Vitamin D deficiency is a risk factor for delayed tooth eruption associated with persistent primary tooth

Prevalence and local causes for retention of primary teeth and the associated delayed permanent tooth eruption

BACKGROUND

This study aimed to evaluate the prevalence of retained primary teeth (RPT) associated with delayed permanent tooth eruption and the factors associated with this condition in German children.

METHODS

This is a cross-sectional retrospective study that evaluated panoramic radiographs from orthodontic patients. The diagnosis of RPT was established according to Nolla developmental stage. The primary tooth was considered retained when its successor permanent tooth was in Nolla stage 8, 9, or 10. Statistical analysis was performed with an α of 5% (p < 0.05).

RESULTS

A total of 102 children (48 girls and 54 boys), and 574 primary teeth and their respective permanent successor teeth were evaluated. We classified 192 teeth as RPT. Sixty-one (59.8%) children presented one or more RPT. Gender was not significantly different between RPT and control teeth (p = 0.838; odds ratio 0.95, confidence interval 95% 0.44-2.16). In the majority of the RPT cases (68.7%), no clear cause to explain the prolonged retention was identified. The pathological problems most commonly observed with RPT were dental fillings (19.3%), followed by dental caries (4.6%), and ectopic tooth eruption (2.1%).

CONCLUSIONS

The incidence of RPT associated with delayed permanent tooth eruption in German children was high and the most common pathological condition associated with RPT was dental caries.

Correlations between Dental Age, Skeletal Age, and Mandibular Morphologic Index Changes in Turkish Children in Eastern Anatolia and Their Chronological Age during the Pubertal Growth Spurt Period: A Cross-Sectional Study

In age determination, different methods aiming to obtain the closest result to chronological age have been investigated so far. The most commonly used one among these is the radiological method, which is usually used to evaluate the developmental stages of wrist bones or teeth. In our study, we assessed bone age estimations using the Gilsanz-Ratib atlas (GRA), which has recently become commonly used for children aged 9 to 15 years; evaluated the dental age, determined with Cameriere's European method; conducted morphometric measurements of the mandibular bone; and then examined their relationships with chronological age. The results of our study reveal that, in children during the puberty growth spurt, Cameriere's EU formula might have higher accuracy in estimating chronological age in younger age groups, while the GRA might be more accurate for older ages. Additionally, we conclude that of the mandibular morphometric measurements, condylar height and tangential ramus height show strong positive correlations with age. As a result, we conclude that the morphometric measurements evaluated in the present study can be used as auxiliary methods in forensic anthropology and forensic dentistry.

Dental caries in children and vitamin D deficiency: a narrative review

Dental caries represents one of the most prevalent health problems in childhood. Numerous studies have assessed that vitamin D deficiency is highly related to dental caries in primary and permanent teeth in children. The aim of this study is to elaborate a narrative review about proposed mechanisms by which vitamin D deficiency interacts with dental caries process in children. Vitamin D deficiency during pregnancy may cause intrauterine enamel defects, and through childhood is accompanied by insufficient activity of antibacterial peptides, decreased saliva secretion, and a low level of calcium in saliva.  Conclusion: In conclusion, vitamin D deficiency would increase the risk of caries in the primary and/or permanent dentition. Relationship between vitamin D deficiency and dental caries is evident enough for vitamin D deficiency to be considered as a risk factor for dental caries in children. Optimal levels of vitamin D throughout pregnancy and childhood may be considered an additional preventive measure for dental caries in the primary and permanent dentition.

Influence of Single-Nucleotide Polymorphisms on Vitamin D Receptor Expression in Periodontal Ligament Fibroblasts as a Response to Orthodontic Compression

This study aimed to evaluate if single-nucleotide polymorphisms (SNPs) in the vitamin D receptor (VDR) gene are associated with gene expression in human periodontal ligament (hPDL) fibroblasts under simulated orthodontic compressive force. hPDL samples from 57 patients were used. A physiological compressive strain was performed to simulate orthodontic tooth movement in pressure areas under cell culture conditions. The RNA from hPDL fibroblasts was isolated to determine the relative gene expression (mRNA) of the VDR. The DNA was also isolated for the genotyping analysis of five SNPs in the VDR gene: BglI (rs739837, G/T), BsmI (rs1544410, T/C), ApaI (rs7975232, A/C), FokI (rs2228570, A/G), and TaqI (rs731236, A/G). Real-time polymerase chain reaction was used for both analyses. Kruskal−Wallis tests were used to compare VDR expression among genotypes of each SNP. A linear regression analysis was performed to evaluate SNP−SNP interaction. An established alpha of 5% was used. The relative mRNA VDR expression according to the genotypes in the SNPs BglI, BsmI, ApaI, FokI, and TaqI was not statistically significantly different (p > 0.05). The SNP−SNP interaction evaluated by regression analysis did not demonstrate any statistically significant association. No association was observed (p > 0.05). In conclusion, the SNPs BglI (rs739837), BsmI (rs1544410), ApaI (rs7975232), FokI (rs2228570), and TaqI (rs731236) did not show an impact on VDR gene expression in hPDL fibroblasts under simulated orthodontic compressive force.

Effects of a 2-Year Early Childhood Vitamin D3 Intervention on Tooth Enamel and Oral Health at Age 6-7 Years

INTRODUCTION

The aim of the study was to compare the effects of a 30 µg/day versus 10 µg/day vitamin D supplementation, given during the two first years of life, on oral health at the age of six to 7 years.

METHODS

In 2013-2016, we conducted a randomized, double-blinded, clinical trial from age 2 weeks to 2 years of daily vitamin D3 supplementation (10 vs. 30 µg), including 975 healthy infants. For the present follow-up study at age 6-7 years, a sample of 123 children underwent oral examination by investigators blinded to the intervention group. Tooth enamel defect and caries findings, oral rinse active matrix metalloproteinase-8 levels, and tooth eruption were recorded. The intervention groups were compared with χ2 and Mann-Whitney U tests. Associations of the oral health outcomes were evaluated with correlation analysis and logistic regression.

RESULTS

Of the children (median age 7.4 years, 51% boys), 56% belonged to the 30 µg intervention group. Developmental defect of enamel (DDE) was found in 39% of the children in the 10 µg intervention group and in 53% of the 30 µg group (p = 0.104). In total, 94% of children were vitamin D sufficient (25[OH]D ≥50 nmol/L) and 88% had caries-free teeth. No associations were found between vitamin D intervention group in infancy and oral health or the presence of DDE.

CONCLUSION

Daily supplementation with 10 µg vitamin D3 in the Northern Hemisphere seems adequate in healthy children younger than 2 years in ensuring good oral health at early school age.

Single Nucleotide Polymorphisms in COX2 Is Associated with Persistent Primary Tooth and Delayed Permanent Tooth Eruption

Persistent primary tooth (PPT) is a prevalent clinical condition that occurs when a primary tooth is over-retained beyond the established period of its normal exfoliation time, remaining in the oral cavity. Many factors could be involved in the risk of PPT; therefore, the aim of this study was to evaluate if single nucleotide polymorphisms (SNPs) in the COX2 gene are associated with PPT. Children undergoing orthodontic treatment were screened. Orthopantomographs were assessed to evaluate PPT according to the Nolla stage of its permanent successor. The primary tooth was considered retained when its successor permanent tooth was in Nolla stage 8 and below the alveolar crypt, Nolla stage 9, or Nolla stage 10. A saliva sample from each child was collected and used for DNA extraction. A real-time PCR of two SNPs, rs689466 (-1195 G/A) and rs5275 (+665 T/C), was performed. A chi-square test was used to compare the allele and genotype distribution. Haplotype analysis was also performed. A total of 100 children were included in the study. Fifty-one had at least one PPT, while 49 children were classified as a control. The number of teeth persistent in the oral cavity ranged from 1 to 8. The genotype distribution was associated with PPT in the co-dominant model (p = 0.006) for SNP rs5275. The individuals that carry two T alleles (TT) compared with the individuals that carry at least one C allele (C + TC) had an almost three times higher chance of presenting with PPT (p = 0.012; OR = 2.99, CI95% 1.28 to 6.95-recessive model). The haplotype C-A for the SNPs rs5275 and rs689466, respectively, was significantly associated (p = 0.042). In conclusion, single nucleotide polymorphisms in the gene encoding for COX2 are associated with persistent primary tooth and may delay permanent tooth eruption.