Possible Risk Factors for Dental Fear and Anxiety in Children Who Suffered Traumatic Dental Injury.

BACKGROUND: Children who undergo painful experiences such as traumatic dental injury (TDI) during their early years are more likely to be at an increased risk of developing dental fear and anxiety (DFA). The purpose of this study was to identify potential risk factors for DFA of these children. METHODS: The study participants were 220 parents/caregivers and their children who experienced TDI. Their socio-demographic backgrounds were investigated with the modified WHO Oral Health Questionnaire for Children that included questions about parents' knowledge and attitudes, while the DFA level was determined using the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) and the Simplified Oral Hygiene Index (OHI-S Index) was used to assess oral hygiene status. RESULTS: The confirmed risk factors are parental knowledge, female gender, and degree of oral hygiene and pain in the last three months, while age, type of TDI, presence of soft-tissue injury, and number of subjective complaints were not confirmed. The overall model predicted approximately 54% of variance in DFA, R2 = 0.545, F (4.215) = 64.28 p < 0.001. CONCLUSIONS: These findings emphasise the importance of addressing pain management, improving oral hygiene, and enhancing parental knowledge to mitigate DFA in children with TDIs.

Measuring tooth vibrations induced during cavity preparation with time-averaged holography and its influence on near vision acuity in dentists.

The aim of this study was to quantify vibrations and their influence on visual acuity. The study consisted of two parts, laboratory and clinical. Time-averaged holographic interferometry (TAHI) method was used in laboratory for measuring the amplitude of tooth vibrations induced by dental handpiece. The amplitudes of tooth vibrations were measured for the three diameters and three speeds. The larger diameter coupled with increasing speed resulted in greater vibration amplitudes, whereby a maximum amplitude of less than one micrometer was detected. For quantifying the natural visual acuity for the corresponding tooth vibrations, we have used the clinical condition approach with miniaturized Snellen optotype as an assessing tool. Central visual acuity did not display variance in visual acuity at rest or under load. Results indicate that the vibrations induced during cavity preparation are not sufficient to negatively affect visual acuity of dentists.

Psychosocial and Economic Status of the Parents with Children with and without Tooth Trauma.

BACKGROUND: The main goal of this research is to try and understand influence of psychological and social factors in children with tendencies to repeat tooth trauma. SUBJECTS AND METHODS: Research included 147 patients, children of preschool and school age (88 boys and 59 girls). In the research patients were divided in two age groups: 5-8 and 9-12 years. In both groups there were 49 patients with no experience of dental trauma and 69 patients with experience of one dental trauma and 29 patients with repeated dental trauma. All patients that were involved in the study had previous experience with dental and medical treatment. Study included evaluation of dental anxiety and also factors that caused dental phobia previous their visit to the office in the children with no dental trauma compared to repeat dental trauma patients. On the whole study group differences considering sex, age and psychosocial status in the level of dental anxiety and dental fear were also measured. RESULTS: Categories of children without trauma and with one or multiple trauma showed that it is a similar sex division in the categories. In the no trauma group participation of the boys is lower (46.9%) while in the group with repeated trauma their participation is significantly higher (79.3%). Based on that the risk of repeated dental trauma is characteristic of boys. CONCLUSIONS: Results of this study show that tested psychosocial variables do not differentiate participants according to the tested groups or in other words there is no difference between tested groups in their psychosocial standing.

Measuring the Influence of Galilean Loupe System on Near Visual Acuity of Dentists under Simulated Clinical Conditions.

AIM: The purpose of this study was to compare near visual acuity of dentists without optical aids (VSC) with near visual acuity of those using the Galilean telescope system (VGA2) with magnification of x 2.5, and the distance of 350 mm in simulated clinical conditions. METHODS: The study included 46 dentists (visual acuity 1.0 without correction). A visual acuity testing was carried out using a miniaturized Snellen visual acuity chart which was placed in the cavity of molar teeth mounted in a phantom head in simulated clinical conditions. Near visual acuity for the vicinity was examined: 1) without correction at a distance of 300-400 mm (VSC); 2) with Galilean loupes with magnification of x2.5, focal length of 350mm. RESULTS: The distributions of near visual acuity recorded using VSC and VGA2, 5 systems were compared by the Wilcoxon Signed Rank test. The results obtained by Wilcoxon Signed Rank test pointed to a statistically significant difference in the distribution of recorded visual acuity between the VSC and VGA2 optical systems (W = - 403.5; p <0.001). CONCLUSION: If using the VGA2, 5 systems, higher values of the near visual acuity were recorded and subsequently compared to near visual acuity without magnifying aids (VSC).

Medical Emergencies in Pediatric Dentistry.

Medical emergencies that are life threatening can occur in dental practice. Complications may arise because of an underlying disease or a reaction to medication. Reactions to medications may be allergic and toxic. The most common reactions are toxic reactions to local anesthetics, whereas allergies occur mainly as a consequence of the application of antibiotics, usually penicillin. In response to stress, vasovagal syncope typically occurs. Other causes may be related to an underlying disease-specific pathology (such as acute asthma attack, diabetic ketoacidosis, hypoglycemia, or seizures) or accidents (aspiration of a foreign body causing obstruction of the respiratory system). For all the above conditions, guidelines have been established that need to be known. If complications occur or necessary measures are not taken, it can lead to cardiac and respiratory arrest. Therefore, cardiopulmonary resuscitation is needed. All procedures and dosages should be adapted to the age of the child.

Recent achievements in preventive dentistry by introducing a new probiotic toothpaste.

Artificially synthesized probiotic from Lactobacillus strain, contained in the tested toothpaste, led to an innovative approach in preventive dentistry. A new concept resulting from this research can be explained due to possible mechanisms of action of probiotic bacteria, according to which equilibrium of hostile bacterial flora is achieved by mechanical elimination of cariogenic bacteria from the mouth. This research was conducted during a 4-week period on a randomly selected Croatian sample of 50 participants, with the aim to investigate the efficacy of the first probiotic toothpaste ever produced in Croatia. CRT tests (Ivoclar Vivadent AG, FL-9494 Schaan/Liechtenstein) were used and individually administrated to each participant to assess the number of Streptococci and Lactobacilli. Saliva samples were tested before, as well as 2 and 4 weeks after using the tested toothpaste. After having had obtained detailed information on the research protocol, participants signed informed consent, and strictly following the instructions, brushed their teeth exclusively using the tested toothpaste and toothbrush of the same manufacturer over the 4 week period. Statistical results obtained after 4 weeks of using the probiotic toothpaste showed significant reduction in the number of participants who, prior to commencing the study, were diagnosed a high number of cariogenic bacteria. The number of participants with the high number of streptococci was significantly reduced from 78.4 to 26.5%, as well as the number of participants with the high number of Lactobacilli, which significantly dropped down from 52.9 to 26.5%. The results indicate a significant efficacy of the tested toothpaste, which can be attributed to the effect of the contained synthetized probiotic substance. Therefore, this research reveals a new achievement in innovative technologies, based on which probiotics can be used with purpose of maintaining balance of bacterial flora within the oral cavity, particularly in high risk groups who are more prone to developing caries.

Effect of LGG yoghurt on Streptococcus mutans and Lactobacillus spp. salivary counts in children.

The aim of this study was to establish effect of 14 day consumption of commercially available yoghurt containing Lactobacillus rhamnosus ATCC53103 - LGG (Bioaktiv LGG, Dukat, Croatia) on Streptococcus mutans and Lactobacillus spp. salivary counts in children. Twenty five patients, 6-10 yr old participated in the study. At the inclusion in the study caries risk for every patient was evaluated. The saliva samples were tested with chair side kits for saliva buffer capacity (CRT buffer, Vivadent, Schaan, Liechtenstein), S. Mutans and Lactobacillus counts (CRT bacteria test, Vivadent, Schaan, Liechtenstein). Seven, 14 and 30d after yoghurt consumption saliva samples were tested again with CRT buffer and CRT bacteria tests. Obtained data were analyzed using chi2 and Kruskal-Wallis tests. Results showed significant increase in saliva buffer capacity 30d after yoghurt consumption. S. Mutans salivary counts were significantly decreased after 30d. Significant differences in Lactobacillus counts were not observed. It could be concluded that daily consumption of yoghurt containing LGG have an inhibitory effect on oral pathogenic bacteria and may be beneficial in caries prevention.

Heat-treated glass ionomer cement fissure sealants: retention after 1 year follow-up.

OBJECTIVE: The aim of this study was to assess the retention rate of glass ionomer cement (GIC) fissure sealants heated during setting time. METHODS: One hundred and twelve teeth with well-delineated fissure morphology were sealed with composite resin and GIC. Composite resin (Helioseal F, Vivadent) was used in control group A (56 teeth). GIC (Fuji VII, GC) was applied using split-mouth design with conditioning in group B (26 teeth) and without surface conditioning in group C (30 teeth). GIC was heated with external heat source (Elipar Trilight, Espe) for 40 s during the setting time according to the manufacturer's instructions. Fissure sealants were evaluated 1 year after clinical service. RESULTS: Retention rate in group A was 80.4% after 1 year of clinical service. Group B showed retention rate of 30.8%, and group C of 26.7%. Two new caries lesions were detected in groups B and C. Significant differences in retention between the composite group and GIC groups were obtained by Kruskal-Wallis and Mann-Whitney tests. CONCLUSION: It could be concluded that retention rate of GIC sealing treated with heat during setting time was significantly lower than retention of conventional composite resin. The heating procedure during setting of GIC sealants cannot be recommended as routine treatment in clinical practice.

Soft-start polymerization of fissure sealant: retention after three years.

The aim of this study was to investigate retention of composite fissure sealant polymerized with standard and soft-start technique after a three year clinical trial. One hundred teeth were divided into two groups (A&B) of teeth and sealed with composite material (Visioseal, 3M Espe) using split mouth design. Sealants were polymerized using standard (Group A) and soft-start (Group B) techniques with commercial polymerization unit (Elipar Highlight, 3M Espe). Retention rate in Group A was 72%. In 14 teeth sealant was partially or completely missing. Group B showed retention rate of 80%. Sealant was partially or completely missing in 10 teeth. Six new caries lesions in Group A (3) and B (3) were detected. Mann-Whitney test did not reveal significant differences between the polymerization techniques. After three years complete retention of sealants, regardless of the group, was 76% (76 teeth) with six new caries lesions. Soft-start polymerization showed a comparable retention rate as the standard polymerization technique.

Craniofacial anthropometric pattern profile in hypohidrotic ectodermal dysplasia--application in detection of gene carriers.

Hypohidrotic ectodermal dysplasia (HED) is characterized by clinical manifestations of severe hypodontia or anodontia, hypotrichosis, hypohidrosis, and specific facial appearance. Affected males show complete expression of clinical features of this condition. Their mothers, who are gene carriers, express only some signs, which are usually very mild. Currently available clinical methods are not sufficient for routine identification of the HED heterozygous gene carriers. The purpose of this study was to identify and describe the facial characteristics of HED patients and their mothers and to evaluate the usefulness of craniofacial pattern profile analysis (CFPP) in the diagnosis of this syndrome and the detection of gene carriers. In this study six affected males and their mothers were evaluated. Z-scores for each variable were calculated and compared with age- and sex-matched controls. Anthropometric analysis showed a specific dysmorphic pattern in CST patients that includes decreased skull base width (t-t: -1.67 Z); decreased forehead width (ft-ft: -1.8 Z), decreased midface depth (sn-t: -2.02 Z), markedly decreased total facial height (n-gn: -3.4 Z), and markedly decreased maxillary arc (t-sn-t: -2.5 Z). Gene carriers showed a similar tendency in their pattern profiles. They showed the same tendency towards lower Z-values for forehead width, facial height, and mouth width. The values for these measurements were between those of the affected and healthy controls. The most pronounced findings were increased head width (eu-eu: +2.83 Z), increased lower face width (go-go: +2.06 Z), and reduction of total facial height (n-gn: -0.95 Z). They also displayed increased nose width (al-al: +2.41 Z) and increased biocular distance (ex-ex: +2.01 Z). When used in conjunction with other methods the anthropometrics pattern profile analysis can considerably enhance detection of gene carriers for HED and increase objective assessment of the craniofacial region in HED patients.