samples. Pores developed in RMGI when pAsp was added. A thin layer at the dentin-cement interface, rich in polymer formed possibly from a reaction between pAsp and the RMGI. When analyzed by SEM under vacuum, most lesions delaminated from the cement interface. EDS-analysis showed some but not full recovery of calcium and phosphorous levels for treatment groups that involved pAsp. Nanoindentations placed across the interface indicated improvement for RMGI containing 40% pAsp, and were significantly elevated when lesions were rehydrated with pAsp before being restored with RMGI. In particular the most demineralized outer zone recovered substantially in the elastic modulus, suggesting that functional remineralization has been initiated by pAsp delivery upon rehydration of air-dried demineralized dentin. In contrast, the effectiveness of the RMGI on functional remineralization of dentin was minimal when pAsp was absent. SIGNIFICANCE: Incorporation of pAsp into restorative treatments using RMGIs promises to be a feasible way to induce the PILP-mineralization process in a clinical setting and to repair the structure and properties of dentin damaged by the caries process.

Integrated self-regulating resistive heating for isothermal nucleic acid amplification tests (NAAT) in Lab-on-a-Chip (LoC) devices.

Isothermal nucleic acid amplification tests (NAAT) in a Lab-on-a-Chip (LoC) format promise to bring high-accuracy, non-instrumented rapid tests to the point of care. Reliable rapid tests for infectious diseases allow for early diagnosis and treatment, which in turn enables better containment of potential outbreaks and fewer complications. A critical component to LoC NAATs is the heating element, as all NAAT protocols require incubation at elevated temperatures. We propose a cheap, integrated, self-regulating resistive heating solution that uses 2xAAA alkaline batteries as the power source, can maintain temperatures in the 60-63°C range for at least 25 minutes, and reaches the target range from room temperature in 5 minutes. 4 heating element samples with different electrical characteristics were evaluated in a thermal mock-up for a LoC NAAT device. An optimal heating element candidate was chosen based on temperature profiling. The optimal candidate was further evaluated by thermal modelling via finite element analysis of heat transfer and demonstrated suitable for isothermal nucleic acid amplification.

Interprofessional Oral Health Education Improves Knowledge, Confidence, and Practice for Pediatric Healthcare Providers.

Dental caries is the most prevalent chronic childhood disease in the United States. Dental caries affects the health of 60-90% of school-aged children worldwide. The prevalence of untreated early childhood dental caries is 19% for children 2-5 years of age in the U.S. Some factors that contribute to the progression of dental caries include socioeconomic status, access to dental care, and lack of anticipatory guidance. The prevalence of dental caries remains highest for children from specific ethnic or racial groups, especially those living in underserved areas where there may be limited access to a dentist. Although researchers have acknowledged the various links between oral health and overall systemic health, oral health care is not usually a component of pediatric primary health care. To address this public health crisis and oral health disparity in children, new collaborative efforts among health professionals is critical for dental disease prevention and optimal oral health. This evaluation study focused on a 10-week interprofessional practice and education (IPE) course on children's oral health involving dental, osteopathic medical, and nurse practitioner students at the University of California, San Francisco. This study's objective was to evaluate changes in knowledge, confidence, attitude, and clinical practice in children's oral health of the students completed the course. Thirty-one students participated in the IPE and completed demographic questionnaires and four questionnaires before and after the IPE course: (1) course content knowledge, (2) confidence, (3) attitudes, and (4) clinical practice. Results showed a statistically significant improvement in the overall knowledge of children's oral health topics, confidence in their ability to provide oral health services, and clinical practice. There was no statistically significant difference in attitude, but there was an upward trend toward positivity. To conclude, this IPE evaluation showed that offering an interprofessional course on children's oral health to graduate students in dentistry, nursing, and osteopathic medicine can improve their knowledge, confidence, and practice toward children's oral health and expand their professional goals to include caring for underserved, minority children.

Pediatric dentistry for the general practitioner: satisfying the need for additional education and training opportunities.

The Pediatric Oral Health Access Program is a joint project of the California Dental Association and the California Society of Pediatric Dentistry. The results have been remarkable in terms of the number of underserved children who have received oral health services. What is less certain is the number of general dentists who, as a result of the training, have been able and willing to provide comprehensive care to more and younger children.

Models of Hydrogel Swelling with Applications to Hydration Sensing.

Hydrogels, polymers and various other composite materials may be used insensing applications in which the swelling or de-swelling of the material in response tosome analyte is converted via a transducer to a measurable signal. In this paper, we analyzemodels used to predict the swelling behavior of hydrogels that may be used in applicationsrelated to hydration monitoring in humans. Preliminary experimental data related toosmolality changes in fluids is presented to compare to the theoretical models. Overall,good experimental agreement with the models is achieved.

A snapshot of the U.S. postdoctoral pediatric dentistry faculty workforce, 2002.

This study characterizes the faculty shortage in U.S. postdoctoral pediatric dentistry (PD) education. The objectives of the study were to determine: 1) the changes in PD faculty numbers and teaching loads between 1995 and 2002 for postdoctoral PD education, 2) current faculty age and training, and 3) distribution of faculty by age. A questionnaire was sent in 2002 to fifty-four programs, of which forty-six responded (85 percent). Dental school and residency mean class sizes increased in the seven-year study period from 82.8 to 91.8 and from 6.0 to 8.5, respectively. Full- and part-time mean faculty positions increased as did vacancies, the latter growing from 15 to 38.9 and changing during the period from 5 to 10.8 percent of available positions. About one-third of programs used general dentists to teach PD, while programs using foreign-trained educators grew from 4 to 13 percent. Twenty-nine percent of full-time and 27 percent of part-time faculty are fifty-five years or older, and young entry-level faculty, age twenty-five to twenty-nine, represent only 2 percent and 5 percent of full- and part-time faculty respectively. Faculty vacancies have increased along with numbers of students and residents, and the largest segment of PD faculty is within a decade of retirement age.

The paradigm shift in the etiology, prevention, and management of dental caries: its effect on the practice of clinical dentistry.

Treatment of dental caries as an infectious disease will require a paradigm shift in the way dentists and other health care professionals approach prevention and management of the disease. Prevention of dental caries has relied upon patient cooperation and often requires significant lifestyle changes that are at best difficult to implement and maintain or at worst ignored. This paradigm shift in the etiology, prevention, and treatment of dental caries demands that clinicians redirect their energies and emphasis from the "surgical" approach to dental caries to a "medical" strategy that focuses on early (prenatal if possible) risk assessment of the mother and implementation of appropriate therapeutic intervention, including use of antimicrobials, risk assessment of infants at 6 months of age, and a reduction in the levels of caries-producing bacteria. This revolution in how dentists practice and think will require that they develop strategies and curriculum to "retrain" practicing dentists and to train current and future dental students and residents as well as other medical colleagues on the essentials of the paradigm shift.