Periodontal disease detection in primary and mixed dentitions

Custom-made versus prefabricated zirconia crowns for primary molars: A 12-month follow-up

BACKGROUND

Many practitioners have questioned whether the construction method of pediatric zirconia crowns impacts the periodontal health and clinical performance of severely decayed primary molars. The objective of this study was to compare the periodontal health and clinical performance of primary molars restored with custom-made zirconia crowns (CZCs) and prefabricated zirconia crowns.

METHODS

Twenty primary molars indicated for crown restorations were selected from ten patients (5-9 years old) randomly. Each patient received two pediatric zirconia crowns constructed by two different methods: one custom-made and one prefabricated. The primary molars were divided into two groups: Group 1: primary molars received CZCs and Group 2: primary molars received prefabricated zirconia crowns (PZCs).

RESULTS

After a 12-month follow-up, there was no statistically significant difference between the periodontal health of primary molars restored with custom-made and prefabricated zirconia crowns. The clinical performance of primary molars restored with CZCs was statistically significantly higher than those restored with PZCs in terms of retention and fracture resistance (P ≤ 0.05).

CONCLUSIONS

The construction method of pediatric zirconia crowns does not significantly affect the periodontal health of primary molars; however, clinical performance is significantly affected in terms of retention and fracture resistance.

CLINICAL SIGNIFICANCE

A CZC is an excellent alternative option, especially for primary molars whose permanent successors still have a long time to erupt. The PZC is a quick and easy restoration, but the technique is sensitive.

Comparative Clinical Study on Periodontal Health Status and Early Diagnosis of Periodontal Diseases Quantified through Clinical Periodontal Indices on a Group of Children and Adolescents with and without Cardiovascular Diseases

It is well known that bacterial plaque is the main etiological factor that causes the appearance of periodontal diseases and carious disease. Periodontal diseases can affect children and adolescents and are manifested in the form of gingivitis, but also the early form of chronic periodontitis as well as aggressive marginal periodontitis associated with local or general factors. Early periodontitis is frequently undiagnosed by clinicians due to a lack of knowledge of the specific symptoms. Certain systemic diseases, such as cardiovascular diseases, can create favorable conditions for the appearance and progression of severe manifestations of periodontal disease; also, recent research highlights that individuals with periodontal disease present an increased risk of developing cardiovascular diseases. Children with congenital or acquired cardiovascular diseases are at increased risk for complications resulting from the growth of microorganisms in the oral cavity, presenting a risk of infective endocarditis. The specific aim was to highlight the existing differences between the periodontal health of children with cardiovascular diseases and that of children without these diseases. The analyzed group included 124 patients, represented by children and adolescents, aged between 7 and 17 years, who were divided into four subgroups depending on the presence or absence of cardiovascular diseases and periodontal disease. A specialized clinical examination was performed for each patient, and periodontal clinical parameters were quantified (plaque index, gingival bleeding index, gingival index, community periodontal index of treatment needs) and associated with the diagnosis of general condition. Patients diagnosed with periodontal disease underwent specialized treatment and were called to a control visit 3 months after treatment. Statistical analysis showed significant differences between subgroups with much higher values of clinical parameters for patients with cardiovascular disease. Also, the response to the treatment was better in the case of patients in the control subgroup without cardiovascular diseases. The present study highlighted the interaction of three factors in the progression of periodontal diseases: subgingival microbiota, immune system response and environmental factors.

Impact of Oral Health on the Quality of Life of Preschoolers and Their Families

The aim of this study was to evaluate how the oral hygiene condition can influence the Oral Health-Related Quality of Life (OHRQoL) of preschoolers and their families. A cross-sectional study was conducted involving 446 children aged 2 to 6 years from public schools located in Rio de Janeiro, Brazil. The groups were dichotomized: regular/poor oral hygiene condition (RPOH) or good oral hygiene condition (GOH). The caregivers answered the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS). The average score in the RPOH group was 6.36 (6.35 DP) and GOH was 4.43 (5.35 SD) (P < .01). In the child subscale, the average of the RPOH and GOH group were, respectively, 4.12 (4.14 DP) and 3.13 (3.66 DP) (P = .01). In the family subscale, RPOH and GOH group were, respectively, 2.24 (3.12 DP) and 1.29 (2.52 DP) (P = .01). RPOH group had the greatest impact on OHRQoL.

Evaluation of visual pedagogy in improving plaque control and gingival inflammation among preschool children with autism spectrum disorder: An interventional study

BACKGROUND

Visual pedagogy (VP) is a behavioural intervention used to facilitate learning among autistic children. Limited studies have evaluated VP when applied to dentistry.

AIM

To evaluate the effectiveness of VP in improving oral hygiene and gingival health status of autistic children.

DESIGN

The interventional study was conducted among 122 autistic preschool children and their parents in Hong Kong. Toothbrushing visual pedagogy (TBVP) was provided to parents for supervising their children with toothbrushing at home. The children's sociodemographic background, developmental profile, and clinical parameters were obtained via parental questionnaire, standardised assessment form, and clinical examination, respectively. The change in plaque and gingival indices over time and potential confounding factors were evaluated with Friedman's two-way analysis of variance and logistic regressions, respectively.

RESULTS

Significantly lower level of plaque and gingival inflammation was found at 3 months and 6 months than baseline. The oral health status of children with poorer baseline oral hygiene status and gingival health was more likely to improve with TBVP. Other developmental and socio-economic backgrounds had insignificant associations on the improvement of these clinical parameters.

CONCLUSION

The findings suggest TBVP is effective in promoting oral hygiene maintenance and improving the periodontal conditions among individuals diagnosed with ASD.

Oral health and obesity in the SAYCARE study: reliability and internal validity of diagnostic methods

OBJECTIVE

The aim of this pilot study was to address the reliability, internal validity and viability of oral health methods used in the South American Youth/Child cARdiovascular and Environmental study.

METHODS

South American Youth/Child cARdiovascular and Environmental study was a multicentre feasibility observational study and conducted in seven South American cities. The training sessions were performed in two steps before data collection: the first verified the inter-rater reproducibility between the examiners of the six centres in relation to the gold standard, and the second one verified the inter-rater reproducibility between the examiners at each centre in relation to the main rater. The diagnostic methods used were International Caries Detection and Assessment System II and Pulpal Involvement, Ulceration, Fistula and Abscess for dental caries and Periodontal Screening and Recording and Index Plaque for periodontal disease. Anthropometric variables were measured and used to calculate the body mass index and were classified according to the cut-off points defined by the International Obesity Task Force. Cohen's kappa coefficient and proportions of agreement were calculated to report inter-rater and intra-rater reliability in the calibration process and pilot study.

RESULTS

The inter-rater weight kappa ranged from 0.78 to 0.88 and proportion of agreement from 96.07% to 98.10% for the International Caries Detection and Assessment System II and for the Periodontal Screening and Recording, 0.68 to 0.95 and 94.40% to 98.33%, respectively, in the calibration process. At the pilot study, a total of 490 children (40.8% overweight and 12.9% obese) and 364 adolescents (23.4% overweight and 4.3% obese) were examined. The prevalence of dental caries was 66% in children and 78% in adolescents, and gingival bleeding was 49% and 58.20%, respectively.

CONCLUSION

The results demonstrated good reliability and internal validity after the examiners were trained, as well as the feasibility of using the methods chosen for this multicentre study.

Correlation between interleukin-1β and matrix metalloproteinase-1 levels in crevicular fluid with a proposed periodontal disease index in children

Background:

The crevicular fluid contains biomarkers that allow the identification of periodontal disease, anticipation of its risk, and prediction of its progression.

Purpose:

The purpose of this study is to correlate interleukin-1β (IL-1β) and matrix metalloproteinase-1 (MMP-1) levels in crevicular fluid with periodontal disease severity in schoolchildren.

Methods:

A cross-sectional study was conducted in 82 schoolchildren between 9 and 12 years. The biofilm percentage, attachment level, gingival recession, dental calculus, and bleeding on probing were measured in the teeth 16, 26, 36, 41, and 46. These five parameters obtained were considered to propose a disease score between 0 and 10 points. In crevicular fluid from the tooth with the highest score, IL-1β and MMP-1 levels were measured.

Results:

According to the proposed score, mild gingivitis was identified in 20 schoolchildren, moderate gingivitis in 30, and severe gingivitis in 32. Biofilm percentage, IL-1β, and MMP-1 levels increased as the severity of the disease increase. The mean and 95% confidence interval were 23.2 pg/μl (18.6–27.7), 37.3 pg/μl (27.8–46.9), and 44.6 pg/μl (34.4–58.8) (P = 0.01) for IL-1β and 2.69 mol/min (2.51–2.87), 4.43 mol/min (3.9–4.95), and 5.59 mol/min (4.81–6.38) (P < 0.001) for MMP-1 in each group, respectively. The proposed clinical score correlated with biofilm percentage (r = 0.63), IL-1β (r = 0.50), and MMP-1 (0.45) levels, P < 0.001 in all cases.

Conclusions:

The proposed clinical score for periodontal disease in children correlated with percentage of biofilm, IL-1β, and MMP-1 levels.