Updated clinical recommendations for the management of tuberous sclerosis complex associated epilepsy

Children with tuberous sclerosis complex (TSC), may experience a variety of seizure types in the first year of life, most often focal seizure sand epileptic spasms. Drug resistance is seen early in many patients, and the management of TSC associated epilepsy remain a major challenge for clinicians. In 2018 clinical recommendations for the management of TSC associated epilepsy were published by a panel of European experts. In the last five years considerable progress has been made in understanding the neurobiology of epileptogenesis and three interventional randomized controlled trials have changed the therapeutic approach for the management of TSC associated epilepsy. Pre-symptomatic treatment with vigabatrin may delay seizure onset, may reduce seizure severity and reduce the risk of epileptic encephalopathy. The efficacy of mTOR inhibition with adjunctive everolimus was documented in patients with TSC associated refractory seizures and cannabidiol could be another therapeutic option. Epilepsy surgery has significantly improved seizure outcome in selected patients and should be considered early in all patients with drug resistant epilepsy. There is a need to identify patients who may have a higher risk of developing epilepsy and autism spectrum disorder (ASD). In the recent years significant progress has been made owing to the early identification of risk factors for the development of drug-resistant epilepsy. Better understanding of the mechanism underlying epileptogenesis may improve the management for TSC-related epilepsy. Developmental neurobiology and neuropathology give opportunities for the implementation of concepts related to clinical findings, and an early genetic diagnosis and use of EEG and MRI biomarkers may improve the development of pre-symptomatic and disease-modifying strategies.

mTOR Inhibitors as a New Therapeutic Strategy in Treatment Resistant Epilepsy in Hemimegalencephaly: A Case Report

Hemimegalencephaly is a hamartomatous malformation of one hemisphere. Functional hemispherectomy, the definitive treatment, is associated with significant morbidity and mortality in early infancy. Dysregulation of the mTOR pathway can result in malformations of cortical development, and mTOR inhibitors can effectively reduce seizures in tuberous sclerosis complex. We report a 6-day-old female with hemimegalencephaly and frequent seizures despite 9 antiseizure medications. At 3 months of age, while awaiting hemispherectomy, an mTOR inhibitor, rapamycin, was initiated by the neurologist. After 1 week of treatment, there was >50% reduction in seizures and total seizure burden, and after 2 weeks, development improved, resulting in deferral of surgery by 2.5 months with an increased body weight. Pathology demonstrated cortical dysplasia with upregulation of the mTOR pathway. Deep-sequencing of brain tissue demonstrated 16% mosaicism for a pathogenic de novo MTOR gene mutation. This case exemplifies how mTOR inhibitors could be considered for seizure reduction in patients with hemimegalencephaly while awaiting surgery.

[Self-applied topical fluoride products for children available in Israel. Part two: Mouthwashes]

The use of self applied topical fluoride products is considered, today, the most effective caries prevention measure. The daily or weekly/biweekly use of fluoridated mouth rinses, containing adequate concentrations of fluoride ion, has been shown to be an important adjunct in caries prevention and arrest. The purpose of this paper was 1. to review the various types of fluoridated mouth rinses, with regard to the type of fluoride compound and its effectiveness; 2. to focus on the fluoridated mouthrinses available for children in Israel in regard to concentration and additives, and 3. to give recommendations for rational and safe use. The mouthrinses are presented according to their concentration, showing Fluoride compound, additives, alcohol presence, flavor and manufacturer. The issues of safety in regard to ingestion of the rinse by small children are discussed. Rinses of no less than a 230-250 ppm are recommended to children of medium and high caries risk above the age of 6. The product should carry clear information regarding the type of fluoride compound, its concentration, instructions for use and age restriction. The products should be further protected by child proof caps.

Communication strategies used during pediatric dental treatment: a pilot study

PURPOSE

Effective verbal communication is essential for successful dental treatment. The purpose of this study was to qualitatively and quantitatively examine communication techniques used by pediatric postdoctoral students during treatment. The operation of a communication model comprised of three linguistic approaches-permissive, empathic and personal-together with other strategies common to all three, was examined.

METHODS

The study group consisted of 24 children (14 boys and 10 girls), 3 to 12 years of age. All four dentists were 2nd year residents in pediatric dentistry. Conversations were taped and analyzed linguistically and statistically. The frequency of use of each approach was tabulated and correlated to the children's reported anxiety, cooperation during treatment, success of treatment, and mood at the end of treatment.

RESULTS

All dentists used the three approaches; the permissive approach, which supplied procedural information, was the most frequently used approach. The empathic approach was the least frequently used. Correlation tests showed that the empathic approach was most significantly related to the success of the treatment. Components of the permissive approach that contributed to the success of treatment were sensory information and supplying reasons.

CONCLUSIONS

Although generalization is limited because of the small sample, improving verbal conversational skills, emphasizing certain strategies, and improving linguistic abilities will contribute to better communication between child and pediatric dentist and to better cooperation and success in treatment.

Microabrasion of teeth with discoloration resembling hypomaturation enamel defects: four-year follow up

Microabrasion with 18% HCl and pumice to remove enamel dysmineralization and improve esthetics is an accepted and effective treatment. This technique can probably be extended even to generalized defects resembling hypomaturation amelogenesis imperfecta that appear on all erupted teeth. Five children aged 9 to 11 with two types of enamel-hypomaturation probably due to developmental defects were treated successfully by microabrasion, with marked improvement of the discoloration. The patients were followed for up to four years. During this period, no tooth-sensitivity or staining was noted. The teeth looked healthier and shinier.

In vitro viability, mitogenicity and clonogenic capacities of periodontal ligament fibroblasts after storage in four media supplemented with growth factors

The choice of storage medium for preserving traumatically avulsed teeth is important for the success of future replantation. The objective of this study was to evaluate the effectiveness of growth factors (IGF-1 and PDGF-BB) when added to storage media in preserving the functional abilities of cultured periodontal ligament fibroblasts (PDLF). The evaluated storage media were: ViaSpan, Hanks' balanced salt solution (HBSS), alpha minimal essential medium (alpha MEM), and alpha MEM supplemented with FCS and antibiotic (alpha MEM-S). PDLF were obtained from explants of human healthy extracted teeth. Plates with confluent PDLF were soaked in the various media supplemented with IGF-1 (10 ng/ml) and PDGF-BB (4 ng/ml) for 2, 8 and 24 h at room temperature (24 degrees C). The control group was incubated with the examined storage media without growth factors at 24 degrees C. An additional control group was incubated with culture medium at 37 degrees C without growth factors. After incubation, the viability of the cells was determined by Trypan blue exclusion test. Viable cells were then analyzed for mitogenic (with thymidine) and clonogenic (by culturing one cell/well) capacities. Storage of PDLF with growth factors (GF) for 2, 8 and 24 h decreased their vitality by only 3% (not statistically significant). The mitogenicity of PDLF stored for 2, 8 and 24 h in various media with GF was statistically comparable to that of the control group. Generally, the highest mitogenic capacity of PDLF stored with or without GF was found after 8 h of storage. Increasing the storage period to 24 h decreased the mitogenic capacity of the cells stored with GF by only 10-40% compared to the control group. In contrast, the clonogenic capacity of PDLF stored with GF increased with increasing storage periods by 100-300%, and the highest clonogenic capacity was found in most storage media after 24 h of storage with GF. The highest clonogenic and mitogenic capacities were found in cells stored in HBSS followed by alpha MEM-S. The mitogenic and clonogenic capacities of PDLF stored in various media supplemented with GF for 2-8 h were generally lower than without GF supplementation. The mitogenic and clonogenic effects of GF-supplementation was observed only after 24 h of storage. After 24 h of storage with GF, the clonogenic capacity increased by 8-224% and the mitogenicity by 20-37%, except in cells stored in alpha MEM (-1%). However, these differences were generally not statistically significant. In conclusion, the mitogenic and clonogenic effects of GF were observed only after 24 h of storage at room temperature. HBSS and alpha MEM-S supplemented with GF were the most effective media for preserving the viability, mitogenicity and clonogenic capacity of PDLF stored for 24 h at room temperature. For short periods of storage (2 and 8 h), HBSS and alpha MEM-S without GF were preferable.

Russell bodies in the pulp of a primary tooth

Russell bodies can be found in the majority of the inflamed tissues throughout the body. They have been shown to consist of accumulations of normal globulins that may burst out of the distended plasma cells that secrete them. Russell bodies have also been described in oral tissues and are believed to occur in 80% of the chronic periapical lesions. Yet their occurrence in the pulp has not been subjected to scrutiny. Concentrations of large intracellular (in-plasma cells) and extracellular Russell bodies have been found in the inflammatory tissue occupying the pulp cavity of carious primary teeth. Their significance is so far unknown.

In vitro viability, mitogenicity and clonogenic capacity of periodontal ligament cells after storage in four media at room temperature

The choice of storage medium for preserving traumatically avulsed teeth is important for the success of future replantation. The objective of this study was to compare the effectiveness of four recommended storage media (Hank's balanced salt solution [HBSS], culture medium, alpha minimal essential medium [alpha-MEM], and ViaSpan) to preserve cultured periodontal ligament fibroblasts (PDLF) at room temperature (22 degrees C). PDLF were obtained from explants of extracted healthy human teeth. Plates with confluent PDLF were soaked in the various media for 2, 8 and 24 h at room temperature. A control group was incubated with culture medium at 37 degrees C. After incubation, viability of the cells was determined by trypan blue exclusion test. Viable cells were then analyzed for mitogenic (with thymidine) and clonogenic capacity (by culturing one cell/well). Viability of PDLF stored up to 24 h was comparable in all tested media, and the differences were limited to 1%-3%. PDLF stored for up to 24 h in various media had statistically comparable mitogenicity to the control group. After 8 h of storage, the differences were limited to 2%-9%, except for the alpha-MEM group which had 23%-29% lower mitogenic capacity compared to the control group. Increasing the storage time up to 24 h further decreased the mitogenicity of the cells by 22%-47%. The highest mitogenicity after 24 h of storage was found in PDLF stored in culture medium or HBSS, and the lowest in alpha-MEM. PDLF stored for 2-8 h in various media had a comparable clonogenic capacity to the control group. However, after 24 h, the cells' clonogenic ability dropped by 14%-66%. A similar trend of reduction was noted in the mitogenic and clonogenic capacity, although it was statistically significant only in the clonogenic capacity. Culture medium and ViaSpan, followed by HBSS, were the most effective in preserving the clonogenic capacity of PDLF after 24 h of storage. The lowest clonogenic capacity after 24 h of storage was in the alpha-MEM group (66%, P < 0.0025). In conclusion, culture medium, followed by HBSS and ViaSpan, was the most effective media for preserving the viability, mitogenicity and clonogenic capacity of PDLF stored for up to 24 h at room temperature. The lowest functional abilities were found in PDLF stored in alpha-MEM.

In vitro viability, mitogenicity and clonogenic capacity of periodontal ligament cells after storage in six different media

The choice of storage medium for preserving traumatically avulsed teeth is important for the success of future replantation. The objectives of this study were to evaluate the effectiveness of six different media: culture medium, alpha minimal essential medium (alpha-MEM), milk, Hank's balanced salt solution (HBSS), ViaSpan and conditioned medium (CM) to preserve cultured periodontal ligament fibroblasts (PDLF). Periodontal ligament fibroblasts were obtained from explants of human healthy extracted teeth. Plates with confluent PDLF were soaked in the various media for 2, 8 and 24 h at 4 degrees C. A control group was incubated with culture medium at 37 degrees C. After incubation, cell viability was determined by trypan blue exclusion test. Viable cells were then analyzed for mitogenic (with thymidine) and clonogenic capacity (by culturing one cell/well). Storage of PDLF up to 24 h decreased their vitality by only 2%-14%. Vitality of the PDLF after 2, 8 and 24 h was highest when stored in milk or HBSS (91%-97%) and lowest when stored in ViaSpan or CM (82%-93%). PDLF stored for 2-8 h in various media had a mitogenic capacity comparable to the control. However, increasing the storage period to 24 h decreased the mitogenicity of the cells by 3%-39%. The highest mitogenicity was found in PDLF stored in milk or HBSS and the lowest in CM or ViaSpan. The clonogenic capacity of the cells dropped by 38%-71% after 24 h and was the best indicator of the deteriorating effect of long storage. Milk and HBSS were the most effective in preserving the clonogenic capacity. Nevertheless, reduction in the viability, mitogenicity or clonogenic capacity was statistically significant in nearly all the tested media only after 24 h of incubation. In conclusion, HBSS and milk were the most effective media for preserving the viability, mitogenicity and clonogenic capacity after storage for up to 24 h at 4 degrees C.

Old thoughts, new ideas: comparing traditional Talmudic education with today's medical education

The authors compare innovative learning strategies in medical education today with the traditional educational methods of Jewish Talmudic study. These methods began to be developed in yeshivas (the highest Jewish educational institutions) in the third century BC and continue to be used in yeshivas today. The teaching in thousands of yeshivas of Talmudic study worldwide emphasizes student-centered, problem-based, small-group, and lifelong learning. Further, in the yeshivas rote memorization is discouraged; students are selected on the basis of merit rather than social status; and the teachers (particularly master teachers) are expected to act as role models for all aspects of living. Over the centuries, the yeshiva has been slightly modified and specialized, and the number of students has increased, but the institution has retained its basic instructional format. The authors briefly describe each aspect of Talmudic study and how it relates to current educational practices in medical schools. They argue that comparing these two educational institutions--the yeshiva and medical school--is valuable, in that the history of the yeshiva educational system, which has successfully produced generations of creative scholars, educators, and leaders, as well as an enormous body of literature, validates the innovative teaching approaches being used in medical schools today.

Computed tomography in pediatric oral and maxillofacial surgery

The use of computed tomography (C.T.) in the diagnosis and management of developmental and pathological conditions of the jaws in children was evaluated. CT was found to be superior to plain film radiography in estimation of the three-dimensional morphology of the abnormality in the jaws, in determining spatial relationship and proximity to vital structures. It is valuable by allowing accurate planning of the surgical procedure, estimation of the extent of the surgery and prediction of outcome as well as complications and prognosis. CT in the appropriate circumstances, is a very useful diagnostic tool in pediatric maxillofacial surgery. Tissue preservation and precision are of utmost importance, especially in children where many structures have not reached their final dimensions. Careful consideration should be given to risk benefit ratios due to higher exposure to radiation.

Periodontal ligament injection in the dog primary dentition: spread of local anaesthetic solution

The spread of local anaesthetic solution administered with a pressure syringe has not been studied as extensively in young animals having primary or mixed dentitions as in adult animals. The purpose of this investigation was to study the distribution of local anaesthetic solution injected into the periodontal ligament of young dogs. India ink was added to carpules containing 2% lidocaine and 1:100,000 epinephrine, and the spread of solution was examined macroscopically and microscopically. Injections were made with a pressure syringe (Ligmaject) at 58 sites mesial and distal to primary teeth in five dogs aged 3-9 months. Three dogs were killed within 12 hours, the other two after 5 days. Spread of the ink was studied in non-decalcified slabs, in three-dimensional cleared specimens, and in histological sections. The solution usually reached the alveolar bone crest, seeped under the periosteum and alongside vascular channels into bone marrow, reaching natural cavities such as the crypts of tooth buds and the mandibular canal. The ink did not penetrate into the enamel organ or contact the permanent tooth buds. The solution appeared to spread along the path of least resistance, governed by the intricacies of anatomical structures and fascial planes. Therefore the risk of mechanical damage to permanent tooth germs appears to be minimal.

Periodontal ligament injection: spread of the solution in the dog

Investigations of the spread of anesthetic solutions administered with the periodontal ligament injection have reported conflicting findings. The purpose of this investigation was to study the distribution of the injected fluid by macroscopic and microscopic techniques. One third of the liquid of the carpules (2% lidocaine with 1:100,000 epinephrine) was replaced with India ink as a marker. Injections were made with a pressure syringe, (Ligmaject) at 90 sites in 12 dogs. Twenty-five control sites were injected with a marked solution without a vasoconstrictor (3% mepivacaine). Seven dogs were killed within 24 h; the others after 5 days. Spread of the ink was studied in undemineralized slices, in three-dimensional cleared specimens, and in histological sections. The solution usually reached the alveolar crest, seeped under the periosteum, and entered into bone marrow spaces alongside vascular channels. The ink spread along the path of least resistance, influenced by the intricacies of anatomical structures and fascial planes, rather than penetrating into the periodontal ligament or in the root canal. In the controls without a vasoconstrictor the spread was more diffuse. Five days postoperatively, carbon particles were present only within macrophages.

A treatment need index: a pilot study

The traditional caries index, DMF, provides inadequate information to assess dental treatment needs of a community. Dental health planners are often called upon to estimate the treatment needs, costs, time and personnel required for a proposed programme. A treatment needs index (TNI) is presented which provides important data for dental health planning. The index defines seven basic levels of treatment: (0) no treatment needed; (1) preventive treatment; (2) fissure sealants; (3) initial conservative restorations; (4) moderate conservative restorations; (5) advanced conservative restorations; and (6) radical treatment, including pulp therapy, prosthetic restorations and extractions. A pilot study and an example comparing data of both DMF and TNI demonstrates the values of the latter index. The Treatment Needs Index provides a more accurate description of caries severity and extent than does the traditional DMF index, and can be used to estimate the time required to treat a community.

Dental and oral findings in patients with familial dysautonomia

Familial dysautonomia is an inherited autosomal recessive disease found almost exclusively in Ashkenazi Jews. It is characterized by selective damage to the sensory, motor, and autonomic peripheral nervous system. The main clinical features include decreased pain sensation, impaired temperature and blood pressure regulation, lack of tearing, absent tendon reflexes, and fungiform papillae on the tongue. The purpose of this study was to explore in depth and to verify the oral and dental status in familial dysautonomia. Twenty-two patients and 44 match-paired healthy persons of Ashkenazi descent were examined. Patients and parents had only little concern for their oral condition. Caries prevalence was lower than normal and plaque accumulation increased in all patients. Dental trauma was found in 59% of the patients, and 32% showed orodental self-mutilation. Dental age was within normal range, and dental arch measurements implied proportionally small jaws and little crowding. The low caries rate may be related to the known "hypersalivation" in familial dysautonomia and/or a possible change in the salivary composition and content, caused by chronic autonomic denervation.

The role of instruction and a brushing device on the oral hygiene of blind children

A brushing device using the tactile ability of blind children was compared to the use of a toothbrush. The experimental group consisted of 18 blind children, 7-14 years old; controls consisted of two groups of sighted classmates of the blind children. All children studied together in an integrated school and were match-paired. The brushing device was made from a valcran strip worn on a fingertip and used for cleaning the tooth surfaces. The experiment was conducted for 36 weeks with alternating periods of reinforcement and non-reinforcement. General oral hygiene improved after instruction and declined after non-reinforcement periods. The performance of the blind children improved with the cleaning device. The device was also helpful in developing a sense of "tooth cleanliness" and could be used as a pre-learning aid to prepare the blind children to efficiently use a toothbrush. Instruction followed by individual supervision and reinforcement will encourage all children to improve their oral hygiene level.

Increased caries prevalence in adolescents who immigrated from Ethiopia to Israel

The prevalence of caries in adolescents who immigrated from Ethiopia increased rapidly, the longer their residence in Israel. A total of 159 newly immigrated adolescents, aged 11-19, who lived in small absorption institutions, as well as 52 Ethiopian adolescents and 173 Israeli-born adolescents living together in a larger institution, were examined. Caries was recorded using the DMFT index, which indicates caries experience. The mean caries prevalence (DMFT) of the newly immigrated Ethiopians was 0.49 and of those residing in Israel 12-24 months was 1.76. The caries rate was highest in the Israeli group (DMFT-10.0). The percentages of caries-free individuals were 10.0% for the Israelis, 58.8% for the Ethiopians who immigrated earlier and 81.8% for the newly immigrated. The abrupt change in dietary habits seems to have created a new high risk caries group. Caries preventive measures, the use of fluoride products, and patient education and motivation are urgently required.

Physiologic pigmentation of the oral mucosa in Israeli children

Physiologic melanin pigmentation (racial pigmentation) of the oral mucosa varies in prevalence among different races and ethnic groups. The purpose of this study was to investigate the prevalence of physiologic pigmentation in Israeli Jewish children of different ethnic origins. A total of 1,300 children, 6 to 10 years of age, was examined. Physiologic pigmentation was found in 13.5% of the population studied. Children of Eastern origin showed a significantly higher prevalence of pigmentation compared with Ashkenazi and Sephardic groups. Because melanin pigmentation can be enhanced by mechanical and chemical stimulation (smoking), this study may serve as a baseline for investigation of melanin pigmentation in various ethnic groups.

Caries protective aspects of saliva and enamel

Saliva may be considered as being similar to enamel but in a liquid phase. Saliva, the mechanics of remineralization and demineralization, the acquired pellicle and the enamel surface all act to maintain the status quo, resisting mineral loss from the enamel.

Effect of the birth process on the neonatal line in primary tooth enamel

The neonatal line is a histologic landmark in primary tooth enamel corresponding to the event of birth. The average width of the neonatal line (NNL) in primary tooth enamel of 147 children was measured. In children with normal birth histories the width of the NNL was found to be 11.9 +/- 4.8 microns. It was wider (18.6 +/- 5.7 microns) in children born by difficult operative delivery and thinner (7.6 +/- 1.5 microns) in children born by Caesarean section. The data suggest that concomitant with the change from intrauterine to extrauterine environment, the birth process itself also contributes to the width of the NNL.

Comparison of dental findings in patients with isolated growth hormone deficiency treated with human growth hormone (hGH) and in untreated patients with Laron-type dwarfism

The effect of human growth hormone (hGH) on dental structures was investigated by comparing two groups of patients with hypopituitarism. One group of 19 patients with isolated growth hormone deficiency who received hGH replacement therapy was compared with a group of 13 patients with high immunoreactive growth hormone and IGF-I deficiency, Laron-type dwarfism, who could not benefit from hGH treatment. Plaster casts of the dentitions and panoramic radiographs were obtained from all patients and analyzed for dental age, arch length, arch circumference, and width of teeth. the main findings were that (1) hGH therapy did not accelerate dental age but enhanced bone age; (2) the mandible was significantly smaller in the untreated group but no significant difference was found between the groups in the maxilla; (3) third molars were missing in more than 90% of the patients with Laron-type dwarfism whereas hypodontia of other teeth was found in 30% of all the patients; and (4) crowding was less prevalent than expected and the mesiodistal width of the teeth seemed to be smaller.

Timing of orthodontic tooth movement in a case with traumatized and avulsed anterior teeth

A traumatic injury to a patient undergoing orthodontic treatment resulted in avulsion, dislodgement, and fracture of upper anterior teeth. Deciding when to institute endodontic treatment and when to resume orthodontic treatment was based upon minimizing the changes for ankyloses and root resorption. Endodontic treatment was carried out two weeks after trauma, and orthodontic treatment continued three weeks after trauma. Radiographs taken six months, one year, and two years after orthodontic completion showed progressive root resorption to the avulsed tooth and minimum root resorption to the remaining anterior teeth.

Changing patterns of dental caries in Ethiopian adolescents who immigrated to Israel

The aim of this investigation was to explore changes in caries prevalence and gingival health in adolescents who immigrated from Ethiopia to Israel, experiencing an abrupt cultural transition. Fifty adolescents, aged 15-17, born in Ethiopia, and 196 adolescents born in Israel were examined. All were pupils of a boarding school, sharing the same living conditions and eating schedules. The results showed a nearly sixfold difference in caries prevalence between the Ethiopian and the Israeli group (1.5/9.6). No differences could be seen clinically between the Ethiopians who immigrated more than 1 yr ago and those who arrived within the last year. Radiographically, a significant difference was found between the two Ethiopian subgroups. Those who arrived more than 1 yr ago had nearly three times more initial caries. Total interproximal caries scores for the Israeli group, Ethiopians who arrived more than 1 yr ago, and newly arrived Ethiopians were 6.9, 5.7 and 2.1 respectively. Oral hygiene was poorer in the Ethiopian group than in the Israeli group; little difference was found in gingival health. Change in dietary habits, more meals per day and more frequent consumption of fermentable carbohydrates, could have been the cause of the change in caries rate.

Diagnosis of developmental dental anomalies using panoramic radiographs

Early detection and diagnosis require medical and dental histories, clinical examination, and radiographs. The panoramic radiograph will yield more accurate results in children older than eight to nine years, when most tooth buds should be discernible.

Deciduous tooth eruption in children who fail to gain weight

In order to investigate the usefulness of the number of erupted deciduous teeth (NET) as a growth parameter, we studied deciduous tooth eruption (DTE) in 46 infants between the ages of 6 and 30 months, who failed to gain weight. The cause of the failure to thrive was intrauterine growth retardation in 17 children, and undetermined in 29. In these babies, height and head circumference were significantly below the mean as well. However, NET was almost unchanged when compared to NET of Israeli children of the same age. These findings support the view that DTE is an independent process, unrelated to other anthropometric measurements. Thus, NET may not be used as a clinical parameter of physical development.

Deciduous tooth eruption in Israeli children. A cross-sectional study

Deciduous tooth eruption (DTE) was studied in 366 Jewish Israeli children: 193 boys and 173 girls. The number of erupted teeth (NET) at different ages was similar in both sexes. No statistically significant correlation was found between NET and anthropometric measurements at birth (weight and length) or subsequently, after eliminating the influence of age, between NET and weight, height, and head circumference. The high normal variability in NET at a given age is demonstrated.