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Dental Research, Dental Clinics, Dental Prospects - Volume:9 Issue: 2, Spring 2015

Journal of Dental Research, Dental Clinics, Dental Prospects
Volume:9 Issue: 2, Spring 2015

  • Pediatric Dentistry Special
  • تاریخ انتشار: 1394/03/11
  • تعداد عناوین: 13
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  • Masoud Fallahinejad Ghajari, Ghassem Ansari, Ali Asghar Soleymani, Shahnaz Shayeghi, Faezeh Fotuhi Ardakani Pages 61-65
    Background And Aims
    There are several known sedative drugs, with midazolam and ketamine being the most com-monly used drugs in children. The aim of this study was to compare the effect of intranasal and oral midazolam plus ket-amine in children with high levels of dental anxiety.
    Materials And Methods
    A crossover double-blind clinical trial was conducted on 23 uncooperative children aged 3‒6 (negative or definitely negative by Frankel scale), who required at least two similar dental treatment visits. Cases were randomly given ketamine (10 mg/kg) and midazolam (0.5 mg/kg) through oral or intranasal routes in each visit. The sedative efficacy of the agents was assessed by an overall success rate judged by two independent pediatric dentists based on Houpt’s scale for sedation. Data analysis was carried out using Wilcoxon test and paired t-test.
    Results
    Intranasal administration was more effective in reduction of crying and movement during dental procedures compared to oral sedation (P<0.05). Overall behavior control was scored higher in nasal compared to oral routes at the time of LA injection and after 15 minutes (P<0.05). The difference was found to be statistically significant at the start and during treatment. However, the difference was no longer significant after 30 minutes, with the vital signs remaining with-in physiological limits. Recovery time was longer in the intranasal group (P<0.001) with a more sleepy face (P=0.004).
    Conclusion
    Intranasal midazolam/ketamine combination was more satisfactory and effective than the oral route when sedating uncooperative children.
    Keywords: Anxiety, intranasal, ketamine, midazolam, oral sedation
  • Mehrsa Paryab, Maryam Ahmadyar Pages 66-71
    Background And Aims
    One of the most common reasons for the inferior alveolar nerve block anesthesia failure is the variation in mandibular foramen location. The aim of this study was to assess the location of mandibular foramen in children with mandibular retrognathism in comparison to children with normal skeletal occlusion in the mixed dentition.
    Materials And Methods
    One hundred and twenty panoramic radiographs of patients in mixed dentition period, undergoing orthodontic treatment, were selected based on inclusion criteria, skeletal occlusion and stage of dental development. The radiographs were divided into two groups: I: 60 panoramic radiographs of patients with normal skeletal occlusion (15 in each of the Hellman dental age stages); II: 60 panoramic radiographs of patients with mandibular retrognathism (15 in each of the Hellman dental age stages). The radiographs were traced and the linear distance from the mandibular foramen to the borders of the mandibular ramus and its angular position were identified. The measurements were compared between the two groups and among the four dental age groups by t-test, ANOVA and post hoc tests.
    Results
    No statistically significant differences were found between the patients with normal skeletal occlusion and patients with mandibular retrognathism (P>0.05). Statistical tests showed significant differences in the vertical location of mandibular foramen and gonial angle between the four dental age groups (P<0.05).
    Conclusion
    Mandibular retrognathism does not have a significant impact on the location of the mandibular foramen in the mixed dentition period. The child’s dental age would be considered in the localization of the mandibular foramen.
    Keywords: Foramen, location, mandible, mixed dentition, retrognathism
  • Shahrzad Javadinejad, Hajar Sekhavati, Roshanak Ghafari Pages 72-78
    Background And Aims
    Tooth development is widely used in determining age and state of maturity. Dental age is of high importance in forensic and pediatric dentistry and also orthodontic treatment planning. The aim of this study was to compare the accuracy of four radiographic age estimation methods.
    Materials And Methods
    Orthopantomographic images of 537 healthy children (age: 3.9-14.5 years old) were evaluated. Dental age of the subjects was determined through Demirjian’s, Willem’s, Cameriere’s, and Smith’s methods. Differences and correlations between chronological and dental ages were assessed by paired t-tests and Pearson’s correlation analysis, respectively.
    Results
    The mean chronological age of the subjects was 8.93 ± 2.04 years. Overestimations of age were observed following the use of Demirjian’s method (0.87 ± 1.00 years), Willem’s method (0.36 ± 0.87 years), and Smith’s method (0.06 ± 0.63 years). However, Cameriere’s method underestimated age by 0.19 ± 0.86 years. While paired t-tests revealed significant differences between the mean chronological age and ages determined by Demirjian’s, Willem’s, and Cameriere’s methods (P < 0.001), such a significant difference was absent between chronological age and dental age based on Smith’s method (P = 0.079). Pearson’s correlation analysis suggested linear correlations between chronological age and dental age determined by all four methods.
    Conclusion
    Our findings indicated Smith’s method to have the highest accuracy among the four assessed methods. However, all four methods can be used with acceptable accuracy.
    Keywords: Dental age determination, Forensic dentistry, panoramic radiography
  • Hamidreza Poureslami, Naser Asl Aminabadi, Alireza Sighari Deljavan, Leila Erfanparast, Azin Sohrabi, Zahra Jamali, Sina Ghertasi Oskouei, Kameliya Hazem Pages 79-85
    Background And Aims
    Predicting the teeth eruption time is a valuable tool in pediatric dentistry since it can affects scheduling dental and orthodontic treatments. This study investigated the relationship between the eruption time of first primary and permanent teeth and the variation in the eruption time considering socioeconomic status (SES) in a 9-year population- based cohort study.
    Materials And Methods
    307 subjects were examined at bimonthly intervals during the first and second years of life and then at six-month intervals until the eruption of first permanent tooth. Eruption times of primary and permanent tooth were recorded for each child. A modified form of Kuppuswamy’s scale was used to assess the SES.
    Results
    Among 267 subjects completed all follow-ups, the eruption time for first primary and permanent teeth indicated a direct strong correlation; in that one month delayed or early eruption of first primary tooth resulted in 4.21 months delayed or early eruption of first appearing permanent tooth (r = 0.91, n = 267, P <0.001). No significant correlation was observed between the eruption time of first primary and first permanent teeth and SES (P = 0.67, P = 0.75, respectively).
    Conclusion
    The eruption timing for the first primary tooth had a correlation with the first permanent tooth eruption timing, while SES did not have any influence on eruption times.
    Keywords: Deciduous, dentition, permanent, tooth eruption
  • Hossein Afshar, Arghavan Kamali Sabeti, Mahdi Shahrabi Pages 86-91
    Background And Aims
    Due to anatomic variation in tooth anatomy between populations, this study compared the buccolingual (BL) and mesiodistal (MD) dimensions of primary molars with those of stainless steel crowns (SSCs) in an Iranian population.
    Materials And Methods
    Impressions were taken from both dental arches of children, and casts were poured. Teeth with caries, restoration, hypoplasia or other dental anomalies were excluded. 216 primary molars were selected and divided into 4 groups of 54 each (maxillary and mandibular first and second primary molars). MD/BL dimensions were measured using a digital caliper with 0.01 mm precision on casts and SCCs (3M brand). Data were assessed using paired t-test, post hoc test and ANOVA. P < 0.05 was considered statistically significant.
    Results
    The MD dimension of the lower first molar SSC and the BL dimension of the lower second molar SSC had the least difference with the corresponding values of the respective teeth. The MD dimension of the upper second molar SSC and the BL dimension of the upper first molar SSC had the greatest difference with the corresponding values in the respective teeth. Comparison of the two different brands of SSCs for the upper first molar revealed that both types had significant differences with the teeth in terms of both MD (P = 0.0) and BL (P = 0.0) dimensions.
    Conclusion
    In the studied population, best adaptation was seen in second lower molars and the least adaptations were seen in first and second upper molars.
    Keywords: Dimension, primary molar, stainless steel crown
  • Faezeh Ghaderi, Ali Mardani Pages 92-95
    Background And Aims
    The majority of failures in Class II amalgam restorations occur in the first primary molar teeth; in addition, use of compomer instead of amalgam for primary molar teeth restorations is a matter of concern. The aim of the present study was to compare the success rate of Class II compomer and amalgam restorations in the first primary molars.
    Materials And Methods
    A total of 17 amalgams and 17 compomer restorations were placed in 17 children based on a split-mouth design. Restorations were assessed at 12- and 24-month intervals for marginal integrity, the anatomic form and recurrent caries. Data were analyzed with SPSS 11. Chi-squared test was applied for the analysis. Statistical significance was set at P<0.05.
    Results
    A total 34 restorations of 28 restorations (14 pairs) of the total restorations still survived after 24 months. Compomer restorations showed significantly better results in marginal integrity. Recurrent caries was significantly lower in compomer restorations compared to amalgam restorations. Cumulative success rate at 24-month interval was significantly higher in compomer restorations compared to amalgam restorations. There was no statistically significant difference in anatomic form between the two materials.
    Conclusion
    Compomer appears to be a suitable alternative to amalgam for Class II restorations in the first primary molars.
    Keywords: Amalgam, compomer, dental restorations, primary teeth
  • Shirin Fattahi, Sepideh Vosoughhosseini, Monir Moradzadeh Khiavi, Seyed Mostafa Mahmoudi, Parya Emamverdizadeh, Seyed Gholamreza Noorazar, Neda Yasamineh, Rana Lotfi Pages 96-100
    Background And Aims
    Head and neck tumors are the most common complaints of people referring to different medical sections, especially in children. The aim of this study was to evaluate the prevalence of these tumors in children less than 12 years of age to provide a better perspective for future studies.
    Materials And Methods
    All the files in Department of Pathology at Tabriz Pediatric Hospital from 2001 to 2011 were screened for head and neck tumors in children under 12 years of age. Data including age and gender as well as the type, the location, and benign/malignant characteristic of the tumor were recorded. Data were analyzed by SPSS 15 statistical software, using descriptive statistics and chi-square test.
    Results
    A total of 160 cases were identified. Most of the tumors were benign (68%) and most of the tumors occurred in the neck region (41%). The most frequent benign and malignant tumors were lymphangioma and non-Hodgkin lymphoma, respectively. The majority of benign tumors were found in children younger than 2 years old (P=0.007), but there was no age predilection for malignant tumors.
    Conclusion
    According to our results, benign tumors were more prevalent than malignant ones. Although a low rate of benign tumors in males shows that more attention should be paid to the early diagnosis of head and neck tumors.
    Keywords: Head, neck tumor, children, benign tumors, malignant tumors
  • Asghar Ebadifar, Nazila Ameli, Hamid Reza Khorramkhorshid, Mehdi Salehi Zeinabadi, Kourosh Kamali, Tayyebeh Khoshbakht Pages 101-104
    Background And Aims
    The aim of the present study is to determine the incidence of MTHFR C677 T and A1298C mutations in Iranian patients with cleft lip and/or cleft palate.
    Materials And Methods
    We screened 61 Iranian patients with cleft lip and/or cleft palate for mutations in the two alleles of MTHFR gene associated with cleft lip and/or palate: A1298C and C677T, using Polymerase Chain Reaction following by RFLP.
    Results
    The 677T and 1298C homozygote genotypes showed a frequency of 36.1% and 11.4%, respectively. Combined genotype frequencies in newborns having oral clefts showed that the highest genotype was 677TT/1298AA (22.9%) and 677TT/1298CC genotypes were not observed.
    Conclusion
    The results showed that 65.6% of all patients had at least one T mutant allele in C677T and 58.9% C mutant allele for A1298C. According to the frequencies of homozygosity of mutant alleles, it could be said that MTHFR genotype of 677TT shows a greater role in having oral clefts.
    Keywords: A1298C, C677T, methylenetetrahydrofolate reductase, orofacial cleft, polymorphism
  • Behjatolmolook Ajami, Ghazale Abolfathi, Eftekhar Mahmoudi, Zahra Mohammadzadeh Pages 105-108
    Background And Aims
    In the presence of certain systemic diseases, oral microflora may aggravate the condition of the disease. Microbial population in the oral cavity especially with heart disease can increase the risk of bacterial endocarditis. The aim of this study was to evaluate the rate of oral Streptococcus mutans and the rate of caries in children suffering from heart disease.
    Materials And Methods
    In this cross-sectional research, 66 children with congenital or acquired heart disease and 50 healthy children were selected. Children were orally examined and decayed, missing, and filled teeth (DMFT) index was recorded for each subject. Saliva samples were taken from all subjects, and cultured on a special laboratory media and another specific media for S. mutans (sorbitoll + manitol). Bacterial counts were recorded, and for statistical analysis, chi square, Pearson’s, and Exact Fisher tests were performed using SPSS 16 software.
    Results
    The rate of S. mutans in children with congenital heart disease was significantly higher than the rates in children with acquired heart disease and healthy control subjects. The mean DMFT in children with acquired heart disease who took penicillin as prophylaxis monthly was significantly lower than the other groups.
    Conclusion
    The results revealed lower oral bacteria counts and comparatively lower caries rates in children with heart diseases, probably because of an effect of the regular prophylactic antibiotic regimen.
    Keywords: Dental caries, heart diseases, Streptococcus mutans
  • Masoumeh Moslemi, Mandana Sattari, Fahimeh Kooshki, Faezeh Fotuhi, Neda Modarresi, Zahra Khalili Sadrabad, Mohammad Saeid Shadkar Pages 109-114
    Background And Aims
    Lysozyme and lactoferrin are salivary proteins which play an important role in innate defense mechanisms against bacteria. This study investigated the association of salivary lysozyme and lactoferrin concentrations with early childhood caries (ECC).
    Materials And Methods
    This study was carried out on 42 healthy children (age range, 36 to 71 months), of whom 21 were caries free (CF) and 21 had ECC. Disposable needle-less syringes were used to collect unstimulated saliva from buccal and labial vestibules. Fifteen children who had ECC were treated completely and their saliva was collected in the same way for the second time, three months after treatment. Lysozyme and lactoferrin concentrations were measured and recorded by the ELISA method. The intergroup comparisons were carried out using chi-square, Student’s t-test and Wilcoxon signed ranked test. A P-value less than 0.05 was considered as statistically significant.
    Results
    The mean concentration of lysozyme was significantly higher in CF group compared with that of ECC group (P = 0.04). Although the mean concentration of lactoferrin in ECC group was higher in comparison with ECC group, the difference was not statistically significant (P = 0.06). After dental treatment, the mean concentrations of lysozyme and lactoferrin did not change in comparison with their concentrations before treatment.
    Conclusion
    ECC may have a relationship with lower concentrations of unstimulated salivary lactoferrin and lysozyme and reduced amounts of these two salivary proteins may be a risk factor for dental caries in children.
    Keywords: Dental caries, lactoferrin, lysozyme, saliva
  • Mitali Jain, Ritu Namdev, Meenakshi Bodh, Samir Dutta, Parul Singhal, Arun Kumar Pages 115-120
    Background And Aims
    Early Childhood Caries (ECC) is a public health problem with biological, social and behavioural determinants and the notion that the principal etiology is inappropriate feeding modalities is no longer tenable. Hence this study was undertaken to assess the relationship between ECC and socio-demographic factors, dietary habits, oral hygiene habits and parental characteristics.
    Materials And Methods
    The study involved a dental examination of 1400 children aged 0‒71 months, recording caries using Gruebbel’s deft index and a structured questionnaire to interview parents or caretakers. The tabulated data was statistically analyzed using t-test and ANOVA at 5% level of significance.
    Results
    The variables significantly associated with ECC were age (P<0.001), geographical location (P<0.05), duration of breast/bottle feeding (P<0.001), use of sweetened pacifiers (P<0.001), frequency of snacking (P<0.05), frequency of tooth brushing (P<0.001), the person responsible for child’s oral health care (P<0.05) and education level of parents (P<0.05). However, other variables like child’s gender, number of siblings, types of snack the child preferred and age at which tooth brushing was instituted did not have statistically significant relationship with ECC (P>0.05).
    Conclusion
    ECC is preventable and manageable with proper information and skills. It is important for healthcare professionals, family physicians and parents to be cognizant of the involved risk factors as their preventive efforts represent the first line of defense.
    Keywords: Preschool children, dental caries, questionnaire, risk factors, tooth brushing
  • Maryam Mehrabkhani, Behjatolmolok Ajami, Iman Parisay, Ali Bolboli, Golsa Akbarian Pages 121-125
    Background And Aims
    Dental trauma is an important oral health problem in children that requires immediate and appropriate management for long term success. The aim of this study was to evaluate the knowledge of elementary school teachers about emergency management of traumatic dental injuries in children.
    Materials And Methods
    A total of 163 teachers from 21 elementary schools from Mashhad, Iran participated in this study. Data were collected using a two-part questionnaire comprised of questions regarding demographic data and participants'' knowledge about dental trauma.
    Results
    The level of the teachers'' knowledge was moderate (53.3%). Of the 163 participants, 104 (63.8%) were females and 59 (36.2%) were males. Among several predictors that were surveyed in this study, only the age of respondents significantly impacted the teachers'' knowledge (P = 0.004).
    Conclusion
    The results of this study showed the moderate level of knowledge of teachers regarding emergency management of traumatized teeth. Adding dental trauma management courses in the teacher training curriculum and requiring teachers to be updated in regards to this issue can improve their knowledge and thus led to better management of traumatic dental injuries in children.
    Keywords: Dental trauma, knowledge, teacher
  • Taraneh Movahhed, Behjatalmolook Ajami, Mojtaba Dorri, Nima Biouki, Hadi Ghasemi, Mohammad Taghi Shakeri, Mahboobe Dehghani Pages 126-130
    Background And Aims
    Tooth loss may lead to mastication disability, which in turn has important impact on individual’s quality of life. Social and psychological factors have been shown to be associated with tooth loss. This study aimed to investigate the social determinants and prevalence of tooth loss, and presence of functional dentition among female heads of household under support of Welfare Organization in Mashhad, Iran.
    Materials And Methods
    In current study 556 participants aged 16-76 years were recruited. Sociodemographic characteristics (age, level of education, family size, and monthly income) were collected using interviewer-led questionnaire. Data about number of teeth and functional dentition were obtained by oral examination. The data were analyzed using Chi-square, Kruskal-Wallis, T-test and binary logistic regression analysis.
    Results
    Four percent of participants were edentulous. Tooth loss was significantly associated with level of education, age and family size (P < 0.001). There was no significant association between level of income and tooth loss (P = 0.88). Only 37.5% of dentate subjects had functional dentition (anterior and premolar teeth). Women older than 40 years were 0.63 times less likely to have functional dentition than those younger than 40 years. Females with at least a high-school diploma were six times more likely to have functional dentition than their illiterate counterparts.
    Conclusion
    Social determinants of functional dentition should be taken into account when planning oral health promoting programs for female heads of household. For reducing oral health inequalities access to dental services should be facilitated.
    Keywords: Dentition, female, head of household, single, parent family, tooth loss